Short-Term Central Venous Catheter-Related Bloodstream Infxns

S. aureus

Risk of endocarditis in bacteremia: ~25% (JACC 1997;30:1072). ID consult a/w ↓ mortality (ClD 2015;60:1451). Remove CVC, evaluate for endocarditis, osteo, hardware infections. Preferred abx: MSSA → nafcillin, oxacillin, or cefazolin. MRSA → vancomycin. Duration: 2 wks if normal host, no implants, no e/o endocarditis or metastatic complications. Otherwise 4–6 wks.

Coag-neg staphylococci

CVC retention does not ↓ rate of resolution, but a/w ↑ rate of recurrence (CID 2009;49:1187). If CVC left, treat 10–14 d; if removed 5–7d.

Enterococcus

Remove CVC & treat for 7–14 d

GNR

Remove CVC esp if Pseudomonas. Rx for 14 d (7 if uncomplicated).

Yeast

Remove CVC & treat for 14 from first ⊖ BCx. ID consult a/w ↓ mortality.