title: Very low birthweight infants face an increased risk of bloodstream infections following the removal of umbilical catheters.
abstract: OBJECTIVE
  This study examined whether there was a temporal association between removing umbilical catheters and bloodstream infections (BSI) in a neonatal intensive care unit, as this is an area of research that has not received sufficient attention.
  
  
  METHODS
  We carried out a retrospective study of all neonates receiving umbilical catheters during 2011 and 2012 in the neonatal intensive care unit at Sahlgrenska University Hospital, Gothenburg, Sweden. The time from umbilical catheter removals to the first subsequent BSI was recorded.
  
  
  RESULTS
  A total of 372 infants had umbilical catheters inserted and 146 of these had a birthweight of <1500 g. Antibiotics were discontinued when umbilical catheters were removed in 67 of these low birthweight infants and 20 of them needed to be retreated for BSI within 72 hours. We found that very low birthweight infants had a significantly increased risk of developing BSI if antibiotics were discontinued at the same time as umbilical catheters were removed, rather than being continued after removal (p < 0.001).
  
  
  CONCLUSIONS
  This NICU study demonstrated a temporal association between removing umbilical catheters and BSI in very low birthweight infants weighting <1500 g.
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Simon
authors.initials: S
authors.lastname: Lindquist
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Hentz
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Tessin
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Elfvin
mesh_terms: D016470:Bacteremia / Q000209:etiology*; D057785:Catheters / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D012189:Retrospective Studies; D014472:Umbilicus / Q000601:surgery
keywords: Central venous catheter; Low birthweight infants; Neonatal septicaemia; Preterm infant; Umbilical artery catheter