I read the article on Staphylococcus aureus cather-associated bacteremia by Malanoski et al1 with interest, as my colleagues and I previously published an article about catheter-related infections.2 It is my opinion that Malanoski and colleagues make a sweeping conclusion when they state that "the results of this and other studies suggest that the infected catheter should be promptly removed." Unfortunately, they have little data to support such a claim for long-term catheters such as the Hickman, Broviac, and Groshong catheters.
The authors analyzed follow-up from 11 Hickman catheter-related episodes of S aureus sepsis. These data were not reported or analyzed separately from the overall group, possibly because of the very small number of incidents involved.
Our much larger study included 54 episodes of S aureus—related (Hickman or Broviac catheter) sepsis.2 There were no deaths in our group, and only 30 (56%) patients required catheter removal. Even