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CoNS Catheter Salvage Antibiotic Lock — ESENeph MCQ

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ModerateHaemodialysisCoNS Catheter Salvage Antibiotic LockESENeph

A 50-year-old man on HD develops Staphylococcus epidermidis bacteraemia from his tunnelled catheter. Blood cultures clear within 48 hours of IV Vancomycin. Can the catheter be salvaged?

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Correct answer: B — For uncomplicated coagulase-negative Staphylococcus BSI with rapid culture clearance, catheter salvage with antibiotic lock therapy plus systemic antibiotics for 2-3 weeks is reasonable – salvage rates are 60-80%

CoNS is a low-virulence organism that typically responds to appropriate antibiotics. UKKA and IDSA guidelines support catheter salvage for uncomplicated CoNS BSI: systemic IV Vancomycin plus antibiotic lock therapy (Vancomycin or Gentamicin lock instilled into catheter lumens between sessions). Success rates are 60-80%. Catheter removal is indicated if: cultures persist >72 hours, complications develop (metastatic infection, tunnel infection), or the patient deteriorates clinically.

Reference: UKKA 2019 – VA; IDSA 2009 – Catheter Infection