Prevention of peripheral intravenous catheter-related bloodstream infections: the need for routine replacement

In reply: We thank Collignon and colleagues for their letter regarding our study on peripheral intravenous catheter (PIVC)-associated Staphylococcus aureus bacteraemia.1 We agree with their comments. Both their data and ours support the potential importance of establishing a national standard for the insertion and management of PIVCs in Australia. Such a standard needs to address the basics of PIVC management: not inserting PIVCs unless required;2 using an aseptic technique when inserting PIVCs (including the use of sterile gloves); immediate removal of PIVCs placed in emergency situations; and subsequent removal of all PIVCs after no longer than 72 hours. Adherence to such a national standard could then be regularly audited, in much the same way that hand hygiene is now audited across the country,3 allowing comparisons and feedback between hospitals. Such an initiative is necessary if we are to see rates of PIVC-associated S. aureus bacteraemia decrease.