What is the most effective way to reduce central line infections in neonates?

• A. Remove central line when no longer indicated
• B. Use antimicrobial-coated lines
• C. Strict hand hygiene only during insertion
• D. Daily line changes regardless of indication

Answer: (A)

Removing the central line as soon as it is no longer indicated lowers infection risk most because exposure to the catheter is the main driver of bloodstream infection in neonates. The infection risk accumulates with every day the line stays in place, so eliminating unnecessary catheter duration directly reduces the opportunity for bacteria to enter the bloodstream. Neonates have immature immune defenses and skin barriers, making them especially vulnerable to CLABSI, so shortening exposure time has a powerful protective effect. Other measures help but don’t match the impact of prompt removal: antimicrobial-coated lines can reduce risk somewhat but don’t replace the need to reassess and remove lines when they’re no longer needed; strict hand hygiene is essential for all line care but focusing it only on insertion ignores maintenance and manipulation periods where infections can occur; and daily line changes without a clinical indication increase line handling and skin disruption, which can raise infection risk. Prioritizing daily reassessment and removing the line promptly when no longer indicated is the most effective single strategy to reduce central line infections.