Persistent catheter-related bacteremia: clearance with antibiotics and urokinase

A patient with terminal osteogenic sarcoma and catheter-related coagulase-negative staphylococcal bacteremia was treated with vancomycin and blood cultures were positive for 4 days documented with quantitative colony counts. Urokinase therapy was initiated and was associated with a transient bacteremia with markedly increased colony counts of coagulase-negative Staphylococcus prior to eradication of the catheter-related infection. We feel that the combination of urokinase and appropriate antibiotics may be an effective method to eradicate line-associated coagulase-negative staphylococcal infection in selected patients.