Introduction
The document discusses the Premistar antimicrobial PICC, designed for neonatal vascular access, particularly in Neonatal Intensive Care Units (NICUs). It addresses the global challenge of Catheter-Related Bloodstream Infections (CRBSI), which contribute significantly to neonatal mortality.

Consequences of CRBSI
CRBSI is a major concern in NICUs, with infection rates ranging from 7% to 24.5%, and up to 40% in extremely low birth weight or preterm infants. The document highlights the severe outcomes of CRBSI, including increased mortality, tachycardia, bradycardia, and other critical health issues.

Risk Factors and Economic Impact
Key risk factors for CRBSI include low birth weight and prolonged catheter dwell time. Hospital-acquired infections (HAI) significantly extend hospital stays by an average of 24 days and incur additional costs, primarily due to pharmaceuticals and ancillary items.

Antimicrobial Strategy
The Premistar catheter employs a combination of Miconazole and Rifampicin, leveraging their synergistic antimicrobial properties to combat CRBSI. Miconazole disrupts cell walls, while Rifampicin inhibits RNA synthesis, effectively targeting both gram-positive and gram-negative bacteria, as well as fungi.

Clinical Trial Results
A pilot study conducted in Munich and Bozen compared Premistar with standard catheters in 83 preterm infants. The results showed a fourfold reduction in complications such as colonization, infection, and sepsis, with no sepsis cases reported in the Premistar group.

Technical Features
The document provides detailed specifications of the Premistar catheter, including dimensions, flow rates, and the presence of a breakaway needle.

Recommendations
Preventive strategies, including the use of antibiotic-impregnated central venous catheters, are recommended to reduce CRBSI in very low birth weight infants. The document emphasizes the importance of prioritizing these strategies to improve neonatal outcomes.

Conclusion
The Premistar catheter, with its innovative antimicrobial coating, offers a promising solution to reduce CRBSI in NICUs, thereby improving the survival and health of preterm infants.