Lipid Emulsions and Bacteremia in the NICU

To the Editor: Freeman et al. (Aug. 2 issue) 1 found an association between the infusion of lipid emulsions and the detection of coagulase-negative staphylococci in blood cultures from neonates. An alternative hypothesis to explain the association would be that the infusion of lipids might itself cause the symptoms prompting blood cultures to be drawn. A large number of cultures might be sent after such an infusion, and an unknown number of these would be positive by contamination only. This problem was accentuated by the design of Freeman's study, since all calculations were based on the identification of one positive culture, . . .