ObjectiveTo assess the incidence of local and systemic infection caused by central venous catheters in a general hospital population.SettingConcord Repatriation General Hospital, Sydney, April to August 1991 inclusive.DesignA prospective survey of all patients with in situ central venous catheters. Systemic catheter‐related infection was detected by blood and routine catheter tip culture, and local infection by clinical observation of the catheter exit site.Outcome measuresLocal and systemic infection and complications.Results479 central venous catheters were surveyed in 311 patients. Local infection developed in association with 54 catheters (11%) and systemic infection with 32 (6.7%). Local infection was predictive of systemic infection, but its absence did not exclude systemic infection. Haemodialysis catheters were responsible for a higher systemic infection rate than other catheter types, the most common organism responsible being methi‐cillin‐resistantStaphylococcus aureus.Twenty per cent of all bac‐teraemias (33/160) detected in the hospital occurred in patients with a central venous catheter and 24 of these (73%) were definitely or probably due to the catheter. Staphylococci were the predominant isolates and 40% of the methicillin‐resistantS. aureusbacteraemias detected were due to catheter‐related infection. Infection complications were few: three patients developed local abscesses; one endocarditis; and two died.ConclusionsCentral venous catheter‐related infection is com‐mon in general hospital populations. Staphylococcal bacteraemia and local infection in a patient with a central venous catheter are strongly suggestive of catheter‐related systemic infection. Empirical antibiotic treatment should include at least antistaphylococcal cover.