Nosocomial bloodstream infection (BSI) has been reported as a major source of morbidity and mortality in patients with MCS [472]. In general the risk of infection associated with catheters depends on type, location and duration in situ [473]. A recent study from the International Society of Heart and Lung Transplantation IMACS Registry, to which the EUROMACS Registry contributes, showed that early-onset BSI was associated with a significantly increased 24-month mortality rate and that 85% of these BSIs were not device related. There is an opportunity for infection prevention practices to decrease the BSI event rate in the intensive care unit and post-surgical settings, which may affect the 24-month survival rate [474].