Trends in central line-associated bloodstream infections in pediatric intensive care units: a single-center study

Background: Central line-associated bloodstream infection (CLABSI) is the most common type of healthcare-associated infection in children.It can cause several morbidities and mortality, prolonging the hospital stay and increasing health care costs.Therefore, the effective management of CLABSI is crucial, especially in critically ill pediatric patients.Methods: This was a retrospective single-center cohort study in a 14-bed multidisciplinary pediatric intensive care unit (PICU).Patients admitted to the PICU from January 1, 2014 to December 31, 2023 who had a central venous catheter and were diagnosed with CLABSI were included.We reviewed the electrical medical records of these patients, focusing on trends in CLABSIs and the evaluation of management interventions.Results: In total, 119 CLABSI cases were identified.There were 67 (56.3%)Gram-negative infections.However, the most common causative organism was Staphylococcus aureus in 22 (18.5%).Thirty cases (25.2%) were infected by multi-drug resistant organisms.During the 10 years, the number of CLABSIs per 1,000 device-days decreased with several management interventions, including central line bundle, changes in dressing methods, education, and monitoring with monthly reports.In particular, the implementation of 2% chlorhexidine bathing significantly decreased CLABSIs.Conclusion: CLABSI remains a significant health care issue leading to morbidity and mortality.From 2014 to 2023, CLABSIs decreased with the implementation of several management interventions in our PICU.A further nationwide multicenter prospective study on the characteristics of CLABSI and the effect of management interventions for prevention in critically ill children are required.