Central line-associated blood stream infections in newborns: From vulnerability to prevention

Newborns, especially preterm infants, are vulnerable to invasive infections due to their developing immune system and frequent need for central venous catheters. Central line-associated bloodstream infections (CLABSI) are among the most common invasive infections in this population and represent the leading cause of neonatal bloodstream infection in many settings. Neonatal CLABSI is associated with substantial mortality, long-term morbidity, and increased healthcare costs. Most importantly, CLABSI is preventable. Bundles centered on rigorous hand hygiene combined with standardized practices for catheter insertion, maintenance and removal have proven effective in reducing infection rates in neonates. Benchmarking and quality improvement initiatives enable neonatal intensive care units (NICUs) to track progress and share best practices. While no novel prevention strategies with robust evidence have emerged, sustained declines in CLABSI rates in many NICUs and networks over the past decades highlight the importance of a comprehensive multidisciplinary approach to implement and maintain best practices.