Which Pediatric Patients Still Experience Laboratory-Confirmed and Catheter-Related Bloodstream Infections: A Quality Analysis

IntroductionCentral line-associated bloodstream-infection (CLA-BSI) and catheter-related bloodstream infections (CR-BSI) remain a significant concern in pediatric inpatient units. ObjectiveTo analyze a case series of CLA-BSI and CR-BSI in hospitalized pediatric patients in hospitals with rigorous infection prevention measures. Materials and MethodsThis was an analytical, descriptive, and retrospective study conducted in patients aged 0 to 18 years, admitted between August 2023 and March 2025, with a diagnosis of CLA-BSI or CR-BSI in two pediatric hospitals in Rio de Janeiro, Brazil. Variables potentially associated with the occurrence of infection were analyzed. ResultsA total of 86 infections were evaluated, comprising 66 CLA-BSI and 20 CR-BSI. Sixty patients (69.8%) were male, with a mean age of 71.8 months. Sixty-five (83.7%) had previous comorbidities, 63 (73.2%) had a prior hospitalization, and 27 (31.4%) had another invasive device. The mean time from catheter insertion to infection diagnosis was 32.1 days, and the mean time from hospital admission to infection onset was 18.45 days. Gram-negative bacteria were isolated in 40/86 (46.5%) cases. At 30 days post-infection, 61/86 (70.9%) had been discharged, 20/86 (23.3%) remained hospitalized, and 5/86 (5.8%) had died. There was no correlation between the bacterial group and the type of catheter used (p=0.068), nor between infection type (CLA-BSI vs. CR-BSI) and mortality outcome (p=1). ConclusionsCLA-BSI and CR-BSI occurred predominantly in patients with prolonged hospital stays and underlying comorbidities, and were mainly caused by Gram-negative bacteria.