Healthcare-associated bloodstream infections in children: epidemiology, risk factors and prevention strategies

Abstract

Introduction. Health care-associated bloodstream infections represent a major public health concern, significantly impacting morbidity, mortality, and the overall cost of pediatric medical care. Materials and methods. A literature review was conducted based on systematic searches in PubMed, SCOPUS, and Web of Science, following PRISMA guidelines. Results. The incidence of healthcare-associated bloodstream infections ranges from 2 to 25 cases per 1,000 central venous catheter days, with higher rates reported in pediatric and neonatal intensive care units, where patients are frequently exposed to risk factors such as central venous catheter use, mechanical ventilation, and immunosuppression. Pediatric patients with health care-associated bloodstream infections experience significantly longer hospital stays compared to those without infection (25 vs. 7 days, P < 0.0001). In pediatric intensive care units, the average length of hospital stay due to these infections varies between 11.40 and 21.10 days, while in neonatal intensive care units, it ranges from 4 to 27.80 days. Mortality associated with these infections among children varies between 15% and 50%, depending on the severity of infection and underlying comorbidities. Additionally, health care-associated bloodstream infections lead to increased use of medical resources and generate substantial additional costs for the healthcare system-costs that are, in fact, largely preventable. Conclusions. Evidence-based strategies, such as strict hand hygiene and standardized protocols for medical device use, can significantly reduce the incidence of these infections.