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Risk factors for catheter-related bloodstream infection in children undergoing blood purification therapy: a

Lihong Hu1, Xiaofan Wang1, Lei Kang1

  • 1Department of Pediatric Intensive Care Unit, Hebei Children's Hospital, Hebei Provincial Clinical Research Center for Child Health and Disease, Shijiazhuang, China.

Translational Pediatrics
|May 20, 2026
PubMed

Insights

Pediatric catheter-related bloodstream infections are linked to immunosuppression, femoral catheterization, and longer indwelling times. Standardized dressing changes significantly reduce infection risk in children undergoing blood purification.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Catheter-related bloodstream infection (CRBSI) is a significant complication in pediatric patients undergoing blood purification therapy.
  • Limited evidence exists on specific risk factors for CRBSI in this vulnerable pediatric population.
  • Understanding these factors is crucial for improving central venous catheter (CVC) management and reducing patient morbidity.

Purpose of the Study:

  • To identify independent risk factors for catheter-related infections in children receiving blood purification therapy.
  • To provide evidence-based recommendations for optimizing CVC management and nursing strategies.
  • To reduce the incidence of CRBSI and associated healthcare burden in pediatric patients.

Main Methods:

  • Retrospective study design involving pediatric patients with indwelling CVCs during blood purification therapy.
  • Data collection included demographics, underlying conditions, catheter characteristics, treatment details, and nursing practices.
  • Statistical analysis employed univariate screening followed by multivariate logistic regression to determine independent risk factors for CRBSI.

Main Results:

  • Independent risk factors for CRBSI included immunosuppression (OR=2.182), femoral vein catheterization (OR=2.445), catheter diameter ≥7 Fr (OR=2.201), and prolonged catheter indwelling (OR=1.344).
  • Standardized and timely dressing changes demonstrated a protective effect against CRBSI (OR=0.355).
  • Chlorhexidine-alcohol antisepsis, parenteral nutrition, and catheter reinsertion were not significantly associated with CRBSI after adjustment.

Conclusions:

  • Immunosuppression, femoral catheterization, larger catheter diameter, and longer indwelling duration are significant risk factors for CRBSI in pediatric blood purification.
  • Consistent, standardized dressing changes are a key protective measure against CRBSI.
  • Clinical protocols should emphasize enhanced risk assessment and standardized CVC management to minimize infection rates.
Abstract

Keywords:
Childrenblood purificationcatheter-related infectioncentral venous catheter (CVC)risk factors

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