Infection Associated With Invasive Devices in Pediatric Health Care: A Meta-analysis

Abstract

CONTEXT: Indwelling invasive devices inserted into the body for extended are associated with infections. OBJECTIVE: This study aimed to estimate infection proportion and rates associated with invasive devices in pediatric healthcare. DATA SOURCES: Medline, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished study databases were searched. STUDY SELECTION: Cohort studies and trials published from January 2011 to June 2022, including (1) indwelling invasive devices, (2) pediatric participants admitted to a hospital, (3) postinsertion infection complications, and (4) published in English, were included. DATA EXTRACTION: Meta-analysis of observational studies in epidemiology guidelines for abstracting and assessing data quality and validity were used. MAIN OUTCOMES AND MEASURES: Device local, organ, and bloodstream infection (BSIs) pooled proportion and incidence rate (IR) per-1000-device-days per device type were reported. RESULTS: A total of 116 studies (61 554 devices and 3 632 364 device-days) were included. The highest number of studies were central venous access devices associated BSI (CVAD-BSI), which had a pooled proportion of 8% (95% confidence interval [CI], 6–11; 50 studies) and IR of 0.96 per-1000device-days (95% CI, 0.78–1.14). This was followed by ventilator-associated pneumonia in respiratory devices, which was 19% (95% CI, 14–24) and IR of 14.08 per-1000-device-days (95%CI, 10.57–17.58). CONCLUSIONS: Although CVAD-BSI and ventilator associated pneumonia are well-documented, there is a scarcity of reporting on tissue and local organ infections. Standard guidelines and compliance initiatives similar to those dedicated to CVADs should be implemented in other devices in the future.