Infection Risks Associated with Invasive Devices in Pediatric Healthcare: Key Findings from a Meta-Analysis
Introduction:
Invasive devices are vital in pediatric healthcare, but they pose significant infection risks. This meta-analysis aims to estimate infection rates and proportions associated with these devices, highlighting the need for improved preventive measures.
Background:
Indwelling invasive devices, such as central venous access devices (CVADs) and ventilators, are crucial for treatment but can lead to severe infections. Understanding the infection rates associated with these devices can help develop better prevention strategies.
Objective:
The study estimates infection rates and proportions linked to invasive devices in pediatric healthcare, focusing on bloodstream infections (BSIs) and ventilator-associated pneumonia.
Methods:
1. Data Sources: Medline, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished study databases.
2. Study Selection: Cohort studies and trials from January 2011 to June 2022, involving pediatric patients with indwelling invasive devices.
3. Data Extraction: Followed guidelines for abstracting and assessing data quality and validity. Main outcomes included device-related local, organ, and BSIs, with incidence rates per 1000 device-days.
Key Findings:
1. Central Venous Access Devices (CVADs):
- BSI Pooled Proportion: 8% (95% CI, 6-11) across 50 studies.
- Incidence Rate (IR): 0.96 per 1000 device-days (95% CI, 0.78-1.14).
2. Respiratory Devices: Ventilator-Associated Pneumonia:
- Pooled Proportion: 19% (95% CI, 14-24).
- IR: 14.08 per 1000 device-days (95% CI, 10.57-17.58).
Conclusions:
While CVAD-BSIs and ventilator-associated pneumonia are well-documented, there is a lack of data on tissue and local organ infections. Standard guidelines and compliance initiatives similar to those for CVADs should be extended to other devices to reduce infection risks.
Authors: Mari Takashima, Areum Hyun, Grace Xu, Adriana Lions, Victoria Gibson, Marilyn Cruickshank, Amanda Ullman
