Risk factors for catheter-related infection in children with cancer: A systematic review and meta-analysis

Rationale: To understand the risk factors for catheter-related infection during treatment of pediatric cancer is essential to implement measures to prevent its occurrence.Background: We performed a comprehensive systematic review of the literature with meta-analysis to iden-tify and synthesize the main risk factors for catheter-related infection in children undergoing oncological treatment.Methods: Systematic searches were conducted in Medline, Embase, Lilacs, and BVS (Biblioteca Virtual em Sa & DBLBOND;ude) until January 2022, following PRISMA guidelines. The search was not limited to language or dates. Risk factors were divided into host-related, assistance-related, and catheter types. We also describe the most common pathogens.Results: Thirteen studies were included in the review. Diagnosis of hematological neoplasm, the intensity of treatment, blood transfusion in the 4-7 days before the infection, type of long-term catheters (tunneled externalized catheters, double lumen, greater diameter), inpatient treatment, and a longer period of hospital-ization were the most consistent risk factors. Metanalysis showed that neutropenia at the moment of cathe-ter placement is not a risk factor for central-line-associated bloodstream infections, however, there is high heterogeneity between studies. Staphylococcus epidermidis was the most common pathogen reported. Conclusions: Understanding risk factors is an essential step to reduce morbidity and mortality of catheter-related infection. Education for preventive measures, reduction of hospitalization, wisely choosing the most adequate type of catheter, and the best moment for catheter insertion may reduce the occurrence of cathe-ter-related infection.& COPY; 2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.