Central line–associated bloodstream infections in the pediatric intensive care and hemato-oncology unit: a prospective observational study from Western India

Introduction: Central line–associated bloodstream infections (CLABSI) are serious patient safety hazards in pediatric intensive care. Children from hemato-oncology have prolonged line duration yet may incur different infection risks and resistance patterns versus general PICU patients. Thus, the aim of the study was to compare central line utilization, incidence of CLABSI, risk factors and antimicrobial resistance between PICU and hemato-oncology patients, and to identify targets for quality improvement in a resource-limited setting. Methods A prospective observational study in a tertiary PICU in India over 24 months. All children aged 1 month–18 years requiring central venous access were enrolled. We recorded insertion practices, line duration, and CLABSI incidence using standard definitions. Antimicrobial isolates and resistance profiles were compared between the PICU and hemato-oncology subgroups. Results Among 1,931 central line days in 69 children, there were 13 CLABSI episodes. Hemato-oncology patients had longer line durations but lower CLABSI incidence (5.08/1,000 line days) vs general PICU patients (10.87/1,000 line days). Gram-negative bacteria predominated across both groups; PICU isolates showed higher resistance to cephalosporins and carbapenems. Conclusion Infection risk in PICU is shaped not only by line duration but also by insertion urgency, patient acuity, and antimicrobial exposure. Structured bundles, safe insertion/maintenance practices, and stewardship programs are recommended to improve patient safety in pediatric critical care in LMICs.