REVIEW article
Front. Public Health
Sec. Children and Health
This article is part of the Research TopicPublic Health Innovations for Enhancing Newborn and Maternal Well-BeingView all 12 articles
Risk factors for neonatal catheter-associated bloodstream infections: a systematic review and meta-analysis
Provisionally accepted
- 1Hainan Women and Children's Medical Center, Haikou, China
- 2The Second Affiliated Hospital of Hainan Medical University, Haikou, China
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Background: Catheter-related bloodstream infections (CRBSI) is a prevalent nosocomial infection in neonatal units. The incidence of CRBSI may extend hospitalization, inflict irreparable harm, and have a negative impact on newborn survival and quality of life. Previous research has revealed risk factors for the CRBSI, but the findings have been inconsistent, and all predisposing factors have not been systematically described. This study aims to investigate the risk factors for developing CRBSI in neonates, and provide a scientific basis for decision-making in the prevention of neonatal CABSI. Methods: The systematic search of PubMed, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Database was performed from the time of database construction to October 1,2025. The search strategy was a combination of subject terms and free words. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the literature, and meta-analysis was carried out with RevMan 5.3. Heterogeneity was evaluated using the I2 statistic method, and the publication bias was analyzed with funnel plot tests. Results: Eighteen articles involving 11963 participants were included in this study. In the meta-analysis, the risk factors for the development of CRBSI in neonates, in order of their association from strongest to weakest, were Multi-lumen CVC≥2, 5-min Apgar score≤7, Number of manipulations≥2, Catheter indwelling time>14d, Gestational age≤32w, Parenteral nutrition, Maternal disease, Birth weight<1500g, Male gender and Catheterization of the upper and lower limbs. These risk factors are associated with the development of CRBSI. Conclusion: This meta-analysis identifies key modifiable risk factors for CRBSI in neonates, informing a proposed evidence-based prevention bundle. This bundle targets factors like catheter dwell time, aseptic technique, and nutrition management to reduce CRBSI incidence and improve resource efficiency, especially in high-risk neonates.
Keywords: neonate, Catheter-related bloodstream infection, CRBSI, risk factor, Meta-analysis
Received: 05 Oct 2025; Accepted: 29 Nov 2025.
Copyright: © 2025 Wang, Chi and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xingye Zhou
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