Risk factors for neonatal catheter-related bloodstream infections: a systematic review and meta-analysis
Bibliographic record
Abstract
Background Catheter-related bloodstream infection (CRBSI) is a prevalent nosocomial infection in neonatal units. The incidence of CRBSI can prolong hospitalization, cause irreparable harm, and negatively affect newborn survival and quality of life. Previous research has identified risk factors for CRBSI, but the findings have been inconsistent, and all predisposing factors have not been systematically described. This study aimed to investigate the risk factors for developing CRBSI in neonates and to provide a scientific basis for decision-making in the prevention of neonatal CRBSI. Methods A systematic search of PubMed, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), and the Wanfang Database was performed from the time of each database’s inception to 1 October 2025. The search strategy combined subject terms and free-text keywords. The Newcastle–Ottawa scale (NOS) was used to assess the quality of the literature, and meta-analysis was carried out using RevMan 5.3. Heterogeneity was evaluated using the I 2 statistic method, and publication bias was analyzed with funnel plot tests. Results A total of 18 articles involving 11,963 participants were included in this study. In the meta-analysis, the risk factors for the development of CRBSI in neonates, ranked from strongest to weakest association, were as follows: Multi-lumen central venous catheters (CVCs) ≥ 2, 5-min Apgar score≤7, number of manipulations≥2, catheter indwelling time>14d, gestational age≤32w, parenteral nutrition (PN), maternal disease, birth weight<1,500 g, male sex, and catheterization of the upper and lower limbs. These risk factors were found to be significantly 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 such as catheter dwell time, aseptic technique, and nutrition management to reduce CRBSI incidence and improve resource efficiency, especially in high-risk neonates.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.036 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".