Trends of Racial/Ethnic Disparities in Pediatric Central Line-Associated Bloodstream Infections

BACKGROUND AND OBJECTIVES: Central line-associated bloodstream infections (CLABSIs), eminently preventable nosocomial infections, are a substantial source of morbidity, mortality, and increased resource utilization in pediatric care. Racial or ethnic disparities in health outcomes have been demonstrated across an array of medical specialties and practices in pediatric patients. However, it is unknown whether disparities exist in the rate of CLABSIs. Our objective was to evaluate the trends in racial and ethnic disparities of CLABSIs over the past 5 years. METHODS: This is a retrospective cohort study using data from Pediatric Health Information System database collected from tertiary children's hospitals in the United States. Participants included 226802 children (<18 years) admitted to the emergency department or inpatient ward between 2016 and 2021 who required central venous catheter placement. The primary outcome was risk-adjusted rate of CLABSI, occurring during the same admission, across race and ethnicity. RESULTS: Of the 226802 children, 121156 (53.4%) were White, 40589 (17.9%) were Black, and 43374 (19.1%) were Hispanic. CLABSI rate decreased in all racial/ethnic groups over the study period, with the rates being consistently higher in Black (relative risk [RR], 1.27; 95% confidence interval [CI], 1.17-1.37; P < .01) and Hispanic children (RR, 1.16; 95% CI, 1.08-1.26; P < .01) than in White children. There was no statistically significant evidence that gaps in CLABSI rate between racial/ethnic groups narrowed over time. CONCLUSIONS: CLABSI rate was persistently higher among Black and Hispanic children than their White peers. These findings emphasize the need for future exploration of the causes of persistent racial and ethnic disparities in pediatric patients.

Automated summary

This retrospective cohort study analyzed data from the Pediatric Health Information System database to evaluate trends in racial and ethnic disparities of central line-associated bloodstream infections (CLABSIs) in pediatric patients over the past 5 years. The study found that the CLABSI rate was consistently higher among Black and Hispanic children compared to their White peers, highlighting the need for further exploration of the causes of these persistent disparities in pediatric patients.