Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Sep 9, 2026; 15(3): 118413
Published online Sep 9, 2026. doi: 10.5409/wjcp.118413
Published online Sep 9, 2026. doi: 10.5409/wjcp.118413
Transforming central line associated blood stream infection prevention in neonates: Results from a multimodal quality improvement initiative
Anish Pillai, Department of Neonatology and Pediatrics, Motherhood Hospital, Navi Mumbai 410210, Mahārāshtra, India
Nandkishor Kabra, Anuja Nayak, Mayuri Bhanushali, Haribalakrishna Balasubramanian, Department of Neonatology, Surya Hospitals, Mumbai 400054, Mahārāshtra, India
Sandesh Shivananda, Division of Neonatology, British Columbia Women’s Hospital and Heath Centre, Vancouver V6H 3N1, British Columbia, Canada
Author contributions: Pillai A and Kabra N conceptualized the work, supervised the work and made critical revisions; Nayak A, Bhanushali M, and Balasubramanian H performed the literature review and prepared the initial manuscript draft; Pillai A and Shivananda S edited the figures and prepared the discussion; Kabra N, Balasubramanian H, and Shivananda S analysed and summarized the data; and all authors reviewed the manuscript and approved the submitted version.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Surya Children’s Medicare, approval No. EC-05/12/2020.
Clinical trial registration statement: Not applicable as this is a quality improvement project.
Informed consent statement: The informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: Not applicable as this is a quality improvement project. SQUIRE guidelines have been followed for this quality improvement project.
Data sharing statement: The datasets generated or analyzed during the current study are not publicly available due to institutional policy. However, de-identified data can be shared at-request by the corresponding author.
Corresponding author: Nandkishor Kabra, Head, Professor, Department of Neonatology, Surya Hospitals, Mangal Ashirvad, S.V Road, Santacruz West, Mumbai 400054, Mahārāshtra, India. drkabra@suryahospitals.com
Received: January 15, 2026
Revised: February 21, 2026
Accepted: April 8, 2026
Published online: September 9, 2026
Processing time: 211 Days and 12.6 Hours
Revised: February 21, 2026
Accepted: April 8, 2026
Published online: September 9, 2026
Processing time: 211 Days and 12.6 Hours
Core Tip
Core Tip: A structured, multimodal quality improvement initiative led to a substantial and sustained reduction in neonatal central line associated blood stream infection rates in a level-3 neonatal intensive care unit. By strengthening hand hygiene, customizing central line care bundles, reinforcing environmental cleaning, conducting regular audits, and providing ongoing nursing education through iterative Plan-Do-Study-Act cycles, central line associated blood stream infection rates fell by over 80% and remained low for 18 months. This low-cost, pragmatic approach is feasible and reproducible in resource-constrained neonatal intensive care unit settings, including low- and middle-income countries.