Review articles Strategies for the prevention of central venous catheter infections: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review Eunice Y. Huang a, ⁎ , Catherine Chen b , Fizan Abdullah c , Gudrun Aspelund d , Douglas C. Barnhart e , Casey M. Calkins f , Robert A. Cowles d , Cynthia D. Downard g , Adam B. Goldin h , Steven L. Lee i , Shawn D. St. Peter j , Marjorie J. Arca f For the 2011 American Pediatric Surgical Association Outcomes and Clinical Trials Committee a Division of Pediatric Surgery, University of Tennessee Health Science Center, Memphis, TN 38105, USA b Department of Surgery, Children's Hospital, Boston, MA 02115, USA c Division of Pediatric Surgery, Johns Hopkins University, Baltimore, MD 21287, USA d Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York–Presbyterian, New York, NY 10032, USA e Primary Children's Medical Center, University of Utah, Salt Lake City, UT 84113, USA f Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI 53226, USA g Kosair Children's Hospital, University of Louisville, Louisville, KY 40202, USA h Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA 98105, USA i Division of Pediatric Surgery, Harbor-UCLA, Torrance, CA 90502, USA j Children's Mercy Hospital, Kansas City, MO 64108, USA Received 27 April 2011; revised 13 June 2011; accepted 15 June 2011 Key words: Central venous catheter; Catheter colonization; Bloodstream infection; Prevention; Chlorhexidine; Pediatric Abstract Purpose: The aim of this study is to review the current evidence-based data regarding strategies for prevention of central venous catheter (CVC) infections at the time of catheter insertion and as a part of routine care. Methods: We conducted a PubMed search from January 1990 to November 2010 using the following keywords: central venous catheter, clinical trials, pediatric, infection, prevention, antibiotic, chlorhexidine, dressing, antiseptic impregnated catheters, ethanol lock, impregnated cuff, insertion site infection, and Cochrane systematic review. Seven questions, selected by the American Pediatric Surgical Association Outcomes and Clinical Trials Committee, were addressed. Results: Thirty-six studies were selected for detailed review based on the strength of their study design and relevance to our 7 questions. These studies provide evidence that (1) chlorhexidine skin prep and chlorhexidine-impregnated dressing can decrease CVC colonization and bloodstream infection, (2) use of heparin and antibiotic-impregnated CVCs can decrease CVC colonization and bloodstream infec- ⁎ Corresponding author. Memphis, TN 38105, USA. Tel.: +1 901 287 6300; fax: +1 901 287 4434. E-mail address: ehuang@uthsc.edu (E.Y. Huang). www.elsevier.com/locate/jpedsurg 0022-3468/$ – see front matter © 2011 Elsevier Inc. All rights reserved. doi:10.1016/j.jpedsurg.2011.06.017 Journal of Pediatric Surgery (2011) 46, 2000–2011