A four-year Iranian cohort study reported that bloodstream infections affected 25.2% of hospitalized children with central venous catheters, with 22.0% mortality among infected cases. Multidrug-resistant organisms drove most infections, accounting for 82.0% of assessable cases. The data quantify the high-risk nature of catheter-associated bloodstream infections in pediatric inpatient settings and highlight the operational need for infection prevention, antimicrobial stewardship, and device management. For hospital-based trial sponsors and device developers, the study supports continued focus on prevention bundles and rapid diagnostics, especially where MDR prevalence drives outcomes and treatment failure risk.