Background: Healthcare-associated infections (HAI) are a major cause of morbidity and mortality in pediatric ICUs. Objective: Evaluation of the process and outcome of surveillance with special emphasis on device-associated infections. Methods: A prospective study including all children admitted to any of 5 ICUs of the pediatric specialized teaching hospital, Cairo University, over 6 months-period over 2 years. Results: Obvious increase in central venous line-associated bloodstream infections. Conclusion: Use of central lines in pediatric ICUs has to be coupled with an efficient infection control program for insertion and maintenance.