Abstract
Background: Infection with resistant Pseudomonas aeruginosa (RPA) in Intensive Care Unit (ICU) is known to be either endogenous or exogenous or both, but the roles of each of these contamination routes is yet to be clarified. Data regarding prevalence, risk factors and environmental factors associated with RPA in ICU are very scanty and even when they exist, they seem to be contradictory. So, there is a strong interest in understanding both individual and environmental factors associated with RPA infection. This systematic review aims to investigate individual and environmental factors associated with the colonization and infection with RPA in ICU.Methodology: MEDLINE (Pubmed), EMBASE (OVID), the Cochrane Library (Wiley), Web of Science, CINAHL (EBSCOHost) and LILACS (BIREME) will be searched from inception onwards. Grey literature will be identified through Google Scholar and open Grey. Two reviewers will independently screen all citations, abstracts and full-text articles. Potential conflicts will be resolved through discussion. Methodological quality including bias will be appraised using appropriate approaches. A narrative synthesis will describe quality and content of the epidemiological evidence. Prevalence, Odds ratio, Relative Risk, Hazard radio with their respective 95% confidence intervals will be calculated. A meta-analysis of data extracted from eligible studies with similar population and RPA testing will be performed. The analysis will evaluate factors influencing the estimates. A random effect model will be used to summarize effect sizes.Discussion: Two contrasting hypotheses on risk factors of acquisition, colonisation, and infection of RPA are being debated, especially in a context where available data are scanty or exhibit high discrepancy. Indeed, most of the reviews have been focalized on hospitalised patients, and not in ICU, and few of them really address the environmental factors issue. To fill that gap, this review will combine both analysis of individual and environmental risk factors using prevalence study in ICU and evaluation of different methodologies. These two hypotheses will be tested and challenged, and could serve as a basis for a more in-depth studies to fill the methodological gaps that will be identified as part of this current review.Systematic review registration: This protocol has been submitted registered with Prospective Register of Systematic Reviews (PROSPERO) on 07 march 2021 under number CRD42021233832
Development and Evaluation of Models to Predict Readmission or Death After Discharge from Intensive Care
