Bloodstream infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae among patients with malignancy: a systematic review and meta-analysis

2017 ◽  
Vol 50 (5) ◽  
pp. 657-663 ◽  
Author(s):  
Michail Alevizakos ◽  
Apostolos Gaitanidis ◽  
Nikolaos Andreatos ◽  
Karuppiah Arunachalam ◽  
Myrto Eleni Flokas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Bloodstream Infections ◽  
Extended Spectrum

scholarly journals A Systematic Review and Meta-analysis of the Prevalence of Community-Onset Bloodstream Infections among Hospitalized Patients in Africa and Asia

2019 ◽  
Vol 64 (1) ◽  
Author(s):  
Christian S. Marchello ◽  
Ariella P. Dale ◽  
Sruti Pisharody ◽  
Matthew P. Rubach ◽  
John A. Crump
Keyword(s):  
Systematic Review ◽  
Antimicrobial Susceptibility ◽  
Meta Analysis ◽  
Febrile Illness ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Content Type ◽  
E Coli ◽  
Ongoing Surveillance ◽  
Community Onset

ABSTRACT Community-onset bloodstream infections (CO-BSI) are major causes of severe febrile illness and death worldwide. In light of new data and the growing problem of antimicrobial resistance (AMR) among pathogens causing BSI, we undertook a systematic review of hospital-based studies of CO-BSI among patients hospitalized with fever. Without restriction to language or country, we searched PubMed, Web of Science, and Scopus for prospective hospital-based studies of culture-confirmed CO-BSI among febrile inpatients. We determined by study the prevalence of BSI among participants, the pathogens responsible for BSI, and the antimicrobial susceptibility patterns of pathogens causing BSI, according to place and time. Thirty-four (77.3%) of 44 eligible studies recruited 29,022 participants in Africa and Asia combined. Among participants in these two regions, the median prevalence of BSI was 12.5% (range, 2.0 to 48.4%); of 3,220 pathogens isolated, 1,119 (34.8%) were Salmonella enterica, 425 (13.2%) Streptococcus pneumoniae, and 282 (8.8%) Escherichia coli. Antimicrobial susceptibility testing was reported in 16 (36.4%) studies. When isolates collected prior to 2008 were compared to those collected in the period of 2008 through 2018, the proportions of typhoidal Salmonella and Staphylococcus aureus isolates resistant to several clinically relevant antimicrobials increased over time, while S. pneumoniae susceptibility was stable. CO-BSI remain a major cause of severe febrile illness among hospitalized patients in Africa and Asia, with S. enterica, S. pneumoniae, and E. coli predominating. There is a concerning increase in AMR among serious infections caused by community-onset pathogens. Ongoing surveillance is needed to inform empirical management and strategies to control AMR.

scholarly journals Length of stay, cost, and mortality of healthcare-acquired bloodstream infections in children and neonates: A systematic review and meta-analysis

2020 ◽  
Vol 41 (3) ◽  
pp. 342-354 ◽  
Author(s):  
Sofia Karagiannidou ◽  
Christos Triantafyllou ◽  
Theoklis E. Zaoutis ◽  
Vassiliki Papaevangelou ◽  
Nikolaos Maniadakis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Healthcare Cost ◽  
Meta Analysis ◽  
Random Effect ◽  
Bloodstream Infections ◽  
Attributable Mortality ◽  
Study Selection ◽  
Critical Appraisal Skills

AbstractObjective:To estimate the attributable mortality, length of stay (LOS), and healthcare cost of pediatric and neonatal healthcare-acquired bloodstream infections (HA-BSIs).Design:A systematic review and meta-analysis.Methods:A systematic search (January 2000–September 2018) was conducted in PubMed, Cochrane, and CINAHL databases. Reference lists of selected articles were screened to identify additional studies. Case–control or cohort studies were eligible for inclusion when full text was available in English and data for at least 1 of the following criteria were provided: attributable or excess LOS, healthcare cost, or mortality rate due to HA-BSI. Study quality was evaluated using the Critical Appraisal Skills Programme Tool (CASP). Study selection and quality assessment were conducted by 2 independent researchers, and a third researcher was consulted to resolve any disagreements. Fixed- or random-effect models, as appropriate, were used to synthesize data. Heterogeneity and publication bias were evaluated.Results:In total, 21 studies were included in the systematic review and 13 studies were included in the meta-analysis. Attributable mean LOS ranged between 4 and 27.8 days; healthcare cost ranged between $1,642.16 and $160,804 (2019 USD) per patient with HA-BSI; and mortality rate ranged between 1.43% and 24%. The pooled mean attributable hospital LOS was 16.91 days (95% confidence interval [CI], 13.70–20.11) and the pooled attributable mortality rate was 8% (95% CI, 6–9). A meta-analysis was not conducted for cost due to lack of eligible studies.Conclusions:Pediatric HA-BSIs have a significant impact on mortality, LOS, and healthcare cost, further highlighting the need for implementation of HA-BSI prevention strategies.

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