scholarly journals Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

2018 ◽  
Vol 100 (2) ◽  
pp. 222-235 ◽  
Author(s):  
S. Manoukian ◽  
S. Stewart ◽  
S. Dancer ◽  
N. Graves ◽  
H. Mason ◽  
...  
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Meta Analysis ◽  
Healthcare Associated Infections ◽  
Statistical Methodology ◽  
Healthcare Associated

scholarly journals The preventable proportion of healthcare-associated infections 2005–2016: Systematic review and meta-analysis

2018 ◽  
Vol 39 (11) ◽  
pp. 1277-1295 ◽  
Author(s):  
Peter W. Schreiber ◽  
Hugo Sax ◽  
Aline Wolfensberger ◽  
Lauren Clack ◽  
Stefan P. Kuster ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Healthcare Associated Infections ◽  
Term Care ◽  
Multifaceted Interventions ◽  
Rate Ratios ◽  
Tract Infections ◽  
Healthcare Associated

AbstractObjectiveThe preventable proportion of healthcare-associated infections (HAIs) may decrease over time as standards of care improve. We aimed to assess the proportion of HAIs prevented by multifaceted infection control interventions in different economic settings.MethodsIn this systematic review and meta-analysis, we searched OVID Medline, EMBASE, CINAHL, PubMed, and The Cochrane Library for studies published between 2005 and 2016 assessing multifaceted interventions to reduce catheter-associated urinary tract infections (CAUTIs), central-line–associated bloodstream infections (CLABSIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAP), and hospital-acquired pneumonia not associated with mechanical ventilation (HAP) in acute-care or long-term care settings. For studies reporting raw rates, we extracted data and calculated the natural log of the risk ratio and variance to obtain pooled risk ratio estimates.ResultsOf the 5,226 articles identified by our search, 144 studies were included in the final analysis. Pooled incidence rate ratios associated with multifaceted interventions were 0.543 (95% confidence interval [CI], 0.445–0.662) for CAUTI, 0.459 (95% CI, 0.381–0.554) for CLABSI, and 0.553 (95% CI, 0.465–0.657) for VAP. The pooled rate ratio was 0.461 (95% CI, 0.389–0.546) for interventions aiming at SSI reduction, and for VAP reduction initiatives, the pooled rate ratios were 0.611 (95% CI, 0.414–0.900) for before-and-after studies and 0.509 (95% CI, 0.277–0.937) for randomized controlled trials. Reductions in infection rates were independent of the economic status of the study country. The risk of bias was high in 143 of 144 studies (99.3%).ConclusionsPublished evidence suggests a sustained potential for the significant reduction of HAI rates in the range of 35%–55% associated with multifaceted interventions irrespective of a country’s income level.

scholarly journals Role of pulsed-xenon ultraviolet light in reducing healthcare-associated infections: a systematic review and meta-analysis

2020 ◽  
Vol 148 ◽  
Author(s):  
Zhenhong Dong ◽  
Na Zhou ◽  
Guijuan Liu ◽  
Li Zhao
Keyword(s):  
Systematic Review ◽  
Ultraviolet Light ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Current Evidence ◽  
Healthcare Associated Infections ◽  
Infection Rates ◽  
Healthcare Settings ◽  
Meta Regression Analysis ◽  
Healthcare Associated

Abstract Pulsed-xenon-ultraviolet light (PX-UVL) is increasingly used as a supplemental disinfection method in healthcare settings. We undertook a systematic search of the literature through several databases and conducted a meta-analysis to evaluate the efficacy of PX-UVL in reducing healthcare-associated infections. Eleven studies were included in the systematic review and nine in the meta-analysis. Pooled analysis of seven studies with before-after data indicated a statistically significant reduction of Clostridium difficile infection (CDI) rates with the use of the PX-UVL (incidence rate ratio (IRR): 0.73, 95% CI 0.57–0.94, I2 = 72%, P = 0.01), and four studies reported a reduction of risk of methicillin-resistant Staphylococcus aureus (MRSA) infections (IRR: 0.79, 95% CI 0.64–0.98, I2 = 35%, P = 0.03). However, a further four trials found no significant reduction in vancomycin-resistant enterococci (VRE) infection rates (IRR: 0.80, 95% CI 0.63–1.01, I2 = 60%, P = 0.06). The results for CDI and MRSA proved unstable on sensitivity analysis. Meta-regression analysis did not demonstrate any influence of study duration or intervention duration on CDI rates. We conclude that the use of PX-UVL, in addition to standard disinfection protocols, may help to reduce the incidence of CDI and MRSA but not VRE infection rates. However, the quality of evidence is not high, with unstable results and wide confidence intervals, and further high-quality studies are required to supplement the current evidence.

scholarly journals Impact of multi-drug resistant bacteria on economic and clinical outcomes of healthcare-associated infections in adults: Systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. e0227139 ◽  
Author(s):  
Miquel Serra-Burriel ◽  
Matthew Keys ◽  
Carlos Campillo-Artero ◽  
Antonella Agodi ◽  
Martina Barchitta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Resistant Bacteria ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Drug Resistant Bacteria ◽  
Healthcare Associated

The Prevalence of Healthcare-Associated Infections in Mainland China: A Systematic Review and Meta-analysis

2018 ◽  
Vol 39 (6) ◽  
pp. 701-709 ◽  
Author(s):  
Jiancong Wang ◽  
Fangfei Liu ◽  
Ermira Tartari ◽  
Jianan Huang ◽  
Stephan Harbarth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Acute Care ◽  
Meta Analysis ◽  
Mainland China ◽  
Healthcare Associated Infections ◽  
General Hospitals ◽  
Healthcare Associated

OBJECTIVETo assess the prevalence of healthcare-associated infections (HAIs) in mainland China.DESIGNSystematic review and meta-analysis.SETTINGAdults and children from secondary and tertiary acute-care hospitals in mainland China.METHODSWe searched PubMed, the China National Knowledge Infrastructure, and Wan Fang for multicenter point-prevalence surveys of acute-care hospitals in mainland China from January 2006 to August 2016. All reports related to HAI, using a point-prevalence methodology and published either in English or Chinese were eligible.RESULTSIn total, 3,021 publications were identified; 115 were eligible for quality assessment and data abstraction. The weighted HAI prevalence (95% confidence interval [CI]) overall, in general hospitals, children’s hospitals, maternal and child health hospitals, and oncology hospitals were 3.12% (95% CI, 2.94%–3.29%), 3.02% (95% CI, 2.79%–3.26%), 4.43% (95% CI, 3.39%–5.47%), 1.88% (95% CI, 1.47%–2.29%), and 3.96% (95% CI, 3.12%–4.79%), respectively. In general hospitals, prevalence was highest in adult intensive care units (26.07%; 95% CI, 23.03%–29.12%), followed by surgery (3.26%; 95% CI, 2.96%–3.57%), and internal medicine (3.06%; 95% CI, 2.67%–3.46%). Overall, lower respiratory tract infection was the most frequent HAI (24,185, 47.28%), followed by urinary tract infection (5,773, 11.29%) and upper respiratory tract infection (5,194, 10.15%). Gram-negative bacilli were the most frequently isolated pathogens, and Pseudomonas aeruginosa (3,395, 14.91%), and Escherichia coli (2,918, 12.82%) were the most common single microorganisms.CONCLUSIONSThis study is the largest systematic review on the prevalence of HAI in mainland China. These results provide a benchmark for future PPSs and a reference for infection prevention and control strategies in mainland China.Infect Control Hosp Epidemiol 2018;39:701–709

Effect of chlorhexidine cleansing on healthcare-associated infections in neonates: a systematic review and meta-analysis

2021 ◽  
pp. fetalneonatal-2021-322429
Author(s):  
Jinyan Zhou ◽  
Lingli Mei ◽  
Shuohui Chen
Keyword(s):  
Systematic Review ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Neonatal Morbidity ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Fixed Effects Model ◽  
Quasi Experimental ◽  
Healthcare Associated

BackgroundHealthcare-associated infections (HAIs) have a significant impact on neonatal morbidity, mortality and long-term prognosis, which have a high incidence in neonates. Many studies have shown that chlorhexidine cleansing is effective in reducing HAIs in adults, but the effect of chlorhexidine cleansing on HAIs in neonates remains controversial.AimThe purpose of this study was to conduct a systematic review and meta-analysis of the effect of chlorhexidine cleansing on HAIs in neonates. The protocol of this review has been registered with the PROSPERO international prospective register of systematic reviews.MethodsA systematic literature search was performed on five medical literature databases, namely MEDLINE, Web of Science, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL), published up until 3 March 2021. In the end, six studies were eligible for inclusion, including four randomised controlled trials and two quasi-experimental studies. Version 2 of the Cochrane tool for assessing risk of bias in randomised trials and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies were used for quality assessment. Pooled risk ratios (RRs) and their associated 95% CIs were calculated using the fixed effects model (I2 <50%) or the random effects model (I2 ≥50%).Findings and conclusionsThe results of the meta-analysis revealed that chlorhexidine cleansing had no significant effect on neonatal sepsis (RR: 0.49, 95% CI 0.18 to 1.38, p=0.18, I2=0%), but significantly reduced neonatal skin bacterial colonisation (RR: 0.61, 95% CI 0.42 to 0.90, p=0.01, I2=50%). In addition, this systematic review showed that chlorhexidine cleansing could significantly reduce central line-associated bloodstream infection in neonates based on large-sample studies. However, more studies are needed to determine the optimal concentration and frequency of chlorhexidine cleansing.PROSPERO registration number CRD42021243858.

A Systematic Review of the Burden of Multidrug-Resistant Healthcare-Associated Infections Among Intensive Care Unit Patients in Southeast Asia: The Rise of Multidrug-Resistant Acinetobacter baumannii

2018 ◽  
Vol 39 (5) ◽  
pp. 525-533 ◽  
Author(s):  
Nattawat Teerawattanapong ◽  
Pornpansa Panich ◽  
Disorn Kulpokin ◽  
Siriwat Na Ranong ◽  
Khachen Kongpakwattana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Length Of Stay ◽  
Southeast Asia ◽  
Cumulative Incidence ◽  
Multidrug Resistant ◽  
Cochrane Library ◽  
Published Data ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETo summarize the clinical burden (cumulative incidence, prevalence, case fatality rate and length of stay) and economic burden (healthcare cost) of healthcare-associated infections (HAIs) due to multidrug-resistant organisms (MDROs) among patients in intensive care units (ICUs) in Southeast Asia.DESIGNSystematic review.METHODSWe conducted a comprehensive literature search in PubMed, EMBASE, CINAHL, EconLit, and the Cochrane Library databases from their inception through September 30, 2016. Clinical and economic burdens and study quality were assessed for each included study.RESULTSIn total, 41 studies met our inclusion criteria; together, 22,876 ICU patients from 7 Southeast Asian countries were included. The cumulative incidence of HAI caused by A. baumannii (AB) in Southeast Asia is substantially higher than has been reported in other regions, especially carbapenem-resistant AB (CRAB; 64.91%) and multidrug-resistant AB (MDR-AB) (58.51%). Evidence of a dose–response relationship between different degrees of drug resistance and excess mortality due to AB infections was observed. Adjusted odds ratios were 1.23 (95% confidence interval [CI], 0.51–3.00) for MDR-AB, 1.72 (95% CI, 0.77–3.80) for extensively drug-resistant AB (XDR-AB), and 1.82 (95% CI, 0.55–6.00) for pandrug-resistant AB (PDR-AB). There is, however, a paucity of published data on additional length of stay and costs attributable to MDROs.CONCLUSIONSThis review highlights the challenges in addressing MDROs in Southeast Asia, where HAIs caused by MDR gram-negative bacteria are abundant and have a strong impact on society. With our findings, we hope to draw the attention of clinicians and policy makers to the problem of antibiotic resistance and to issue a call for action in the management of MDROs.Infect Control Hosp Epidemiol 2018;39:525–533

Sign in / Sign up

Export Citation Format

Share Document