scholarly journals Methodological Questions Regarding a Meta-analysis of the Burden of Healthcare-associated Infections in Southeast Asia

2016 ◽  
Vol 63 (3) ◽  
pp. 428.2-429
Author(s):  
Hong-Min Wang ◽  
Xiao-Hong Zhang ◽  
Jing Wang
Keyword(s):  
Southeast Asia ◽  
Meta Analysis ◽  
Healthcare Associated Infections ◽  
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 Hand hygiene adherence among Iranian nurses: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Bijan Nouri ◽  
Mohammad Hajizadeh ◽  
Kaveh Bahmanpour ◽  
Mahsa Sadafi ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Meta Analysis ◽  
Scientific Information ◽  
Systematic Search ◽  
Measurement Unit ◽  
Healthcare Associated Infections ◽  
Improvement Strategy ◽  
Hand Hygiene Improvement ◽  
Nursing Managers ◽  
Healthcare Associated

Background & Aim: Adherence of nurses to hand hygiene is important for the prevention of healthcare-associated infections. This study aims to systematically review the existing studies that assess Iranian nurses' adherence to hand hygiene and estimate their amount with meta-analysis. Methods & Materials: We performed a systematic search for peer-reviewed journals published from 2005 to 2018. The systematic search was conducted using both international (Google Scholar, PubMed, SCOPUS, and Web of Sciences) and Iranian databases (Scientific Information Database, IranMedex, Magiran, and MedLib). The search was carried out using a combination of the following terms: “adherence”, “compliance”, “hand hygiene”, “nurse”, “Iran”, “nursing practice”, “nursing”, and “guidelines”. The combinations of these words with Boolean operators like ‘AND’, ‘OR’ and ‘NOT’ were used. Results:  A total of 22 articles were used in the final analyses. The pooled proportion of hand hygiene adherence was 40.5 percent [95% confidence interval [CI]: 31.1–49.8]. Sensitivity analysis confirmed that the overall estimated pooled proportion of hand hygiene adherence did not vary significantly with the elimination of any of the 22 studies, observer or self-reported hand hygiene, instrument of measurement, unit of measurements, sample size, and time. Conclusion: The level of adherence of Iranian nurses to hand hygiene can potentially increase the chance of healthcare-associated infections and put patients and nurses at risk. Hospital and nursing managers should take practical steps to investigate factors contributing to the failure of hand hygiene adherence among nursing staff. They should ensure the continuous implementation of hand hygiene improvement strategy.

scholarly journals Association between universal gloving and healthcare-associated infections: A systematic literature review and meta-analysis

2019 ◽  
Vol 40 (7) ◽  
pp. 755-760 ◽  
Author(s):  
Nai-Chung N. Chang ◽  
Ashley E. Kates ◽  
Melissa A. Ward ◽  
Elizabeth J. Kiscaden ◽  
Heather Schacht Reisinger ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Pediatric Intensive Care ◽  
Clinical Settings ◽  
Healthcare Associated Infections ◽  
Random Effects Models ◽  
Healthcare Facilities ◽  
Search Terms ◽  
Significant Burden ◽  
Rate Ratios ◽  
Healthcare Associated

AbstractObjective:Healthcare-associated infections (HAIs) are a significant burden on healthcare facilities. Universal gloving is a horizontal intervention to prevent transmission of pathogens that cause HAI. In this meta-analysis, we aimed to identify whether implementation of universal gloving is associated with decreased incidence of HAI in clinical settings.Methods:A systematic literature search was conducted to find all relevant publications using search terms for universal gloving and HAIs. Pooled incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity was evaluated using the Woolf test and the I2 test.Results:In total, 8 studies were included. These studies were moderately to substantially heterogeneous (I2 = 59%) and had varied results. Stratified analyses showed a nonsignificant association between universal gloving and incidence of methicillin-resistant Staphylococcus aureus (MRSA; pooled IRR, 0.94; 95% CI, 0.79–1.11) and vancomycin-resistant enterococci (VRE; pooled IRR, 0.94; 95% CI, 0.69–1.28). Studies that implemented universal gloving alone showed a significant association with decreased incidence of HAI (IRR, 0.77; 95% CI, 0.67–0.89), but studies implementing universal gloving as part of intervention bundles showed no significant association with incidence of HAI (IRR, 0.95; 95% CI, 0.86–1.05).Conclusions:Universal gloving may be associated with a small protective effect against HAI. Despite limited data, universal gloving may be considered in high-risk settings, such as pediatric intensive care units. Further research should be performed to determine the effects of universal gloving on a broader range of pathogens, including gram-negative pathogens.

scholarly journals Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Felipe Teixeira de Mello Freitas ◽  
Anna Paula Bise Viegas ◽  
Gustavo Adolfo Sierra Romero
Keyword(s):  
Neonatal Intensive Care ◽  
Meta Analysis ◽  
Neonatal Morbidity ◽  
Incidence Density ◽  
Neonatal Intensive Care Units ◽  
Healthcare Associated Infections ◽  
Close Monitoring ◽  
Inclusion Criteria ◽  
Healthcare Associated ◽  
High Degree

Abstract Background Healthcare-associated infections (HAI) are important causes of neonatal morbidity and mortality in developing countries. We reviewed the incidence and the pathogens involved in HAI among infants admitted to neonatal intensive care units (NICU) in Brazil. Methods A search was conducted in the MEDLINE, LILACS and SciELO databases from January 1995 to October 2019. Two authors scrutinized potential articles independently, after one author selected them from screening abstracts from every article flagged as related to neonatal HAI. Then, they were included in the review if they met our inclusion criteria. The studies were evaluated based on a quality score proposed by the authors, rated 0 to 1, with 1 point as the best quality rate. Pooled estimates and 95% confidence intervals (95% CI) for HAI cumulative incidence and incidence density were calculated, when the same denominators were available, using meta-analysis. A quality effect was applied to the models using the MetaXL software. Heterogeneity was assessed using I2 statistics and the Cochran’s Q test. Results Of a total of 5596 citations identified, 15 studies met the inclusion criteria for this review, which comprised 24,408 patients and 312,744 patient-days. Quality of the studies varied between 0.36 and 1 according to the adopted score, and six (40.0%) studies presented a score of 1. Pooled HAI incidence was 36.1 (95% CI 22.8–50.7) infections and 26.3 (95% CI 18.4–35.0) infected patients per 100 patients. Pooled HAI incidence density was 23.5 (95% CI 16.3–33.9) per 1000 patient-days. Pooled incidence density rates of bloodstream infection and ventilator-associated pneumonia were 13.1 per 1000 catheter-days (95% CI 4.3–40.1) and 7.9 per 1000 ventilator-days (95% CI 1.1–55.5), respectively. A high degree of heterogeneity was observed in all models (I2 > 98% and Cochran’s Q test with p < 0.05). Coagulase-negative Staphylococci (32.1%), Staphylococcus aureus (13.8%) and Klebsiella spp. (12.4%) were the most prevalent causative bacterial pathogens. Conclusions The findings show high incidence of neonatal HAI in Brazilian NICU; therefore, efforts to standardize the collection and notification of HAI are needed in order to strengthen surveillance in the country and implement preventive measures, routine assessment, and close monitoring of neonates.

Sign in / Sign up

Export Citation Format

Share Document