OBJECTIVE: The 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. METHODS: In 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. RESULTS: Of 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%). CONCLUSIONS: Published 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.
OBJECTIVE: The 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. METHODS: In 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. RESULTS: Of 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%). CONCLUSIONS: Published 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.
Authors: Gregory M Schrank; Anna Sick-Samuels; Susan C Bleasdale; Jesse T Jacob; Raymund Dantes; Runa H Gokhale; Jeanmarie Mayer; Preeti Mehrotra; Sapna A Mehta; Alfredo J Mena Lora; Susan M Ray; Chanu Rhee; Jorge L Salinas; Susan K Seo; Andi L Shane; Gita Nadimpalli; Aaron M Milstone; Gwen Robinson; Clayton H Brown; Anthony D Harris; Surbhi Leekha Journal: Infect Control Hosp Epidemiol Date: 2022-01-28 Impact factor: 6.520
Authors: Bernardo L Teixeira; João Cabral; André Marques-Pinto; Fernando Vila; Joaquim Lindoro; Avelino Fraga Journal: Can Urol Assoc J Date: 2022-05 Impact factor: 2.052
Authors: Alice A Gaughan; Daniel M Walker; Matthew J DePuccio; Sarah R MacEwan; Ann Scheck McAlearney Journal: Am J Infect Control Date: 2020-06-30 Impact factor: 2.918
Authors: Robby Markwart; Hiroki Saito; Thomas Harder; Sara Tomczyk; Alessandro Cassini; Carolin Fleischmann-Struzek; Felix Reichert; Tim Eckmanns; Benedetta Allegranzi Journal: Intensive Care Med Date: 2020-06-26 Impact factor: 17.440