Targeted surveillance of healthcare-associated infections in ICU: a systematic review andMeta-analysis

Abstract

Objective To evaluate the targeted surveillance of health care-associated infections in ICU. Methods PubMed, EMBASE(Excerpt Medica Database), China Biology Medicine disc, China National Knowledge Infrastructure, Vip Journal Integration Platform and Wanfang Data were searched from 2009 to 2013 by two researchers. Full-text studies on targeted surveillance of healthcare-associated infections in ICUs were included. Studies were evacuated using STROBE and GRADE. Random effects meta-analyses were used to generate summary estimates of infection rates. Results Totals of 21 studies met eligibility criteria, which were all Chinese research papers. Taking the infection rate as an example, 74 600 cases were observed within which 7 318 cases were infected. Pooled meta-analyses of eligible studies revealed that adjusted infection rate: infection rate, case infection rate, daily infection rate, case daily infection rate were 3.27%, 4.92%, 4.58‰, 6.49‰, respectively. The infection rates were 23.12‰ in ventilator associated pneumonia, 5.26‰ in catheter-related bloodstream infections, and 2.38‰ in catheter-associated urinary tract infections. The lower respiratory tract, the blood, and the urinary tract were the main infection sites, accounting for 58.07%, 18.16%, and 15.35%, respectively. A. baumanii, P. Aeruginosa, fungi, S. aureus, K. pneumoniae, E.coli were the main pathogens, accounting for 20.54%, 14.28%, 14.35%, 11.62%, 10.92% and 6.86%, respectively. Conclusions The burden of health-care-associated infection in ICU is high. Our findings indicate a need to improve surveillance and infection-control practices. Key words: Intensive care unit; Nosocomial infections; Meta-analysis; Targeted surveillance