Division of Infectious Diseases, Department of Internal Medicine 1, DZIF Partner Centre, University Hospital Tuebingen, Tuebingen, Germany.
Department of Infectious Diseases and Clinical Microbiology, Hospital Universitario Virgen Macarena, Servicio Andaluz de Salud, Sevilla, Spain.
BMJ Open. 2017 Jan 5;7(1):e013634. doi: 10.1136/bmjopen-2016-013634.
Improving our understanding of outbreaks due to antibiotic-resistant bacteria (ARB) and their control is critical in the current public health scenario. The threat of outbreaks due to ARB requires multifaceted efforts. However, a global overview of epidemiological characteristics of outbreaks due to ARB and effective infection control measures is missing. In this paper, we describe the protocol of a systematic review aimed at mapping and characterising the epidemiological aspects of outbreaks due to ARB and infection control measures in European countries.
The databases MEDLINE, Web of Knowledge and Cochrane library will be searched using a 3-step search strategy. Selection of articles for inclusion will be performed by 2 reviewers using predefined eligibility criteria. All study designs will be included if they report an outbreak and define the microbiological methods used for microorganism identification. The target bacteria will be methicillin-resistant and vancomycin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, ceftazidime-resistant and carbapenem-resistant Acinetobacter baumannii, ceftazidime-resistant and carbapenem-resistant Pseudomonas aeruginosa, ciprofloxacin-resistant Escherichia coli, extended-spectrum β-lactamase-producing E. coli and Klebsiella pneumoniae, carbapenem-resistant and carbapenamase-producing Enterobacteriaceae. Data will be extracted using a tailored pilot tested form and the quality of reporting will be assessed using the ORION (Outbreak Reports and Intervention Studies Of Nosocomial infections) tool. Data will be synthesised and reported by the type of ARB, setting and country. Infection control measures and bundles of measures will be described. The effectiveness will be reported as defined by the authors. Regression analysis will be used to define independent factors associated with outbreaks' control. Heterogeneity between studies will be assessed by forest plots and I² statistics.
Ethical approval is not applicable for this study. Findings will be disseminated through journal publication and conference presentations and talks.
在当前的公共卫生形势下，提高对抗生素耐药菌（ARB）爆发及其控制的认识至关重要。ARB 爆发的威胁需要多方面的努力。然而，目前缺乏对欧洲国家 ARB 爆发和有效感染控制措施的全球流行病学特征概述。在本文中，我们描述了一项系统评价的方案，旨在绘制和描述欧洲国家 ARB 爆发的流行病学特征和感染控制措施。
将使用三步搜索策略在 MEDLINE、Web of Knowledge 和 Cochrane 图书馆中搜索数据库。使用预定义的纳入标准，由 2 名评审员对文章进行选择。如果报告了暴发并定义了用于微生物鉴定的微生物学方法，则将纳入所有研究设计。目标细菌将是耐甲氧西林和万古霉素的金黄色葡萄球菌、耐万古霉素的肠球菌、头孢他啶和碳青霉烯类耐药的鲍曼不动杆菌、头孢他啶和碳青霉烯类耐药的铜绿假单胞菌、环丙沙星耐药的大肠埃希菌、产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌、耐碳青霉烯类和产碳青霉烯酶的肠杆菌科。将使用经过试验验证的定制表格提取数据，并使用 ORION（医院感染暴发报告和干预研究）工具评估报告质量。将按 ARB 类型、环境和国家对数据进行综合和报告。将描述感染控制措施和一整套措施。将根据作者的定义报告有效性。回归分析将用于定义与暴发控制相关的独立因素。通过森林图和 I² 统计评估研究之间的异质性。
本研究不需要伦理批准。研究结果将通过期刊发表、会议报告和演讲进行传播。
