Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
J Hosp Infect. 2019 Feb;101(2):231-239. doi: 10.1016/j.jhin.2018.10.014. Epub 2018 Oct 22.
The survival of pathogenic organisms in the healthcare environment plays a major role in acquiring healthcare-associated infections (HAIs).
This meta-analysis was conducted to investigate whether pathogenic organisms can be transmitted from roommates and prior room occupants to other inpatients and thus increase the risks of HAIs.
PubMed (from January 1966) and Embase (from January 1974) were searched to identify studies up to March 2018. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Heterogeneity was assessed using the I-squared statistic. The random-effects model was applied which provides more conservative estimates. Subgroup analyses, cumulative meta-analysis, publication bias diagnosis, and sensitivity analysis were conducted. All the statistical analyses were performed using Stata statistical software version 9.0.
Twelve studies including 33,153 subjects reported risk from exposure to infected/colonized roommates and nine studies including 49,839 subjects reported risk from infected/colonized prior room occupants. Exposure to infected/colonized roommates and prior room occupants were associated with the increased risks of HAIs with the same organism (odds ratio (OR) = 2.69, 95% confidence interval (CI) = 1.61-4.49; OR = 1.96, 95% CI = 1.36-2.68; respectively). Sensitivity analyses results did not show major changes in the overall findings. No publication bias was detected.
This meta-analysis showed exposure to infected/colonized roommates and prior room occupants significantly increased the risks of HAIs with the same organism. Health authorities and hospitals should attach higher importance to the fact that current standards or practices for disinfection and isolation are often not sufficient to block transmission of pathogens in the healthcare settings, which may warrant enhanced terminal and intermittent disinfection and strict isolation for reducing HAIs.
病原体在医疗环境中的存活对获得医疗保健相关感染(HAIs)起着重要作用。
本荟萃分析旨在调查病原体是否可以从室友和前室友传播给其他住院患者,从而增加 HAIs 的风险。
检索了 PubMed(从 1966 年 1 月开始)和 Embase(从 1974 年 1 月开始),以确定截至 2018 年 3 月的研究。使用纽卡斯尔-渥太华量表评估研究质量。使用 I 平方统计量评估异质性。应用随机效应模型,提供更保守的估计。进行了亚组分析、累积荟萃分析、发表偏倚诊断和敏感性分析。所有统计分析均使用 Stata 统计软件版本 9.0 进行。
12 项研究共纳入 33153 例患者,报告了暴露于感染/定植室友的风险,9 项研究共纳入 49839 例患者,报告了暴露于感染/定植前室友的风险。暴露于感染/定植的室友和前室友与相同病原体的 HAIs 风险增加有关(比值比(OR)=2.69,95%置信区间(CI)=1.61-4.49;OR=1.96,95%CI=1.36-2.68)。敏感性分析结果未显示总体发现有重大变化。未发现发表偏倚。
本荟萃分析表明,暴露于感染/定植的室友和前室友会显著增加相同病原体引起的 HAIs 风险。卫生当局和医院应更加重视这样一个事实,即目前的消毒和隔离标准或实践往往不足以阻止病原体在医疗环境中的传播,这可能需要加强终端和间歇性消毒以及严格的隔离,以减少 HAIs。