School of Public Health, The University of Queensland, Herston, Queensland, Australia.
School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
Zoonoses Public Health. 2019 Aug;66(5):439-457. doi: 10.1111/zph.12589. Epub 2019 May 31.
Effective infection control (IC) provides a safe environment for staff, clients and animals of veterinary practices by reducing the risk of nosocomial and zoonotic infections, which are associated with increased hospital stays, costs, morbidity and mortality. An equally important issue arising from nosocomial infection is the loss of trust between the client and the veterinary practice that has potential negative impacts on the veterinary practice in terms of economic risk and the well-being of staff. Furthermore, an emerging and significant threat, in this context, is antimicrobial resistance. The aim of this systematic review was to critically review published reports that documented current IC practices and evaluated interventions to improve IC practices. A systematic literature search using ten databases to identify papers published over a 20-year period (February 1996 to February 2016) was conducted for studies that met the inclusion criteria. Included studies were assessed using the PRISMA and STROBE-Vet statements. A total of 14 of 1,615 identified studies met our inclusion criteria. Infection control practices included hand hygiene, sharps handling, environmental cleaning, personal protective equipment and personnel vaccination. Descriptive studies were the predominant research design for assessing IC compliance. Only three studies were interventions. Compliance with IC protocols was poor and only marginally increased with multimodal educational campaigns. There was significant variation in the implementation of IC by veterinary staff. Workplaces that had IC policies, management support and a staff member supporting their implementation were more likely to embrace good IC. Infection control data in veterinary practices were inconsistently reported and collected. Clearly defining IC and determining prevalence of these practices within the veterinary field is important given the limited research in this area. Further, developing and implementing educational campaigns for this sector is needed.
有效的感染控制（IC）通过降低医院内和动物源性感染的风险，为兽医诊所的员工、客户和动物提供安全的环境，这些感染与住院时间延长、成本增加、发病率和死亡率上升有关。医院内感染引起的一个同样重要的问题是失去客户对兽医诊所的信任，这对兽医诊所具有潜在的负面影响，包括经济风险和员工福祉。此外，在这种情况下，一个新兴的重要威胁是抗菌素耐药性。本系统评价的目的是批判性地回顾记录当前 IC 实践并评估干预措施以改善 IC 实践的已发表报告。使用十个数据库进行了系统文献检索，以确定在 20 年期间（1996 年 2 月至 2016 年 2 月）发表的符合纳入标准的论文。使用 PRISMA 和 STROBE-Vet 声明评估纳入研究。在 1615 篇确定的研究中，共有 14 篇符合我们的纳入标准。感染控制措施包括手卫生、锐器处理、环境清洁、个人防护设备和人员疫苗接种。评估 IC 依从性的主要研究设计是描述性研究。只有三项研究是干预研究。IC 协议的依从性很差，只有通过多模式教育运动才略有增加。兽医人员实施 IC 的情况存在显著差异。有 IC 政策、管理层支持和一名支持其实施的工作人员的工作场所更有可能采取良好的 IC。兽医诊所的感染控制数据报告和收集不一致。鉴于该领域的研究有限，明确界定 IC 并确定这些实践在兽医领域的流行情况非常重要。此外，还需要为该行业开发和实施教育运动。
