School of Public Health/Global Health Institute, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, China.
Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, M13 9PL, UK.
BMC Infect Dis. 2022 Apr 20;22(1):392. doi: 10.1186/s12879-022-07364-9.
China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals.
Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the [Formula: see text] and I statistics to select the meta-analysis model. Review Manager 5.3 was employed and P < 0.05 was considered as statistical significance.
851 records were filtered from the databases, of which 11 studies were included in the quantitative meta-analysis. A total of 11,922 TB patients were included in the systematic review and meta-analysis, of which 1133 were diagnosed as having HAIs. Age older than 60 years (OR: 2.89 [2.01-4.15]), complications (OR: 3.28 [2.10-5.13]), diabetes mellitus (OR: 1.63 [1.22-2.19]), invasive procedure (OR: 3.80 [2.25-6.42]), longer than 15 hospitalization days (OR: 2.09 [1.64-2.64]), secondary tuberculosis (OR: 2.25 [1.48-3.42]), smoking (OR: 1.40[1.02-1.93]), underlying disease (OR: 2.66 [1.53-4.62]), and use of antibiotics (OR: 2.77 [2.35-3.27]) were the main risk factors associated with HAIs among TB hospitalized patients with a statistical significance (P < 0.05).
Age older than 60 years, presence of complications, presence of diabetes mellitus, invasive procedure, longer than 15 hospitalization days, secondary tuberculosis, smoking, presence of underlying disease, and use of antibiotics were the main risk factors which had a negative impact on HAIs among TB hospitalized patients in Chinese hospitals. These findings provided evidence for policy makers and hospital managers to make effective infection prevention and control measures to constrain the rising HAIs. It is also required that more cost-effective infection prevention and control measures should be widely applied in routinely medical treatment and clinical management to reduce the occurrence of HAIs among TB hospitalized patients.
中国仍面临着结核病（TB）和医疗相关感染（HAIs）负担过重的问题。TB 患者感染 HAIs 的风险较高。中国需要有循证指南或规定来控制住院 TB 患者中 HAIs 的上升。本系统评价和荟萃分析的目的是调查中国医院住院 TB 患者中与 HAIs 相关的危险因素。
检索 Medline、EMBASE 和中国期刊在线数据库。搜索范围限于 2001 年 1 月 1 日至 2020 年 12 月 31 日发表的研究。对住院 TB 患者中 HAIs 患者与无 HAIs 患者的风险因素的 OR 进行荟萃分析。基于 [Formula: see text] 和 I 统计量评估研究间的异质性，选择荟萃分析模型。使用 Review Manager 5.3 进行分析，P 值<0.05 为统计学意义。
从数据库中筛选出 851 条记录，其中有 11 项研究纳入定量荟萃分析。本系统评价和荟萃分析共纳入 11922 例 TB 患者，其中 1133 例被诊断为 HAIs。年龄大于 60 岁（OR：2.89 [2.01-4.15]）、并发症（OR：3.28 [2.10-5.13]）、糖尿病（OR：1.63 [1.22-2.19]）、侵入性操作（OR：3.80 [2.25-6.42]）、住院时间超过 15 天（OR：2.09 [1.64-2.64]）、复发性结核病（OR：2.25 [1.48-3.42]）、吸烟（OR：1.40[1.02-1.93]）、基础疾病（OR：2.66 [1.53-4.62]）和使用抗生素（OR：2.77 [2.35-3.27]）是与住院 TB 患者 HAIs 相关的主要危险因素，具有统计学意义（P<0.05）。
年龄大于 60 岁、存在并发症、患有糖尿病、侵入性操作、住院时间超过 15 天、复发性结核病、吸烟、存在基础疾病和使用抗生素是对中国医院住院 TB 患者 HAIs 产生负面影响的主要危险因素。这些发现为决策者和医院管理者提供了证据，以制定有效的感染预防和控制措施，控制 HAIs 的上升。还需要在常规医疗和临床管理中广泛应用更具成本效益的感染预防和控制措施，以减少住院 TB 患者 HAIs 的发生。
Zotero 插件