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2019年冠状病毒病大流行对医疗相关感染的影响:一项系统评价和荟萃分析

Impact of COVID-19 Pandemic on Healthcare-Associated Infections: A Systematic Review and Meta-Analysis.

作者信息

Abubakar Usman, Awaisu Ahmed, Khan Amer Hayat, Alam Khurshid

机构信息

Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar.

Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Malaysia.

出版信息

Antibiotics (Basel). 2023 Nov 7;12(11):1600. doi: 10.3390/antibiotics12111600.

Abstract

This study investigated how the Coronavirus Disease 2019 (COVID-19) pandemic has affected the rate of healthcare-associated infections (HAIs). PubMed, Scopus and Google Scholar were searched to identify potentially eligible studies published from December 2019 to September 2022. A random effect model was used to determine the changes in the rate of HAIs during the pandemic. Thirty-seven studies, mostly from the United States ( = 13), were included. Fifteen studies described how the pandemic affected the rate of CLABSIs and CAUTIs, and eight of them showed a significant increase in CLABSIs. The risk of CLABSIs and CDIs was 27% (pooled odds ratio [OR]: 0.73; confidence interval [CI]: 0.61-0.89; < 0.001) and 20% (pooled OR: 1.20; CI: 1.10-1.31; < 0.001) higher during the pandemic compared to before the COVID-19 pandemic period, respectively. However, the overall risk of HAIs was unaffected by the pandemic (pooled OR: 1.00; 95 CI: 0.80-1.24; = 0.990). Furthermore, there were no significant changes in the risk of CAUTIs (pooled OR: 1.01; 95 CI: 0.88-1.16; = 0.890), and SSIs (pooled OR: 1.27; CI: 0.91-1.76; = 0.16) between the two periods. The COVID-19 pandemic had no effect on the overall risk of HAIs among hospitalized patients, but an increased risk of CLABSIs and CDI were observed during the pandemic. Therefore, more stringent infection control and prevention measures and prudent interventions to promote the rational use of antibiotics are warranted across all healthcare facilities to reduce the burden of HAIs.

摘要

本研究调查了2019冠状病毒病(COVID-19)大流行如何影响医疗保健相关感染(HAIs)的发生率。通过检索PubMed、Scopus和谷歌学术,以识别2019年12月至2022年9月发表的潜在符合条件的研究。采用随机效应模型来确定大流行期间HAIs发生率的变化。纳入了37项研究,其中大部分来自美国(n = 13)。15项研究描述了大流行如何影响中心静脉导管相关血流感染(CLABSIs)和导尿管相关尿路感染(CAUTIs)的发生率,其中8项研究显示CLABSIs显著增加。与COVID-19大流行之前相比,大流行期间CLABSIs和艰难梭菌感染(CDIs)的风险分别高出27%(合并比值比[OR]:0.73;置信区间[CI]:0.61 - 0.89;P < 0.001)和20%(合并OR:1.20;CI:1.10 - 1.31;P < 0.001)。然而,HAIs的总体风险未受大流行影响(合并OR:1.00;95%CI:0.80 - 1.24;P = 0.990)。此外,两个时期之间CAUTIs的风险(合并OR:1.01;95%CI:0.88 - 1.16;P = 0.890)和手术部位感染(SSIs)的风险(合并OR:1.27;CI:0.91 - 1.76;P = 0.16)没有显著变化。COVID-19大流行对住院患者HAIs的总体风险没有影响,但在大流行期间观察到CLABSIs和CDI的风险增加。因此,所有医疗机构都有必要采取更严格的感染控制和预防措施以及审慎的干预措施,以促进抗生素的合理使用,从而减轻HAIs的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f2e/10668951/377e32b88b35/antibiotics-12-01600-g001.jpg

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