A systematic review and meta-analysis of risk factors associated with healthcare-associated infections among hospitalised patients in Chinese general hospitals from 2001 to 2022.
J Hosp Infect 2023;
135:37-49. [PMID:
36907333 DOI:
10.1016/j.jhin.2023.02.013]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/16/2023] [Accepted: 02/26/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND
Healthcare-associated infections (HAIs) are a serious global public health issue. However, a comprehensive analysis of risk factors for HAIs has yet been undertaken at a large scale among general hospitals in China. The aim of this review is to assess risk factors associated with HAIs in Chinese general hospitals.
METHODS
Medline, EMBASE and Chinese Journals Online databases were searched to find studies published from January 1st 2001 to May 31st 2022. The random-effects model was used to estimate odds ratio (OR). Heterogeneity was assessed based on the τˆ2 and I2 statistics.
RESULTS
5,037 published papers were identified from the initial search and 58 studies were included in the quantitative meta-analysis. 1,211,117 hospitalised patients were incorporated covering 41 regions in 23 provinces of China and 29,737 were identified as having HAIs. Our review showed that HAIs were significantly associated with sociodemographic characteristics including age older than 60 years (OR: 1.74[1.38-2.19]) and male sex (1.33[1.20-1.47]); invasive procedures (3.54[1.50-8.34]); health conditions such as chronic diseases (1.49[1.22-1.82]), coma (OR: 5.12[1.70-15.38]) and immunosuppression (2.45[1.55-3.87]). Other risk factors included long-term bed (5.84[5.12-6.66]), and healthcare-related risk factors as chemotherapy (1.96[1.28-3.01]), haemodialysis (3.12[1.80-5.39]), hormone therapy (2.96[1.96-4.45]), immunosuppression (2.45[1.55-3.87]) and use of antibiotics (6.64 [3.16-13.96]), and longer than 15 hospitalisation days (13.36[6.80-26.26]).
CONCLUSIONS
Being male and aged over 60 years, invasive procedure, health conditions, healthcare-related risk factors, and longer than 15 hospitalisation days were the main risk factors associated with HAIs in Chinese general hospitals. This supports the evidence base to inform the relevant cost effective prevention and control strategies.
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