Risk factors for catheter‐associated urinary tract infection among hospitalized patients: A systematic review and meta‐analysis of observational studies. (21st December 2018) - Li, Fei
Abstract: Aims: The study aimed to identify the risk factors for catheter‐associated urinary tract infection among hospitalized patients. We also tried to explore its potential effect on patient outcomes if possible. Background: Catheter‐associated urinary tract infection accounts for a large proportion of healthcare‐associated infections and remains a considerable threat to patient safety worldwide. Design: A systematic review and meta‐analysis of observational studies. Data sources: We conducted an electronic search in PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews for studies published between January 2008–January 2018. Review methods: Two reviewers searched the articles and extracted the data independently. The quality of the studies was assessed with the Newcastle‐Ottawa Scale. RevMan 5.3 was used to perform the meta‐analysis. Results: Ten studies involving a total of 8785 participants with or without catheter‐associated urinary tract infection were included. The average incidence of catheter‐associated urinary tract infection was 13.79 per 1000 catheter days, with a prevalence rate of 9.33%. The meta‐analysis demonstrated that patients at high risk for catheter‐associated urinary tract infection were female, had a prolonged duration of catheterization, had diabetes, had previous catheterization, and had longer hospital and ICU stays. Additionally, catheter‐associated urinary tract infection was also accompanied by an increase in mortality. Conclusions: Healthcare staff should focus on the identified risk factors for catheter‐associated urinary tract infection. Further research is needed to investigate the microbial isolates and focus on the intervention strategies of catheter‐associated urinary tract infection, so as to reduce its incidence and related mortality. Abstract : 目的: 本研究旨在确定住院患者尿导管相关性尿路感染的风险因素。如可能, 我们还会尝试探索其对患者预后的潜在影响。 背景: 尿导管相关性尿路感染占医疗相关感染的很大一部分, 且对全球患者安全仍是很大的威胁。 设计: 观测研究的系统回顾和荟萃分析 数据来源: 我们在PubMed、EMBASE、Web of Science及Cochrane 系统回顾数据库内对于2008年1月—2018年1月间发布的研究进行了电子搜索。 综述方法: 两名审核员独立搜索文章、提取数据。采用Newcastle‐Ottawa 量表对研究质量进行评估, RevMan 5.3进行荟萃分析。 结果: 共10项研究, 总共涉及8785名有或没有尿导管相关性尿路感染的参与者。尿导管相关性尿路感染的平均发生率为13.79/1000导管日, 患病率为9.33%。荟萃分析表明, 尿导管相关性尿路感染高危患者为女性, 导管留置时间长、患有糖尿病、有导管插入史、且长时间住院并待在ICU。此外, 尿导管相关性尿路感染也伴随着死亡率的增加。 结论: 医疗人员应重点关注已确定的尿导管相关性尿路感染风险因素。需要进行进一步的研究以调查微生物隔离, 并关注尿导管相关性尿路感染的干预策略, 从而减少发病率及相关死亡率。