Table 2 Observational studies in infection prevention and control – Systematic review on implementation of infection prevention and control in acute care hospitals in Mainland China, 2012–2017
Author, year, province | Study aim | Setting | Surveillance protocol | Sample size and study duration | Methodology | Outcome | Quality |
|---|---|---|---|---|---|---|---|
Liu S, 2017, Jiangsu [60] | To investigate the association between ABHR use and HAI | Single centre | Research protocol | 78,344 patients (January to December 2015) | Association between ABHR utilization and HAI incidence analysed by regression models | ABHR use was found to be negatively correlated with SSI incidence (hand sanitizer, r = − 0.85; soap, r = − 0.88; paper towels, r = − 0.83). Significant negative correlation between ABHR use and HAI in non-ICU patients (r = − 0.52 to – 0.65, p = 0.0032–0.029) | Moderate |
Kang J, 2017, Multi-Region [42] | To determine the incidence of PICC-related complications in cancer patients | Multi-centre | Standard surveillance | 477 cancer patients with 50,841 catheter-days (February 2013 to April 2014) | Prospective incidence surveillance | The incidence of CLABSI was 0.12 per 1000 catheter days | Moderate |
Zhou H, 2017, Jiangsu [41] | To determine the HAI incidence in the ICUs of STCHs in one province | Multi-centre | Surveillance in a network | 396,283 patients (July 2010 to June 2015) | Prospective incidence surveillance | The overall HAI incidence was 7.23%; VAP ID: 13.77 per 1000 ventilator days, CLABSI ID: 1.74 per 1000 central catheter days; CAUTI ID: 2.08 per 1000 urinary catheter days | High |
Chen W, 2016, Jiangsu [39] | To determine (infection-associated) VAC incidence in adult ICU patients | Single centre | Standard surveillance | 1014 patients (January to March 2015) | Prospective incidence surveillance | Of 197 patients on mechanical ventilation for a total of 3152 ventilator-days, 46 VACs were identified including 22 classified as infection-related (iVAC; 14.59 and 6.98 per 1000 ventilation days, respectively) | High |
Lv T, 2016, Shanghai [38] | To determine the incidence of device-associated HAI in the NICU | Multi-centre | Standard surveillance | The number of patients was not reported (July to December 2014) | Prospective incidence surveillance | VAP ID was 3.78 cases per 1000 ventilator days, CLABSI ID was 1.63 cases per 1000 central catheter days | Moderate |
Li C, 2015, Zhejiang [61] | To investigate the impact of hour of surgery on SSI in patients undergoing colorectal cancer surgery | Single centre | Standard surveillance | 756 patients (January to December in 2014) | Surgery start time: T1: 07:00 to 12:00; T2: 12:01 to 18:00; T3: 18:01 to 24:00 | SSI incidence was 14.5, 15.3, and 17.5% in groups T1, T2, and T3. The surgery operation timing did not appear to have any effect on the occurrence of SSI | Moderate |
Zhu S, 2015, Sichuan [37] | To determine the incidence of VAEs | Multi-centre | Standard surveillance | 5256 patients (April to July 2013) | Prospective incidence surveillance | VAEs ID were 11.1 per 1000 ventilator days (94 cases); this included 31 patients with iVAC (3.7 per 1000 ventilator days) and 16 with possible VAP | High |
Peng H, 2015, Anhui [40] | To determine HAI incidence in the ICU | Single centre | Standard surveillance | 4013 patients (January 2010 to December 2014) | Prospective incidence surveillance | HAI incidence:10.64%; Device-associated HAI incidence: 9.567 per 1000 bed days; VAP ID: 19.561 per 1000 mechanical ventilator days; CLABSI ID: 2.716 per 1000 central line days; CAUTI ID: 1.508 per 1000 urinary-catheter days | High |
Liu W, 2015, Inner Mongolia [36] | To determine HAI incidence in the ICU | Multi-centre | Standard surveillance | 7255 patients (January to December 2013) | Prospective incidence surveillance | VAP ID: 10.02 per 1000 mechanical ventilator days; CLABSI ID: 1.56 per 1000 central catheter days; CAUTI ID: 2.26 per 1000 urinary catheter-days | Moderate |
Huang H, 2014, Shanghai [46] | To determine CDI incidence, and assess associated risk factors | Single centre | Standard surveillance | 240 patients with hospital-acquired diarrhoea (September 2008 to April 2009) | Prospective incidence surveillance | 90 patients (37.5%) (128.5 per 100,000 patient-days) with CDI (12 due to recurrent disease) | Moderate |
Zhou F, 2014, Shanghai [45] | To identify clinical characteristics of CDI in patients with antibiotic-associated diarrhoea | Single centre | Standard surveillance | 20,437 patients (August 2012 to July 2013) | Prospective incidence surveillance | Antibiotic-associated diarrhoea developed in 1.0% (206 patients) of patients receiving at least one dose of antibiotics; C. difficile was isolated from 30.6% (63) of patients with antibiotic-associated diarrhoea | Moderate |
Wang X, 2014, Si Chuan [44] | To investigate the incidence, clinical profiles and outcome of ICU-onset CDI | Single centre | Standard surveillance | 1277 patients (May 2012 to January 2013) | Prospective incidence surveillance | 124 patients with ICU-onset diarrhoea; 31 patients with CDI (252 cases per 100,000 ICU days) | High |
Peng S, 2013, Liaoning [43] | To determine the incidence, risk factors and outcomes of CRBSI in the ICU | Single centre | Standard surveillance | 174 patients (June 2007 to May 2008) | Prospective incidence surveillance | 21 patients developed CRBSI (11.0 per 1000 central catheter days with a catheter utilization rate of 72.8%) | High |
Hu B, 2013, Multi-region [35] | To determine device-associated HAIs, in ICUs | Multi-centre | Surveillance in a network | 2631 patients (August 2008 to July 2010) | Prospective incidence surveillance | VAP ID: 10.46 per 1000 ventilator-days; CLABSI ID: 7.66 per 1000 central line-days; CAUTI ID: 1.29 per 1000 urinary catheter-days | High |
Xu C, 2013, Hubei [34] | To determine the HAI incidence in the ICUs of Hubei Province | Multi-centre | Surveillance in a network | 20,641 patients (January to December 2010) | Prospective incidence surveillance | CLABSI ID: 1.40 per 1000 central catheter days; VAP ID: 30.82 per 1000 ventilator days; CAUTI ID: 1.50 per 1000 urinary catheter days | Moderate |
Liu Y, 2012, Multi-region [33] | To investigate aetiology and incidence of HAP | Multi-centre | Surveillance in a network | 42,877 patients (August 2008 to December 2010) | Prospective incidence surveillance | 610 HAP with an incidence of 1.4% (0.9% in the respiratory general ward, 15.3% in the respiratory ICU) | Moderate |
Liu K, 2012, Beijing [32] | To determine device-associated HAIs in the ICUs of tertiary-care hospitals | Multi-centre | Standard surveillance | ICUs of 38 tertiary care hospitals in Beijing (no study duration reported) | Prospective incidence surveillance | CRBSI ID: 2.5 per 1000 central catheter days; CAUTI ID: 2.1 per 1000 urinary catheter days; VAP ID: 7.6 per 1000 ventilator days | Moderate |