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Table 1 Characteristics of included studies

From: Approaches to multidrug-resistant organism prevention and control in long-term care facilities for older people: a systematic review and meta-analysis

References Country Study design Control type MDRO type Measured outcomes Staff compliance measured Interventions (duration, months) No. of residents analyzed (baseline) Summary findings
Baldwin et al. [28] Northern Ireland Clustered RCT Concurrent MRSA Colonization Y ED + PI (3, 6, 12) 793 No effect
Bellini et al. [44] Switzerland Clustered RCT Concurrent MRSA Colonization; infections N DC + EC + ED (12) 4750 No effect1
Ben-David et al. [45] Israel Uncontrolled before-after Historical CRE Acquisition N AE + BP + ED + PI (84)  ~ 200002 Reduction3
Bowler et al. [46] United States Uncontrolled before-after Historical MRSA Colonization N DC + EC + ED (13) 687 Reduction3
Chuang et al. [47] Hong Kong SAR, China Clustered RCT Concurrent MRSA Colonization Y BP + EC + ED + HH + PI (6, 9, 12, 15) 2776 No effect
Hequet et al.4 [48] Switzerland Clustered RCT Concurrent MRSA Colonization N DC + EC + ED (12, 60) NS No effect
Ho et al. [49] Hong Kong SAR, China Clustered RCT Concurrent MRSA Infections Y AE + ED + HH + PI (4) 2407 Reduction3
Horner et al. [50] United Kingdom Uncontrolled before-after Historical MRSA Colonization Y ED + PI (6, 9, 12, 18, 24) 22375 No effect
Jaqua-Stewart et al. [51] United States Uncontrolled before-after Historical MRSA Colonization; infections N BP + DC + ED + SC (12, 39) 42 Reduction3
Kauffman et al. [52] United States Uncontrolled before-after Historical MRSA Colonization N DC (76, 57)8 321 Reduction3,9
Mody et al. [53] United States Clustered RCT Concurrent MRSA; VRE; GNB Colonization; infections Y10 BP + ED + HH + PI (24) 418 Reduction3
Morgan et al. [54] United States Controlled before-after Concurrent MRSA Acquisition; infections N BP (48) 75,414 No effect
Ostrowsky et al. [55] United States Uncontrolled before-after Historical VRE Colonization Y11 BP + EC + ED + HH (12, 24) 5221 Reduction3
Peterson et al.12 [56] United States Clustered RCT Concurrent MRSA MRSA infections N DC + EC + ED + SC (12, 24) 7069 Reduction3
Schora et al. [57] United States Clustered RCT Concurrent MRSA Colonization N DC + EC + ED + SC (12, 24) 4424 Reduction3
Schweon et al. [61] United States Uncontrolled interrupted time series Historical MRSA; VRE; C.diff Infections Y AE + ED + HH + PI (22) NS No effect
Silverblatt et al. [58] United States Uncontrolled interrupted time series Historical VRE Colonization N BP + DC + ED + HH (28) NS Absence of outcome
Singh et al. [59] United States Uncontrolled before-after Historical C.diff C.diff infections N AE + BP + EC + ED + HH (33)  ~ 938113 Reduction3
Thomas et al. [60] United States Uncontrolled before-after Historical MRSA Colonization; MRSA infections N BP + ED (3) 164 Reduction3
  1. AE, administrative engagement; BP, barrier precautions; BSI, bloodstream infection; C.diff., Clostridium difficile; DC, decolonization; ED, education; EC, environmental cleaning; GNB, Gram-negative bacteria; HH, hand hygiene; MRSA, methicillin-resistant Staphylococcus aureus; PI, performance improvement; NS, not specified; SC, source control; UC, usual care; VRE, vancomycin-resistant enterococci
  2. 1Colonization prevalence declined in both groups. Absence of invasive infections in both groups
  3. 2The sample size was not specified. We reported the number of beds in nursing homes
  4. 3Statistically significant reduction
  5. 4Extended study from Bellini et al. [44]
  6. 5Since the information was insufficient in survey two and three, we only included participants from survey one and four
  7. 6In Phase one, residents were decolonized in their anterior nares only for seven months
  8. 7In Phase two, residents were decolonized in both their anterior nares and wound for five months
  9. 8We only included results from Phase one in the quantitative analysis since the results from Phase two might be affected by the carryover effect
  10. 9Reductions were reported when decolonization was applied in both nares and wounds but not nares only
  11. 10A structured 30-min observations monitored HCW activities and their use of barrier precautions, but results were not reported
  12. 11The authors used self-reported questionnaires to monitor the staff compliance before and after the interventions implemented
  13. 12Schora et al. [57] and Peterson et al. [56] are based on the same study with the same study sample
  14. 13The authors reported there were a total of 9,288,098 resident days. We estimated there were around 9381 residents after dividing the number of resident days with 30 days and 33 months