The current scope of healthcare-associated infection surveillance activities in hospitalized immunocompromised patients: a systematic review.

Bacterial Infections / epidemiology Cross Infection / epidemiology Delivery of Health Care / organization & administration Epidemiological Monitoring Humans Immunocompromised Host
case ascertainment case definitions healthcare-associated infections immunocompromised surveillance

Journal

International journal of epidemiology
ISSN: 1464-3685
Titre abrégé: Int J Epidemiol
Pays: England
ID NLM: 7802871

Informations de publication

Date de publication:
01 12 2019
Historique:
accepted: 12 07 2019
pubmed: 1 8 2019
medline: 16 7 2020
entrez: 1 8 2019
Statut: ppublish

Résumé

Immunocompromised patients are at increased risk of acquiring healthcare-associated infections (HAIs) and often require specialized models of care. Surveillance of HAIs is essential for effective infection-prevention programmes. However, little is known regarding standardized or specific surveillance methods currently employed for high-risk hospitalized patients. A systematic review adopting a narrative synthesis approach of published material between 1 January 2000 and 31 March 2018 was conducted. Publications describing the application of traditional and/or electronic surveillance of HAIs in immunocompromised patient settings were identified from the Ovid MEDLINE®, Ovid Embase® and Elsevier Scopus® search engines [PROSPERO international prospective register of systematic reviews (registration ID: CRD42018093651)]. In total, 2708 studies were screened, of whom 17 fulfilled inclusion criteria. Inpatients diagnosed with haematological malignancies were the most-represented immunosuppressed population. The majority of studies described manual HAI surveillance utilizing internationally accepted definitions for infection. Chart review of diagnostic and pathology reports was most commonly employed for case ascertainment. Data linkage of disparate datasets was performed in two studies. The most frequently monitored infections were bloodstream infections and invasive fungal disease. No surveillance programmes applied risk adjustment for reporting surveillance outcomes. Targeted, tailored monitoring of HAIs in high-risk immunocompromised settings is infrequently reported in current hospital surveillance programmes. Standardized surveillance frameworks, including risk adjustment and timely data dissemination, are required to adequately support infection-prevention programmes in these populations.

Sections du résumé

BACKGROUND
Immunocompromised patients are at increased risk of acquiring healthcare-associated infections (HAIs) and often require specialized models of care. Surveillance of HAIs is essential for effective infection-prevention programmes. However, little is known regarding standardized or specific surveillance methods currently employed for high-risk hospitalized patients.
METHODS
A systematic review adopting a narrative synthesis approach of published material between 1 January 2000 and 31 March 2018 was conducted. Publications describing the application of traditional and/or electronic surveillance of HAIs in immunocompromised patient settings were identified from the Ovid MEDLINE®, Ovid Embase® and Elsevier Scopus® search engines [PROSPERO international prospective register of systematic reviews (registration ID: CRD42018093651)].
RESULTS
In total, 2708 studies were screened, of whom 17 fulfilled inclusion criteria. Inpatients diagnosed with haematological malignancies were the most-represented immunosuppressed population. The majority of studies described manual HAI surveillance utilizing internationally accepted definitions for infection. Chart review of diagnostic and pathology reports was most commonly employed for case ascertainment. Data linkage of disparate datasets was performed in two studies. The most frequently monitored infections were bloodstream infections and invasive fungal disease. No surveillance programmes applied risk adjustment for reporting surveillance outcomes.
CONCLUSIONS
Targeted, tailored monitoring of HAIs in high-risk immunocompromised settings is infrequently reported in current hospital surveillance programmes. Standardized surveillance frameworks, including risk adjustment and timely data dissemination, are required to adequately support infection-prevention programmes in these populations.

Identifiants

DOI: 10.1093/ije/dyz162 PMID: 31363780
pubmed: 31363780
pii: 5541037
doi: 10.1093/ije/dyz162
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1768-1782

Informations de copyright

© The Author(s) 2019; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Auteurs

Jake C Valentine (JC)

Sir Peter MacCallum Department of Oncology, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia.
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

Lisa Hall (L)

National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

Karin M Verspoor (KM)

National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
School of Computing and Information Systems, University of Melbourne, Melbourne, Victoria, Australia.
Health and Biomedical Informatics Centre, University of Melbourne, Melbourne, Victoria, Australia.

Leon J Worth (LJ)

Sir Peter MacCallum Department of Oncology, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia.
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.

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Classifications MeSH

questionsmedicales.fr › Infection › Infections bactériennes et mycoses › Infections bactériennes › The current scope of healthcare-associated...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie iatrogène › Infection croisée › The current scope of healthcare-associated...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › The current scope of healthcare-associated...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Surveillance épidémiologique › The current scope of healthcare-associated...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The current scope of healthcare-associated...
questionsmedicales.fr › Phénomènes du système immunitaire › Sujet immunodéprimé › The current scope of healthcare-associated...