Abstract
Objectives: Vancomycin-resistant enterococci (VRE) represent a major problem in healthcare settings worldwide. It is still unclear which is the most effective infection control and prevention (ICP) measure to reduce the spread of hospital-acquired VRE. Methods: Cochrane databases, MEDLINE, EMBASE and CINAHL were searched until June 2012 to find studies comparing wards/hospitals where ICP measures to prevent VRE transmission were investigated. In the absence of heterogeneity, a fixed-effects model was used to estimate the pooled risk ratio (RR). Study quality was assessed according to Cochrane Effective Practice and Organisation of Care (EPOC) criteria. Results: The search strategy retrieved 549 studies and 9 studies (1 randomized clinical trial, 3 controlled clinical trials and 5 interrupted time series) with 30949 participants were included. The overall study quality was low. Implementation of hand hygiene was associated with a 47% decrease in the VRE acquisition rate (pooled RR 0.53, 95% CI 0.39-0.73, I2 26%) while contact precautions did not significantly reduce the VRE acquisition rate (pooled RR 1.08, 95% CI 0.63-1.83, I2 0%). Due to the low number of studies, meta-analysis was not applied for surveillance screening, environmental cleaning and antibiotic formulary interventions. No studies were available on the effectiveness of isolation and cohorting of patients and staff. Conclusions: Available evidence on the ICP measures to reduce VRE spread in adult hospitalized patients is poor. This systematic review suggests a significant role for the implementation of hand hygiene. Further studies with appropriate study design are urgently needed to define ICP measures able to reduce the acquisition of VRE among hospitalized patients.
| Original language | English |
|---|---|
| Article number | dkt525 |
| Pages (from-to) | 1185-1192 |
| Number of pages | 8 |
| Journal | Journal of Antimicrobial Chemotherapy |
| Volume | 69 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Contact precaution
- Hand hygiene
- Screening
ASJC Scopus subject areas
- Pharmacology
- Pharmacology (medical)
- Infectious Diseases
- Medicine(all)
Cite this
Infection control and prevention measures to reduce the spread of vancomycin-resistant enterococci in hospitalized patients : A systematic review and meta-analysis. / Angelis, Giulia De; Cataldo, Maria Adriana; DeWaure, Chiara; Venturiello, Silvia; La Torre, Giuseppe; Cauda, Roberto; Carmeli, Yehuda; Tacconelli, Evelina.
In: Journal of Antimicrobial Chemotherapy, Vol. 69, No. 5, dkt525, 2014, p. 1185-1192.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Infection control and prevention measures to reduce the spread of vancomycin-resistant enterococci in hospitalized patients
T2 - A systematic review and meta-analysis
AU - Angelis, Giulia De
AU - Cataldo, Maria Adriana
AU - DeWaure, Chiara
AU - Venturiello, Silvia
AU - La Torre, Giuseppe
AU - Cauda, Roberto
AU - Carmeli, Yehuda
AU - Tacconelli, Evelina
PY - 2014
Y1 - 2014
N2 - Objectives: Vancomycin-resistant enterococci (VRE) represent a major problem in healthcare settings worldwide. It is still unclear which is the most effective infection control and prevention (ICP) measure to reduce the spread of hospital-acquired VRE. Methods: Cochrane databases, MEDLINE, EMBASE and CINAHL were searched until June 2012 to find studies comparing wards/hospitals where ICP measures to prevent VRE transmission were investigated. In the absence of heterogeneity, a fixed-effects model was used to estimate the pooled risk ratio (RR). Study quality was assessed according to Cochrane Effective Practice and Organisation of Care (EPOC) criteria. Results: The search strategy retrieved 549 studies and 9 studies (1 randomized clinical trial, 3 controlled clinical trials and 5 interrupted time series) with 30949 participants were included. The overall study quality was low. Implementation of hand hygiene was associated with a 47% decrease in the VRE acquisition rate (pooled RR 0.53, 95% CI 0.39-0.73, I2 26%) while contact precautions did not significantly reduce the VRE acquisition rate (pooled RR 1.08, 95% CI 0.63-1.83, I2 0%). Due to the low number of studies, meta-analysis was not applied for surveillance screening, environmental cleaning and antibiotic formulary interventions. No studies were available on the effectiveness of isolation and cohorting of patients and staff. Conclusions: Available evidence on the ICP measures to reduce VRE spread in adult hospitalized patients is poor. This systematic review suggests a significant role for the implementation of hand hygiene. Further studies with appropriate study design are urgently needed to define ICP measures able to reduce the acquisition of VRE among hospitalized patients.
AB - Objectives: Vancomycin-resistant enterococci (VRE) represent a major problem in healthcare settings worldwide. It is still unclear which is the most effective infection control and prevention (ICP) measure to reduce the spread of hospital-acquired VRE. Methods: Cochrane databases, MEDLINE, EMBASE and CINAHL were searched until June 2012 to find studies comparing wards/hospitals where ICP measures to prevent VRE transmission were investigated. In the absence of heterogeneity, a fixed-effects model was used to estimate the pooled risk ratio (RR). Study quality was assessed according to Cochrane Effective Practice and Organisation of Care (EPOC) criteria. Results: The search strategy retrieved 549 studies and 9 studies (1 randomized clinical trial, 3 controlled clinical trials and 5 interrupted time series) with 30949 participants were included. The overall study quality was low. Implementation of hand hygiene was associated with a 47% decrease in the VRE acquisition rate (pooled RR 0.53, 95% CI 0.39-0.73, I2 26%) while contact precautions did not significantly reduce the VRE acquisition rate (pooled RR 1.08, 95% CI 0.63-1.83, I2 0%). Due to the low number of studies, meta-analysis was not applied for surveillance screening, environmental cleaning and antibiotic formulary interventions. No studies were available on the effectiveness of isolation and cohorting of patients and staff. Conclusions: Available evidence on the ICP measures to reduce VRE spread in adult hospitalized patients is poor. This systematic review suggests a significant role for the implementation of hand hygiene. Further studies with appropriate study design are urgently needed to define ICP measures able to reduce the acquisition of VRE among hospitalized patients.
KW - Contact precaution
KW - Hand hygiene
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=84898430287&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84898430287&partnerID=8YFLogxK
U2 - 10.1093/jac/dkt525
DO - 10.1093/jac/dkt525
M3 - Article
C2 - 24458513
AN - SCOPUS:84898430287
VL - 69
SP - 1185
EP - 1192
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
SN - 0305-7453
IS - 5
M1 - dkt525
ER -