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The Prevalence of Healthcare-Associated Infections in Mainland China: A Systematic Review and Meta-analysis

Published online by Cambridge University Press:  15 April 2018

Jiancong Wang ,
Fangfei Liu ,
Ermira Tartari ,
Jianan Huang ,
Stephan Harbarth ,
Didier Pittet  and
Walter Zingg
Jiancong Wang
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland Department of Infection Control, Dong Guan Hospital of Traditional Chinese Medicine, Dong Guan City, Guang Dong Province, China
Fangfei Liu
Affiliation:
Department of Nosocomial Infection Management, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
Ermira Tartari
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland Infection Control Department, Mater Dei Hospital, Msida, Malta
Jianan Huang
Affiliation:
Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Nottwil, Switzerland
Stephan Harbarth
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Didier Pittet
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Walter Zingg*
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance Imperial College of London, London, United Kingdom
*
Address correspondence to PD Walter Zingg, MD, Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle Perret-Gentil 4, 1211 Geneva 14, Switzerland (walter.zingg@hcuge.ch).
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Abstract

OBJECTIVE

To assess the prevalence of healthcare-associated infections (HAIs) in mainland China.

DESIGN

Systematic review and meta-analysis.

SETTING

Adults and children from secondary and tertiary acute-care hospitals in mainland China.

METHODS

We searched PubMed, the China National Knowledge Infrastructure, and Wan Fang for multicenter point-prevalence surveys of acute-care hospitals in mainland China from January 2006 to August 2016. All reports related to HAI, using a point-prevalence methodology and published either in English or Chinese were eligible.

RESULTS

In total, 3,021 publications were identified; 115 were eligible for quality assessment and data abstraction. The weighted HAI prevalence (95% confidence interval [CI]) overall, in general hospitals, children’s hospitals, maternal and child health hospitals, and oncology hospitals were 3.12% (95% CI, 2.94%–3.29%), 3.02% (95% CI, 2.79%–3.26%), 4.43% (95% CI, 3.39%–5.47%), 1.88% (95% CI, 1.47%–2.29%), and 3.96% (95% CI, 3.12%–4.79%), respectively. In general hospitals, prevalence was highest in adult intensive care units (26.07%; 95% CI, 23.03%–29.12%), followed by surgery (3.26%; 95% CI, 2.96%–3.57%), and internal medicine (3.06%; 95% CI, 2.67%–3.46%). Overall, lower respiratory tract infection was the most frequent HAI (24,185, 47.28%), followed by urinary tract infection (5,773, 11.29%) and upper respiratory tract infection (5,194, 10.15%). Gram-negative bacilli were the most frequently isolated pathogens, and Pseudomonas aeruginosa (3,395, 14.91%), and Escherichia coli (2,918, 12.82%) were the most common single microorganisms.

CONCLUSIONS

This study is the largest systematic review on the prevalence of HAI in mainland China. These results provide a benchmark for future PPSs and a reference for infection prevention and control strategies in mainland China.

Infect Control Hosp Epidemiol 2018;39:701–709

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 6 , June 2018 , pp. 701 - 709
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. These results were presented in part as poster at the Fourth International Conference on Prevention and Infection Control on June 21, in Geneva, Switzerland.

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