Risk factors on healthcare-associated infections among tuberculosis hospitalized patients in China from 2001 to 2020: A systematic review and meta-analysis

Liu, Xinliang; Ren, Nili; Ma, Zheng Feei; Zhong, Meiling; Li, Hao

Abstract

Background: China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals. Methods: Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the τ ^ 2 and I2 statistics to select the meta-analysis model. Review Manager 5.3 was employed and P < 0.05 was considered as statistical significance. Results: 851 records were filtered from the databases, of which 11 studies were included in the quantitative meta-analysis. A total of 11,922TB patients were included in the systematic review and meta-analysis, of which 1133 were diagnosed as having HAIs. Age older than 60 years (OR: 2.89 [2.01–4.15]), complications (OR: 3.28 [2.10–5.13]), diabetes mellitus (OR: 1.63 [1.22–2.19]), invasive procedure (OR: 3.80 [2.25–6.42]), longer than 15 hospitalization days (OR: 2.09 [1.64–2.64]), secondary tuberculosis (OR: 2.25 [1.48–3.42]), smoking (OR: 1.40[1.02–1.93]), underlying disease (OR: 2.66 [1.53–4.62]), and use of antibiotics (OR: 2.77 [2.35–3.27]) were the main risk factors associated with HAIs among TB hospitalized patients with a statistical significance (P < 0.05). Conclusions: Age older than 60 years, presence of complications, presence of diabetes mellitus, invasive procedure, longer than 15 hospitalization days, secondary tuberculosis, smoking, presence of underlying disease, and use of antibiotics were the main risk factors which had a negative impact on HAIs among TB hospitalized patients in Chinese hospitals. These findings provided evidence for policy makers and hospital managers to make effective infection prevention and control measures to constrain the rising HAIs. It is also required that more cost-effective infection prevention and control measures should be widely applied in routinely medical treatment and clinical management to reduce the occurrence of HAIs among TB hospitalized patients.

• Journal Article Type: Article
• Acceptance Date: Apr 7, 2022
• Online Publication Date: Apr 20, 2022
• Publication Date: Dec 1, 2022
• Deposit Date: Dec 7, 2022
• Publicly Available Date: Dec 8, 2022
• Journal: BMC Infectious Diseases
• Electronic ISSN: 1471-2334
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• Article Number: 392
• DOI: https://doi.org/10.1186/s12879-022-07364-9
• Keywords: Infectious Diseases, Tuberculosis, Healthcare-associated infections, Risk factors, Systematic review and meta-analysis, China
• Public URL: https://uwe-repository.worktribe.com/output/10222575
• Publisher URL: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07364-9
• Additional Information: Received: 16 November 2021; Accepted: 7 April 2022; First Online: 20 April 2022; : ; : It is not applicable.; : It is not applicable.; : The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.