Prevalence of nosocomial infections in Iran: A systematic review and meta-analysis

Authors

  • Ahmad Ghashghaee Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
  • Faezeh Ebadi Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
  • Hesam Seyedin Department of Health Services Management, School of Health Management and In-formation Sciences, Iran University of Medical Sciences, Tehran, Iran.
  • Mahya Razi Moghadam Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
  • Masoud Behzadifar Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Meysam Behzadifar Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran & Department of Epidemiology, Faculty of Health & Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.
  • Nicola Luigi Bragazzi School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  • Roghayeh Mohammadibakhsh Department of Health Services Management, School of Health Management and In-formation Sciences, Iran University of Medical Sciences, Tehran, Iran.
  • Sahar Sadat Saeedi Shahri Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
  • Samad Azari Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Abstract:

Background: Nosocomial infections represent a serious public health concern worldwide, and, especially, in developing countries where, due to financial constraints, it is difficult to control infections. This study aimed to review and assess the prevalence of nosocomial infections in Iran.    Methods: Different databases were searched between January 2000 and December 2017. To determine the pooled prevalence, the stochastic DerSimonian-Laird model was used, computing the effect size with its 95% confidence interval. To examine the heterogeneity among studies, the I2 test were conducted.  The reporting of observational studies in epidemiology (STROBE) checklist was used to assess the methodological quality of observational studies. To further investigate the source of heterogeneity, meta-regression analyses stratified by publication year, sample size and duration of hospitalization in the hospital were carried out.     Results: 52 studies were included. Based on the random-effects model, the overall prevalence of nosocomial infection in Iran was 4.5% [95% CI: 3.5 to 5.7] with a high, statistically significant heterogeneity (I2=99.82%). A sensitivity analysis was performed to ensure the stability results. After removing each study, results did not change. A cumulative meta-analysis of the included studies was performed based on year of publication and the results did not change. In the present study, a high rate of infections caused by Klebsiella pneumoniae (urinary tract, respiratory tract, and bloodstream infections) was found.    Conclusion: Preventing and reducing hospital infections can significantly impact on reducing mortality and health-related costs. Implementing ad hoc programs, such as training healthcare staff on admission to the hospital, may play an important role in reducing infections spreading.  

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Journal title

volume 32  issue 1

pages  273- 282

publication date 2018-02

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