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Risk factors for multidrug‐resistant Gram‐negative bacteria infection in intensive care units: A meta‐analysis
Author(s) -
Ang Hui,
Sun Xuan
Publication year - 2018
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/ijn.12644
Subject(s) - medicine , intensive care , infection control , antimicrobial stewardship , multiple drug resistance , cochrane library , population , intensive care medicine , drug resistance , antibiotic resistance , medline , cohort study , intensive care unit , mechanical ventilation , meta analysis , emergency medicine , antibiotics , environmental health , microbiology and biotechnology , biology , biochemistry
Aims To identify the risk factors for multidrug‐resistant Gram‐negative bacteria systematically and provide suggestions and an evidence‐base for clinical measures. Background With the increase in the social population, changes in human behaviour and ecosystems, as well as economic development, bacteria have gradually produced drug resistance genes. These have swept through intensive care units causing high mortality. Methods Relevant literature which included case‐control and cohort studies published from January 1999 to March 2017 were searched in the Cochrane Library, PubMed, Web of Science, and Medline. Meta‐analysis was performed by using StataSE version 12.0 software. Results Eighteen studies of 235 publications were eligible. Male gender (OR 1.40, 95%CI 1.09, 1.80), having an operative procedure (OR 1.31, 95%CI 1.10, 1.56), a central venous catheter (OR 1.22, 95%CI 1.01, 1.48), mechanical ventilation (OR 1.25, 95%CI 1.07, 1.46), previous antibiotic therapy (OR 1.66, 95%CI 1.41, 1.96), length of ICU stay (weighted mean difference 8.18, 95%CI 0.27, 16.10), and types of health‐associated infections were the identified risk factors for multidrug‐resistant Gram‐negative bacterial infection in intensive care units; moreover, diabetes mellitus was not. Conclusion Six risk factors were associated with multidrug‐resistant Gram‐negative bacterial infection in intensive care units. Antimicrobial stewardship, infection control, and medical staff prevention care are needed.