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

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.

Rate of the incidence of hospital-acquired infections in Iran based on the data of the national nosocomial infections surveillance

“…In a meta-analysis of studies in Iran in 2018, the highest prevalence of HAIs was related to BSIs (9%), pneumonia (7.1%), SSIs (4.4%) and UTIs (3.1%), respectively [ 25 ]. The findings of our study about the most common HAIs are consistent with the results of Eshrati et al.’s 2018 study conducted on 7 018 393 cases of hospitalizations, and Zahraei et al.’s study in 2012 conducted on 1 879 356 patients admitted to hospitals in Iran; these two studies reported UTIs and VAP as the most prevalent types of infection, respectively [ 26 , 27 ].…”

Conjugation of Virulence Plasmid in Clinical Klebsiella pneumoniae Strains through Formation of a Fusion Plasmid

“…In recent years, K. pneumoniae has become the most important causative agent of hospital infections, especially in Asian countries 1–3. Our surveillance data in China and reports from other parts of the world also showed that K. pneumoniae has become the most common clinically isolated bacterial pathogen and the most common bacterial pathogen that causes blood stream infection 4,5. Epidemic and endemic nosocomial infections caused by K. pneumoniae and related species are currently the leading cause of morbidity and mortality.…”

Epidemiologic Characteristics of Orthopedic Surgical Site Infections and Under-reporting Estimation of Registries Using Capture-recapture Analysis

“…3 Hip Prosthesis. 4 Such as Closed Reduction and Internal Fixation, amputation, correction of deformity, and Ilizarov.…”