Infection prevention and control measures for multidrug-resistant organisms: a systematic review and network meta-analysis

作者：Yuhui Geng, Zhuo Liu, Xiaojuan Ma, Ting Shuang Pan, Mingbo Chen, Jingxia Dang, Ping Zhang, Chen Chen, Yuan Zhao, Dongfeng Pan, Peifeng Liang · 发表于：Infection · 年份：2025 · DOI：10.1007/s15010-025-02498-9 · 被引用次数：21 · 研究领域：Infection Control in Healthcare、Antimicrobial agents and applications、Antibiotic Resistance in Bacteria

BACKGROUND: The effectiveness of infection prevention and control measures combating multidrug-resistant organisms (MDROs) in healthcare settings remains controversial. METHODS: PubMed, Embase, MEDLINE, Cochrane Library, and CINAHL were searched from inception to June 1, 2024. The interventions encompassed standard precautions (SP), contact precautions (CP), hand hygiene (HH), environmental cleaning (ENV), antimicrobial stewardship programs (ASP), decolonization (DCL), and chlorhexidine baths (CHG). The primary outcome were the acquisition, infection, and colonization of MDROs. Secondary outcomes were all-cause mortality and MDROs-associated bacteraemia. Effect indicators were expressed as rate ratios (RRs) with 95% confidence intervals (CIs). RESULTS: The study included a total of 97 articles, comprising 19 RCTs and 78 non-RCTs. The results showed that the most effective combination interventions for the acquisition, infection, and colonization of MDROs compared to SP varied as follows: CP + CHG (RR, 0.38 [0.18, 0.79]), SP + CP + ENV (RR, 0.04 [0.02, 0.08]), and SP + CHG (RR, 0.28 [0.14, 0.56]). In subgroup analyses, CP + CHG (RR, 0.36 [0.20,0.64]) was the most effective intervention for the acquisition of MDROs in the ICU setting, whereas SP + CP + ASP (RR, 0.35 [0.14,0.92]) was the most effective hospital-wide. Across subgroups, SP + CP + ENV (RR, 0.04 to 0.09 [95% CI, 0.01 to 0.99]) was identified as the most effective intervention for MDROs infections. In the ICU setting...