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Classification of healthcare-associated infection: a systematic review 10 years after the first proposal

2014Journal article Open access
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dc.contributor.authorCardoso, T.
dc.contributor.authorAlmeida, M.
dc.contributor.authorFriedman, C.
dc.contributor.authorAragão, I.
dc.contributor.authorCosta-Pereira, A.
dc.contributor.authorSarmento, A.
dc.contributor.authorAzevedo, L.
dc.date.accessioned2015-07-21T11:03:06Z
dc.date.available2015-07-21T11:03:06Z
dc.date.issued2014
dc.description.abstractBACKGROUND: Ten years after the first proposal, a consensus definition of healthcare-associated infection (HCAI) has not been reached, preventing the development of specific treatment recommendations. A systematic review of all definitions of HCAI used in clinical studies is made. METHODS: The search strategy focused on an HCAI definition. MEDLINE, SCOPUS and ISI Web of Knowledge were searched for articles published from earliest achievable data until November 2012. Abstracts from scientific meetings were searched for relevant abstracts along with a manual search of references from reports, earlier reviews and retrieved studies. RESULTS: The search retrieved 49,405 references: 15,311 were duplicates and 33,828 were excluded based on title and abstract. Of the remaining 266, 43 met the inclusion criteria. The definition more frequently used was the initial proposed in 2002--in infection present at hospital admission or within 48 hours of admission in patients that fulfilled any of the following criteria: received intravenous therapy at home, wound care or specialized nursing care in the previous 30 days; attended a hospital or hemodialysis clinic or received intravenous chemotherapy in the previous 30 days; were hospitalized in an acute care hospital for ≥2 days in the previous 90 days, resided in a nursing home or long-term care facility. Additional criteria founded in other studies were: immunosuppression, active or metastatic cancer, previous radiation therapy, transfer from another care facility, elderly or physically disabled persons who need healthcare, previous submission to invasive procedures, surgery performed in the last 180 days, family member with a multi-drug resistant microorganism and recent treatment with antibiotics. CONCLUSIONS: Based on the evidence gathered we conclude that the definition initially proposed is widely accepted. In a future revision, recent invasive procedures, hospitalization in the last year or previous antibiotic treatment should be considered for inclusion in the definition. The role of immunosuppression in the definition of HCAI still requires ongoing discussion.por
dc.description.sponsorshipThis research was supported by an ASSUCIP (Associação de Apoio à Unidade de Cuidados Intensivos Polivalente - ICU, Hospital de Santo António, Porto, Portugal) grant. Dr. Cardoso is partially funded by a PhD research grant from the Teaching and Research Department (Departamento de Formação, Ensino e Investigação) of Oporto Hospital Centre. The funding organization had no role in the design or conduct of the study; the collection, analysis or interpretation of the data; or the preparation, review or approval of the manuscript, nor in the decision to submit the manuscript for publication.por
dc.identifier.citationBMC Med. 2014, 12:40por
dc.identifier.doi10.1186/1741-7015-12-40
dc.identifier.issn1741-7015
dc.identifier.urihttp://hdl.handle.net/10400.16/1826
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherBioMed Centralpor
dc.relation.publisherversionhttp://www.biomedcentral.com/1741-7015/12/40por
dc.subjectHealthcare-associated infectionpor
dc.subjectClassificationpor
dc.subjectMultidrug resistant pathogens prevalencepor
dc.subjectPneumoniapor
dc.subjectBloodstream infectionspor
dc.subjectEndocarditispor
dc.subjectUrinary tract infectionspor
dc.subjectIntra-abdominal infectionspor
dc.titleClassification of healthcare-associated infection: a systematic review 10 years after the first proposalpor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceEnglandpor
oaire.citation.titleBMC medicinepor
oaire.citation.volume12por
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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