Systematic review of a patient care bundle in reducing staphylococcal infections in cardiac and orthopaedic surgery
| Autor: | David R. Tivey, Alun Cameron, Nikki Grae, Arthur J. Morris, Sally A. Roberts, Ning Ma |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Staphylococcus aureus medicine.medical_specialty 030106 microbiology Cochrane Library Staphylococcal infections law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Surgical Wound Infection Orthopedic Procedures 030212 general & internal medicine Cardiac Surgical Procedures Intensive care medicine Adverse effect Randomized Controlled Trials as Topic business.industry General Medicine Staphylococcal Infections medicine.disease Observational Studies as Topic Treatment Outcome Systematic review Relative risk Meta-analysis Emergency medicine Surgery Observational study business Patient Care Bundles |
| Zdroj: | ANZ Journal of Surgery. 87:239-246 |
| ISSN: | 1445-1433 |
| DOI: | 10.1111/ans.13879 |
| Popis: | Surgical site infections (SSIs) are serious adverse events hindering surgical patients' recovery. In Australia and New Zealand, SSIs are a huge burden to patients and healthcare systems. A bundled approach, including pre-theatre nasal and/or skin decolonization has been used to reduce the risk of staphylococcal infection. The aim of this review is to assess the effectiveness of the bundle in preventing SSIs for cardiac and orthopaedic surgeries. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Published literature was searched in PubMed, Embase and Cochrane Library of Systematic reviews. Identified articles were selected and extracted based on a priori defined Population-Intervention-Comparator-Outcome and eligibility criteria. Data of randomized controlled trials (RCTs) and comparative observational studies were synthesized by meta-analyses. Quality appraisal tools were used to assess the evidence quality. The review included six RCTs and 19 observational studies. The bundled treatment regimens varied substantially across all studies. RCTs showed a trend of Staphylococcus aureus SSIs reduction due to the bundle (relative risk = 0.59, 95% confidence interval (CI) = 0.33, 1.06) with moderate heterogeneity. Observational studies showed statistically significant reduction in all-cause and S. aureus SSIs, with 51% (95% CI = 0.41, 0.59) and 47% (95% CI = 0.35, 0.65), respectively. No publication biases were detected. SSIs in major cardiac and orthopaedic surgeries can be effectively reduced by approximately 50% with a pre-theatre patient care bundle approach. |
| Databáze: | OpenAIRE |
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