Risk of Developing Central Line-Associated Bloodstream Infections in Integrated Health Care System of Pakistan-A Meta-Analysis
Keywords:Healthcare system, Hospital-acquired infections, Risks
Studies regarding the prevalence of CLABSIs in Pakistan are limited. However, it is known that healthcare-associated infections are a concern in many low- and middle-income countries, including Pakistan. The present study is aimed to identify the relative risk of developing CLABSIs in the hospital care setups of Pakistan. The risk of biases in included studies was assessed using Cochrane tool parameters. Analysis of results revealed a relative risk of getting CLABSIs is 1.78 (p<0.001) among patients admitted in the hospitals for greater than 72 hours. This shows that the chances of getting infected at the central line site were more than 50% among patients admitted to ICUs in Pakistan. It has been concluded that the relative risk of CLABSIs in the integrated healthcare system of Pakistan is high.
Dandoy CE, Alonso PB. MBI-LCBI and CLABSI: more than scrubbing the line. Bone marrow transplantation. 2019 Dec;54(12):1932-9.
Yuvaraj N, Raja RA, Kousik NV, Johri P, Divan MJ. Analysis on the prediction of central line-associated bloodstream infections (CLABSI) using deep neural network classification. In Computational Intelligence and Its Applications in Healthcare. 2020: 229-244. Academic Press.
Fakih MG, Bufalino A, Sturm L, Huang RH, Ottenbacher A, Saake K, Winegar A, Fogel R, Cacchione J. Coronavirus disease 2019 (COVID-19) pandemic, central-line–associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): The urgent need to refocus on hardwiring prevention efforts. Infection Control & Hospital Epidemiology. 2022 Jan;43(1):26-31.
Murhekar MV, Kumar CG. Health-care-associated infection surveillance in India. The Lancet Global Health. 2022 Sep 1;10(9):e1222-3.
Toor H, Farr S, Savla P, Kashyap S, Wang S, Miulli DE. Prevalence of Central Line-Associated Bloodstream Infections (CLABSI) in Intensive Care and Medical-Surgical Units. Cureus. 2022 Mar 3;14(3).
Özalp Gerçeker G, Yardımcı F, Aydınok Y. Central Line–Associated Bloodstream Infections in Children With Hematologic and Oncologic Diseases: First Prevalence Results From a University Hospital. Journal of Pediatric Oncology Nursing. 2019 Sep;36(5):327-36.
Ista E, van der Hoven B, Kornelisse RF, van der Starre C, Vos MC, Boersma E, Helder OK. Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages: a systematic review and meta-analysis. The Lancet Infectious Diseases. 2016 Jun 1;16(6):724-34.
Tripathi S, Gehlbach J, Henrekin L, Neavor A, Woods-duvendack T, Capati A. 1266: Clabsi Maintenance Bundle And Clabsi Rates: Is There More To It Than Compliance. Critical Care Medicine. 2022 Jan 1;50(1):633.
Lee JH, Kim MU, Kim ET, Shim DJ, Kim IJ, Byeon JH, Kim HB. Prevalence and predictors of peripherally inserted central venous catheter associated bloodstream infections in cancer patients: a multicentre cohort study. Medicine. 2020 Feb;99(6).
Castronova IA. Preventing CLABSIs: Experimental Interventions and Opportunities for Diagnostic and Antimicrobial Stewardship in Solid Organ Transplant Patients (Doctoral dissertation, University of Pittsburgh).
Yaseen M, Suliman M, Yaseen M, Ali S, Sultan A. Knowledge and Compliance Regarding Central Line Associated Blood Stream Infections (CLABSIs) Prevention Among Public and Private Hospital Intensive Care Unit Nurses: Central Line Associated Blood Stream Infections. THE THERAPIST (Journal of Therapies & Rehabilitation Sciences). 2022 Dec 31:15-9.
Novosad SA, Fike L, Dudeck MA, Allen-Bridson K, Edwards JR, Edens C, Sinkowitz-Cochran R, Powell K, Kuhar D. Pathogens causing central-line–associated bloodstream infections in acute-care hospitals—United States, 2011–2017. Infection Control & Hospital Epidemiology. 2020 Mar;41(3):313-9.
Noor A, Ishaq AR, Jafri L, Jabeen F, Rani R, Kiani BH, Akhtar N, Javed Z, Younis T, Jalal F. Health Care Associated Infections (HCAIs) a New Threat for World; U-Turn from Recovery to Death. InCampylobacter 2021 Apr 30. IntechOpen.
Hernández-Aceituno A, Vega-Costa V, Ruiz-Álvarez M, Figuerola-Tejerina A, Méndez-Hernández R, Ramasco-Rueda F. Effectiveness of a bundle of measures for reducing central line-associated bloodstream infections. Revista Española de Anestesiología y Reanimación (English Edition). 2020 May 1;67(5):227-36.
Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, Koffel JB. PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews. Systematic reviews. 2021 Dec;10(1):1-9.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología. 2021 Sep 1;74(9):790-9.
Hussain AS, Ahmed AM, Arbab S, Ariff S, Ali R, Demas S, Zeb J, Rizvi A, Saleem A, Farooqi J. CLABSI reduction using evidence based interventions and nurse empowerment: a quality improvement initiative from a tertiary care NICU in Pakistan. Archives of Disease in Childhood. 2021 Apr 1;106(4):394-400.
Sayeed MA, Farooqi J, Jabeen K, Mahmood SF. Comparison of risk factors and outcomes of Candida auris candidemia with non-Candida auris candidemia: A retrospective study from Pakistan. Medical Mycology. 2020 Aug;58(6):721-9.
Babar Z, Dodani SK, Nasim A, Kumar S, Azmi M. Central Line Associated Blood Stream Infection with Gram Negative Organisms: Clinical Features, Risk Factors and Mortality. Infectious Diseases Journal. 2020;29(1):17-22.
Farooqi JQ, Jabeen K, Saeed N, Iqbal N, Malik B, Lockhart SR, Zafar A, Brandt ME, Hasan R. Invasive candidiasis in Pakistan: clinical characteristics, species distribution and antifungal susceptibility. Journal of medical microbiology. 2013 Feb;62(0 2):259.
Hammer GP, du Prel JB, Blettner M. Avoiding bias in observational studies: part 8 in a series of articles on evaluation of scientific publications. Deutsches Ärzteblatt International. 2009 Oct;106(41):664.
Malek AE, Raad II. Preventing catheter-related infections in cancer patients: a review of current strategies. Expert Review of Anti-infective Therapy. 2020 Jun 2;18(6):531-8.
Eturajulu RC, Ng KH, Tan MP, Zakaria MI, Chinna K, Ponnampalavanar S, Vijayananthan A, Yaakup NA, Chung E. Quality Improvement Report: Safety Program for Prevention of Central Line–associated Bloodstream Infections. RadioGraphics. 2022 Nov;42(7):E216-23.
Mazi WA, Abdulwahab MH, Alashqar MA, Aldecoa YS, Bahat ZR, Suaking JL, Saeed A, Yassin OS, Mahfouz SA, Senok A. Sustained Low Incidence Rates of Central Line-Associated Blood Stream Infections in the Intensive Care Unit. Infection and Drug Resistance. 2021;14:889.
Gaind R, Chakrabarty S. Experience of clabsi prevention measures in a medical ICU in a tertiary care hospital in a developing country. Chest. 2022 Jun 1;161(6):A290.
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