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Review
. 2021 Jan;50(1):58-68.
doi: 10.18502/ijph.v50i1.5072.

Prevalence and Predictive Factors for Nosocomial Infection in the Military Hospitals: A Systematic Review and Meta-Analysis

Ehsan Teymourzadeh  1 , Mohamadkarim Bahadori  1 , Hamed Fattahi  2   3 , Hossein Ali Rahdar  4 , Sima Mirzaei Moghadam  5 , Azad Shokri  6
Affiliations
Review

Prevalence and Predictive Factors for Nosocomial Infection in the Military Hospitals: A Systematic Review and Meta-Analysis

Ehsan Teymourzadeh et al. Iran J Public Health. 2021 Jan.

Abstract

Background: To assess prevalence and predictive factors for Nosocomial Infection (NI) in the military hospitals.

Methods: PubMed, Scopus, Cochrane and PreQuest databases were systematically searched for studies published between Jan 1991 and Oct 2017 that reported the prevalence of NI and predictive factors among military hospitals. We performed the meta-analysis using a random effects model. Subgroup analysis was done for heterogeneity and the Egger test to funnel plots was used to assess publication bias.

Results: Twenty-eight studies with 250,374 patients were evaluated in meta-analysis. The overall pooled estimate of the prevalence of NI was 8% (95% 6.0-9.0). The pooled prevalence was 2% (95% CI: 2.0-3.0) when we did sensitivity analysis and excluding a study. The prevalence was highest in burn unit (32%) and ICU (15%). Reported risk factors for NI included gender (male vs female, OR: 1.45), age (Age≥65, OR: 2.4), diabetes mellitus (OR: 2.32), inappropriate use of antibiotics (OR: 2.35), received mechanical support (OR: 2.81), co-morbidities (OR: 2.97), admitted into the ICU (OR: 2.26), smoking (OR: 1.36) and BMI (OR: 1.09).

Conclusion: The review revealed a difference of prevalence in military hospitals with other hospitals and shows a high prevalence of NI in burn units. Therefore careful disinfection and strict procedures of infection control are necessary in places that serve immunosuppressed individuals such as burn patient. Moreover, a vision for the improvement of reports and studies in military hospitals to report the rate of these infections are necessary.

Keywords: Military hospital; Nosocomial infection; Predictive factors.

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Conflict of interest statement

Conflict of interest The authors declare that there is no conflict of interests.

Figures

Fig. 1:
Fig. 1:
Flow diagram for selection of articles
Fig. 2:
Fig. 2:
Forest plot for the overall estimate of the prevalence of NI. (A) Before sensitivity analysis and (B) After sensitivity analysis. Abbreviations: CI, confidence interval; ES, effect size
Fig. 3:
Fig. 3:
Comparing prevalence of NI in different hospital wards
See this image and copyright information in PMC

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