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Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review

BACKGROUND: Healthcare-associated infections in long-term care are associated with substantial morbidity and mortality. While infection prevention and control (IPC) guidelines are well-defined in the acute care setting, evidence of effectiveness for long-term care facilities (LTCF) is missing. We th...

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Autores principales: Bloch, Nando, Männer, Jasmin, Gardiol, Céline, Kohler, Philipp, Kuhn, Jacqueline, Münzer, Thomas, Schlegel, Matthias, Kuster, Stefan P., Flury, Domenica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585745/
https://www.ncbi.nlm.nih.gov/pubmed/37853477
http://dx.doi.org/10.1186/s13756-023-01318-9
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author Bloch, Nando
Männer, Jasmin
Gardiol, Céline
Kohler, Philipp
Kuhn, Jacqueline
Münzer, Thomas
Schlegel, Matthias
Kuster, Stefan P.
Flury, Domenica
author_facet Bloch, Nando
Männer, Jasmin
Gardiol, Céline
Kohler, Philipp
Kuhn, Jacqueline
Münzer, Thomas
Schlegel, Matthias
Kuster, Stefan P.
Flury, Domenica
author_sort Bloch, Nando
collection PubMed
description BACKGROUND: Healthcare-associated infections in long-term care are associated with substantial morbidity and mortality. While infection prevention and control (IPC) guidelines are well-defined in the acute care setting, evidence of effectiveness for long-term care facilities (LTCF) is missing. We therefore performed a systematic literature review to examine the effect of IPC measures in the long-term care setting. METHODS: We systematically searched PubMed and Cochrane libraries for articles evaluating the effect of IPC measures in the LTCF setting since 2017, as earlier reviews on this topic covered the timeframe up to this date. Cross-referenced studies from identified articles and from mentioned earlier reviews were also evaluated. We included randomized-controlled trials, quasi-experimental, observational studies, and outbreak reports. The included studies were analyzed regarding study design, type of intervention, description of intervention, outcomes and quality. We distinguished between non-outbreak and outbreak settings. RESULTS: We included 74 studies, 34 (46%) in the non-outbreak setting and 40 (54%) in the outbreak setting. The most commonly studied interventions in the non-outbreak setting included the effect of hand hygiene (N = 10), oral hygiene (N = 6), antimicrobial stewardship (N = 4), vaccination of residents (N = 3), education (N = 2) as well as IPC bundles (N = 7). All but one study assessing hand hygiene interventions reported a reduction of infection rates. Further successful interventions were oral hygiene (N = 6) and vaccination of residents (N = 3). In outbreak settings, studies mostly focused on the effects of IPC bundles (N = 24) or mass testing (N = 11). In most of the studies evaluating an IPC bundle, containment of the outbreak was reported. Overall, only four articles (5.4%) were rated as high quality. CONCLUSION: In the non-outbreak setting in LTCF, especially hand hygiene and oral hygiene have a beneficial effect on infection rates. In contrast, IPC bundles, as well as mass testing seem to be promising in an outbreak setting. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13756-023-01318-9.
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spelling pubmed-105857452023-10-20 Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review Bloch, Nando Männer, Jasmin Gardiol, Céline Kohler, Philipp Kuhn, Jacqueline Münzer, Thomas Schlegel, Matthias Kuster, Stefan P. Flury, Domenica Antimicrob Resist Infect Control Review BACKGROUND: Healthcare-associated infections in long-term care are associated with substantial morbidity and mortality. While infection prevention and control (IPC) guidelines are well-defined in the acute care setting, evidence of effectiveness for long-term care facilities (LTCF) is missing. We therefore performed a systematic literature review to examine the effect of IPC measures in the long-term care setting. METHODS: We systematically searched PubMed and Cochrane libraries for articles evaluating the effect of IPC measures in the LTCF setting since 2017, as earlier reviews on this topic covered the timeframe up to this date. Cross-referenced studies from identified articles and from mentioned earlier reviews were also evaluated. We included randomized-controlled trials, quasi-experimental, observational studies, and outbreak reports. The included studies were analyzed regarding study design, type of intervention, description of intervention, outcomes and quality. We distinguished between non-outbreak and outbreak settings. RESULTS: We included 74 studies, 34 (46%) in the non-outbreak setting and 40 (54%) in the outbreak setting. The most commonly studied interventions in the non-outbreak setting included the effect of hand hygiene (N = 10), oral hygiene (N = 6), antimicrobial stewardship (N = 4), vaccination of residents (N = 3), education (N = 2) as well as IPC bundles (N = 7). All but one study assessing hand hygiene interventions reported a reduction of infection rates. Further successful interventions were oral hygiene (N = 6) and vaccination of residents (N = 3). In outbreak settings, studies mostly focused on the effects of IPC bundles (N = 24) or mass testing (N = 11). In most of the studies evaluating an IPC bundle, containment of the outbreak was reported. Overall, only four articles (5.4%) were rated as high quality. CONCLUSION: In the non-outbreak setting in LTCF, especially hand hygiene and oral hygiene have a beneficial effect on infection rates. In contrast, IPC bundles, as well as mass testing seem to be promising in an outbreak setting. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13756-023-01318-9. BioMed Central 2023-10-18 /pmc/articles/PMC10585745/ /pubmed/37853477 http://dx.doi.org/10.1186/s13756-023-01318-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Bloch, Nando
Männer, Jasmin
Gardiol, Céline
Kohler, Philipp
Kuhn, Jacqueline
Münzer, Thomas
Schlegel, Matthias
Kuster, Stefan P.
Flury, Domenica
Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
title Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
title_full Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
title_fullStr Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
title_full_unstemmed Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
title_short Effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
title_sort effective infection prevention and control measures in long-term care facilities in non-outbreak and outbreak settings: a systematic literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585745/
https://www.ncbi.nlm.nih.gov/pubmed/37853477
http://dx.doi.org/10.1186/s13756-023-01318-9
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