Prevalence and Predictive Factors for Nosocomial Infection in the Military Hospitals: A Systematic Review and Meta-Analysis
-
Ehsan TEYMOURZADEH
,
Mohamadkarim BAHADORI
,
Hamed FATTAHI
,
Hossein Ali RAHDAR
,
Sima MIRZAEI MOGHADAM
,
Azad SHOKRI
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.
1. Chen Y, Shan X, Zhao J, et al (2017). Predict-ing nosocomial lower respiratory tract infec-tions by a risk index based system. Sci Rep, 7(1): 15933.
2. Allegranzi B, Nejad SB, Combescure C, et al (2011). Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet, 377(9761): 228-41.
3. Pashman J, Bradley E, Wang H, et al (2007). Promotion of hand hygiene techniques through use of a surveillance tool. J Hosp In-fect, 66(3): 249-54.
4. Mansour MGE, Bendary S (2012). Hospital-acquired pneumonia in critically ill children: Incidence, risk factors, outcome and diag-nosis with insight on the novel diagnostic technique of multiplex polymerase chain re-action. Egypt J Med Hum Genet, 13(1): 99-105.
5. Starfield B (2000). Is US health really the best in the world? JAMA, 284(4): 483-5
6. Evriviades D, Jeffery S, Cubison T, et al (2011). Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine. Philos Trans R Soc Lond B Biol Sci, 366(1562): 219-30.
7. Warkentien T, Rodriguez C, Lloyd B, et al (2012). Invasive mold infections following combat-related injuries. Clin Infect Dis, 55(11): 1441-9.
8. Yan T, Liu C, Li Y, et al (2018). Prevalence and predictive factors of urinary tract infec-tion among patients with stroke: A meta-analysis. Am J Infect Control, 46(4): 402-409
9. Rodríguez-Acelas AL, de Abreu Almeida M, Engelman B, Cañon-Montañez W (2017). Risk factors for health care–associated in-fection in hospitalized adults: Systematic re-view and meta-analysis. Am J Infect Control, 45(12): e149-e156.
10. Hoy D, Brooks P, Woolf A, et al (2012). As-sessing risk of bias in prevalence studies: modification of an existing tool and evi-dence of interrater agreement. J Clin Epi-demiol, 65(9): 934-9.
11. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003). Measuring inconsistency in me-ta-analyses. BMJ, 327(7414): 557-60.
12. Liu H, Zhao J, Xing Y, et al (2014). Noso-comial infection in adult admissions with hematological malignancies originating from different lineages: a prospective observa-tional study. PLoS One, 9(11): e113506.
13. Whitford DL, Ofurum KA (2010). Health-Care Associated Infection Rates among Adult Patients in Bahrain Military Hospital: A Cross Sectional Survey. Bahrain Med Bull, 32(1):11-14.
14. Chen Y, Zhao J, Shan X, et al (2017). A point-prevalence survey of healthcare-associated infection in fifty-two Chinese hospitals. J Hosp Infect, 95(1): 105-111.
15. Abdel Fattah M (2008). Nosocomial pneumo-nia: risk factors, rates and trends. 83-90. East Mediter Health J, 14(3): 546-555
16. Šuljagić V, Čobeljić M, Janković S, et al (2005). Nosocomial bloodstream infections in ICU and non-ICU patients. Am J Infect Control, 33(6): 333-40.
17. Al-Helali NS, Al-Asmary SM, Abdel-Fattah MM, et al (2004). Epidemiologic study of nosocomial urinary tract infections in Saudi military hospitals. Infect Control Hosp Epidemiol, 25(11): 1004-7.
18. Al-Asmary SM, Al-Helali NS, Abdel-Fattah MM, et al (2004). Nosocomial urinary tract infection. Risk factors, rates and trends. Saudi Med J, 25(7): 895-900.
19. Lesperance R, Lehman R, Lesperance K, et al (2011). Early postoperative fever and the “routine” fever work-up: results of a pro-spective study. J Surg Res, 171(1): 245-50.
20. Suljagić V, Jevtic M, Djordjevic B, Jovelic A (2010). Surgical site infections in a tertiary health care center: prospective cohort study. Surg Today, 40(8): 763-71.
21. Starčević S, Munitlak S, Mijović B, et al (2015). Surgical site infection surveillance in ortho-pedic patients in the Military Medical Acad-emy, Belgrade. Vojnosanit Pregl, 72(6): 499-504.
22. Mladenović J, Veljović M, Udovičić I, et al (2015). Catheter-associated urinary tract in-fection in a surgical intensive care unit. Vojnosanit Pregl, 72(10): 883-8.
23. Jiang X, Ma J, HOu F, et al (2016). Neurosur-gical site infection prevention: single institute experience. Turk Neurosurg, 26(2): 234-9.
24. Xiao Y, Shi G, Zhang J, et al (2015). Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecu-tive cohort study. Surg Endosc, 29(6): 1384-93.
25. Seavey JG, Balazs GC, Steelman T, et al (2017). The effect of preoperative lumbar epidural corticosteroid injection on postop-erative infection rate in patients undergoing single-level lumbar decompression. Spine J, 17(9): 1209-1214.
26. Harold DM, Johnson EK, Rizzo JA, Steele SR (2010). Primary closure of stoma site wounds after ostomy takedown. Am J Surg, 199(5): 621-4.
27. Oncul O, Yüksel F, Altunay H, et al (2002). The evaluation of nosocomial infection dur-ing 1-year-period in the burn unit of a train-ing hospital in Istanbul, Turkey. Burns, 28(8): 738-44.
28. Öncül O, Öksüz S, Acar A, et al (2014). Nos-ocomial infection characteristics in a burn intensive care unit: analysis of an eleven-year active surveillance. Burns, 40(5): 835-41.
29. Oncul O, Ulkur E, Acar A, et al (2009). Pro-spective analysis of nosocomial infections in a burn care unit, Turkey. Indian J Med Res, 130(6):758-64.
30. Schaal J, Leclerc T, Soler C, et al (2015). Epi-demiology of filamentous fungal infections in burned patients: a French retrospective study. Burns, 41(4): 853-63.
31. Becker WK, Cioffi WG, McManus AT, et al (1991). Fungal burn wound infection: a 10-year experience. Arch Surg, 126(1): 44-8.
32. Horvath EE, Murray CK, Vaughan GM, et al (2007). Fungal wound infection (not coloni-zation) is independently associated with mortality in burn patients. Ann Surg, 245(6): 978-85.
33. Zeng J, Wang C-T, Zhang F-S, et al (2016). Effect of probiotics on the incidence of ventilator-associated pneumonia in critically ill patients: a randomized controlled multi-center trial. Intensive Care Med, 42(6): 1018-28.
34. Singh S, Goyal R, Ramesh G, et al (2015). Control of hospital acquired infections in the ICU: A service perspective. Med J Armed Forces India, 71(1): 28-32.
35. Singh S, Chaturvedi R, Garg S, et al (2013). In-cidence of healthcare associated infection in the surgical ICU of a tertiary care hospital. Med J Armed Forces India, 69(2): 124-9.
36. Hajjej Z, Nasri M, Sellami W, et al (2014). In-cidence, risk factors and microbiology of central vascular catheter-related bloodstream infection in an intensive care unit. J Infect Chemother, 20(3): 163-8.
37. Karacaer Z, Oncul O, Turhan V, et al (2014). A surveillance of nosocomial candida infec-tions: epidemiology and influences on mor-talty in intensive care units. Pan Afr Med J, 19: 398.
38. Davis KA, Stewart JJ, Crouch HK, et al (2004). Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital ad-mission and its effect on subsequent MRSA infection. Clin Infect Dis, 39(6): 776-82.
39. DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7(3): 177-88.
40. Danchaivijitr S, Dhiraputra C, Santiprasitkul S, Judaeng T (2005). Prevalence and impacts of nosocomial infection in Thailand 2001. J Med Assoc Thai, 88 Suppl 10:S1-9.
41. Izquierdo-Cubas F, Zambrano A, Frometa I, et al (2008). National prevalence of noso-comial infections. Cuba 2004. J Hosp Infect, 68(3): 234-40.
42. European Centre for Disease Prevention and Control (ECDC) (2008). Annual epidemiological report on communicable diseases in Europe 2008. Stockholm. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/0812_SUR_Annual_Epidemiological_Report_2008.pdf
43. Klevens RM, Edwards JR, Richards Jr CL, et al (2007). Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep, 122(2): 160-6.
44. Guggenheim M, Zbinden R, Handschin AE, et al (2009). Changes in bacterial isolates from burn wounds and their antibiograms: a 20-year study (1986–2005). Burns, 35(4): 553-60.
45. Emaneini M, Beigverdi R, van Leeuwen WB, et al (2018). Prevalence of Methicillin-Resistant Staphylococcus aureus isolated from burn patients: A systematic review and meta-analysis. J Glob Antimicrob Resist, 12:202–6.
46. Emaneini M, Jabalameli F, Rahdar H, et al (2017). Nasal carriage rate of methicillin re-sistant Staphylococcus aureus among Irani-an healthcare workers: a systematic review and meta-analysis. Rev Soc Bras Med Trop, 50(5): 590-7.
47. Lahsaeizadeh S, Jafari H, Askarian M (2008). Healthcare-associated infection in Shiraz, Iran 2004–2005. J Hosp Infect, 69(3): 283-7.
48. Kallel H, Bahoul M, Ksibi H, et al (2005). Prevalence of hospital-acquired infection in a Tunisian hospital. J Hosp Infect, 59(4): 343-7.
49. Jroundi I, Khoudri I, Azzouzi A, et al (2007). Prevalence of hospital-acquired infection in a Moroccan university hospital. Am J Infect Control, 35(6): 412-6.
50. Yuan K, Chen H-L (2013). Obesity and surgi-cal site infections risk in orthopedics: a me-ta-analysis. Int J Surg, 11(5): 383-8.
51. Newell MA, Bard MR, Goettler CE, et al (2007). Body mass index and outcomes in critically injured blunt trauma patients: weighing the impact. J Am Coll Surg, 204(5): 1056-61.
52. Serrano PE, Khuder SA, Fath JJ (2010). Obe-sity as a risk factor for nosocomial infec-tions in trauma patients. J Am Coll Surg, 211(1): 61-7.
53. Watanabe A, Kohnoe S, Shimabukuro R, et al (2008). Risk factors associated with surgical site infection in upper and lower gastroin-testinal surgery. Surg Today, 38(5): 404-12.
54. Eckenrode S, Bakullari A, Metersky ML, et al (2014). The association between age, sex, and hospital-acquired infection rates: results from the 2009-2011 National Medicare Pa-tient Safety Monitoring System. Infect Control Hosp Epidemiol, 35 Suppl 3:S3-9.
55. Cohen B, Choi YJ, Hyman S, et al (2013). Gender differences in risk of bloodstream and surgical site infections. J Gen Intern Med, 28(10): 1318-25.
56. Saeed MJ, Olsen MA, Powderly WG, et al (2017). Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients. J Clin Gastroenterol, 51(1): 70-76.
57. Lee SC, Hua CC, Yu TJ, et al (2005). Risk fac-tors of mortality for nosocomial pneumo-nia: importance of initial anti‐microbial ther-apy. Int J Clin Pract, 59(1): 39-45.
58. Rello J, Ausino V, Ricart M, et al (1993). Im-pact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest, 104(4): 1230-5.
59. Vardakas KZ, Siempos II, Falagas ME (2007). Short report Diabetes mellitus as a risk fac-tor for nosocomial pneumonia and associ-ated mortality. Diabet Med, 24(10): 1168–71.
60. Cavalcanti M, Ferrer M, Ferrer R, et al (2006). Risk and prognostic factors of ventilator-associated pneumonia in trauma patients. Crit Care Med, 34(4): 1067-72.
61. Liang SY, Mackowiak PA (2007). Infections in the elderly. Clin Geriatr Med, 23(2): 441-56.
62. D'Agata EM, Mount DB, Thayer V, Schaffner W (2000). Hospital-acquired infections among chronic hemodialysis patients. Am J Kidney Dis, 35(6): 1083-8.
63. Ylipalosaari P, Ala‐Kokko T, Laurila J, Ohto-nen P, Syrjälä H (2006). Epidemiology of in-tensive care unit (ICU)‐acquired infections in a 14‐month prospective cohort study in a single mixed Scandinavian university hospi-tal ICU. Acta Anaesthesiol Scand, 50(10): 1192-7.
2. Allegranzi B, Nejad SB, Combescure C, et al (2011). Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet, 377(9761): 228-41.
3. Pashman J, Bradley E, Wang H, et al (2007). Promotion of hand hygiene techniques through use of a surveillance tool. J Hosp In-fect, 66(3): 249-54.
4. Mansour MGE, Bendary S (2012). Hospital-acquired pneumonia in critically ill children: Incidence, risk factors, outcome and diag-nosis with insight on the novel diagnostic technique of multiplex polymerase chain re-action. Egypt J Med Hum Genet, 13(1): 99-105.
5. Starfield B (2000). Is US health really the best in the world? JAMA, 284(4): 483-5
6. Evriviades D, Jeffery S, Cubison T, et al (2011). Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine. Philos Trans R Soc Lond B Biol Sci, 366(1562): 219-30.
7. Warkentien T, Rodriguez C, Lloyd B, et al (2012). Invasive mold infections following combat-related injuries. Clin Infect Dis, 55(11): 1441-9.
8. Yan T, Liu C, Li Y, et al (2018). Prevalence and predictive factors of urinary tract infec-tion among patients with stroke: A meta-analysis. Am J Infect Control, 46(4): 402-409
9. Rodríguez-Acelas AL, de Abreu Almeida M, Engelman B, Cañon-Montañez W (2017). Risk factors for health care–associated in-fection in hospitalized adults: Systematic re-view and meta-analysis. Am J Infect Control, 45(12): e149-e156.
10. Hoy D, Brooks P, Woolf A, et al (2012). As-sessing risk of bias in prevalence studies: modification of an existing tool and evi-dence of interrater agreement. J Clin Epi-demiol, 65(9): 934-9.
11. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003). Measuring inconsistency in me-ta-analyses. BMJ, 327(7414): 557-60.
12. Liu H, Zhao J, Xing Y, et al (2014). Noso-comial infection in adult admissions with hematological malignancies originating from different lineages: a prospective observa-tional study. PLoS One, 9(11): e113506.
13. Whitford DL, Ofurum KA (2010). Health-Care Associated Infection Rates among Adult Patients in Bahrain Military Hospital: A Cross Sectional Survey. Bahrain Med Bull, 32(1):11-14.
14. Chen Y, Zhao J, Shan X, et al (2017). A point-prevalence survey of healthcare-associated infection in fifty-two Chinese hospitals. J Hosp Infect, 95(1): 105-111.
15. Abdel Fattah M (2008). Nosocomial pneumo-nia: risk factors, rates and trends. 83-90. East Mediter Health J, 14(3): 546-555
16. Šuljagić V, Čobeljić M, Janković S, et al (2005). Nosocomial bloodstream infections in ICU and non-ICU patients. Am J Infect Control, 33(6): 333-40.
17. Al-Helali NS, Al-Asmary SM, Abdel-Fattah MM, et al (2004). Epidemiologic study of nosocomial urinary tract infections in Saudi military hospitals. Infect Control Hosp Epidemiol, 25(11): 1004-7.
18. Al-Asmary SM, Al-Helali NS, Abdel-Fattah MM, et al (2004). Nosocomial urinary tract infection. Risk factors, rates and trends. Saudi Med J, 25(7): 895-900.
19. Lesperance R, Lehman R, Lesperance K, et al (2011). Early postoperative fever and the “routine” fever work-up: results of a pro-spective study. J Surg Res, 171(1): 245-50.
20. Suljagić V, Jevtic M, Djordjevic B, Jovelic A (2010). Surgical site infections in a tertiary health care center: prospective cohort study. Surg Today, 40(8): 763-71.
21. Starčević S, Munitlak S, Mijović B, et al (2015). Surgical site infection surveillance in ortho-pedic patients in the Military Medical Acad-emy, Belgrade. Vojnosanit Pregl, 72(6): 499-504.
22. Mladenović J, Veljović M, Udovičić I, et al (2015). Catheter-associated urinary tract in-fection in a surgical intensive care unit. Vojnosanit Pregl, 72(10): 883-8.
23. Jiang X, Ma J, HOu F, et al (2016). Neurosur-gical site infection prevention: single institute experience. Turk Neurosurg, 26(2): 234-9.
24. Xiao Y, Shi G, Zhang J, et al (2015). Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecu-tive cohort study. Surg Endosc, 29(6): 1384-93.
25. Seavey JG, Balazs GC, Steelman T, et al (2017). The effect of preoperative lumbar epidural corticosteroid injection on postop-erative infection rate in patients undergoing single-level lumbar decompression. Spine J, 17(9): 1209-1214.
26. Harold DM, Johnson EK, Rizzo JA, Steele SR (2010). Primary closure of stoma site wounds after ostomy takedown. Am J Surg, 199(5): 621-4.
27. Oncul O, Yüksel F, Altunay H, et al (2002). The evaluation of nosocomial infection dur-ing 1-year-period in the burn unit of a train-ing hospital in Istanbul, Turkey. Burns, 28(8): 738-44.
28. Öncül O, Öksüz S, Acar A, et al (2014). Nos-ocomial infection characteristics in a burn intensive care unit: analysis of an eleven-year active surveillance. Burns, 40(5): 835-41.
29. Oncul O, Ulkur E, Acar A, et al (2009). Pro-spective analysis of nosocomial infections in a burn care unit, Turkey. Indian J Med Res, 130(6):758-64.
30. Schaal J, Leclerc T, Soler C, et al (2015). Epi-demiology of filamentous fungal infections in burned patients: a French retrospective study. Burns, 41(4): 853-63.
31. Becker WK, Cioffi WG, McManus AT, et al (1991). Fungal burn wound infection: a 10-year experience. Arch Surg, 126(1): 44-8.
32. Horvath EE, Murray CK, Vaughan GM, et al (2007). Fungal wound infection (not coloni-zation) is independently associated with mortality in burn patients. Ann Surg, 245(6): 978-85.
33. Zeng J, Wang C-T, Zhang F-S, et al (2016). Effect of probiotics on the incidence of ventilator-associated pneumonia in critically ill patients: a randomized controlled multi-center trial. Intensive Care Med, 42(6): 1018-28.
34. Singh S, Goyal R, Ramesh G, et al (2015). Control of hospital acquired infections in the ICU: A service perspective. Med J Armed Forces India, 71(1): 28-32.
35. Singh S, Chaturvedi R, Garg S, et al (2013). In-cidence of healthcare associated infection in the surgical ICU of a tertiary care hospital. Med J Armed Forces India, 69(2): 124-9.
36. Hajjej Z, Nasri M, Sellami W, et al (2014). In-cidence, risk factors and microbiology of central vascular catheter-related bloodstream infection in an intensive care unit. J Infect Chemother, 20(3): 163-8.
37. Karacaer Z, Oncul O, Turhan V, et al (2014). A surveillance of nosocomial candida infec-tions: epidemiology and influences on mor-talty in intensive care units. Pan Afr Med J, 19: 398.
38. Davis KA, Stewart JJ, Crouch HK, et al (2004). Methicillin-resistant Staphylococcus aureus (MRSA) nares colonization at hospital ad-mission and its effect on subsequent MRSA infection. Clin Infect Dis, 39(6): 776-82.
39. DerSimonian R, Laird N (1986). Meta-analysis in clinical trials. Control Clin Trials, 7(3): 177-88.
40. Danchaivijitr S, Dhiraputra C, Santiprasitkul S, Judaeng T (2005). Prevalence and impacts of nosocomial infection in Thailand 2001. J Med Assoc Thai, 88 Suppl 10:S1-9.
41. Izquierdo-Cubas F, Zambrano A, Frometa I, et al (2008). National prevalence of noso-comial infections. Cuba 2004. J Hosp Infect, 68(3): 234-40.
42. European Centre for Disease Prevention and Control (ECDC) (2008). Annual epidemiological report on communicable diseases in Europe 2008. Stockholm. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/0812_SUR_Annual_Epidemiological_Report_2008.pdf
43. Klevens RM, Edwards JR, Richards Jr CL, et al (2007). Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Rep, 122(2): 160-6.
44. Guggenheim M, Zbinden R, Handschin AE, et al (2009). Changes in bacterial isolates from burn wounds and their antibiograms: a 20-year study (1986–2005). Burns, 35(4): 553-60.
45. Emaneini M, Beigverdi R, van Leeuwen WB, et al (2018). Prevalence of Methicillin-Resistant Staphylococcus aureus isolated from burn patients: A systematic review and meta-analysis. J Glob Antimicrob Resist, 12:202–6.
46. Emaneini M, Jabalameli F, Rahdar H, et al (2017). Nasal carriage rate of methicillin re-sistant Staphylococcus aureus among Irani-an healthcare workers: a systematic review and meta-analysis. Rev Soc Bras Med Trop, 50(5): 590-7.
47. Lahsaeizadeh S, Jafari H, Askarian M (2008). Healthcare-associated infection in Shiraz, Iran 2004–2005. J Hosp Infect, 69(3): 283-7.
48. Kallel H, Bahoul M, Ksibi H, et al (2005). Prevalence of hospital-acquired infection in a Tunisian hospital. J Hosp Infect, 59(4): 343-7.
49. Jroundi I, Khoudri I, Azzouzi A, et al (2007). Prevalence of hospital-acquired infection in a Moroccan university hospital. Am J Infect Control, 35(6): 412-6.
50. Yuan K, Chen H-L (2013). Obesity and surgi-cal site infections risk in orthopedics: a me-ta-analysis. Int J Surg, 11(5): 383-8.
51. Newell MA, Bard MR, Goettler CE, et al (2007). Body mass index and outcomes in critically injured blunt trauma patients: weighing the impact. J Am Coll Surg, 204(5): 1056-61.
52. Serrano PE, Khuder SA, Fath JJ (2010). Obe-sity as a risk factor for nosocomial infec-tions in trauma patients. J Am Coll Surg, 211(1): 61-7.
53. Watanabe A, Kohnoe S, Shimabukuro R, et al (2008). Risk factors associated with surgical site infection in upper and lower gastroin-testinal surgery. Surg Today, 38(5): 404-12.
54. Eckenrode S, Bakullari A, Metersky ML, et al (2014). The association between age, sex, and hospital-acquired infection rates: results from the 2009-2011 National Medicare Pa-tient Safety Monitoring System. Infect Control Hosp Epidemiol, 35 Suppl 3:S3-9.
55. Cohen B, Choi YJ, Hyman S, et al (2013). Gender differences in risk of bloodstream and surgical site infections. J Gen Intern Med, 28(10): 1318-25.
56. Saeed MJ, Olsen MA, Powderly WG, et al (2017). Diabetes mellitus is associated with higher risk of developing decompensated cirrhosis in chronic hepatitis C patients. J Clin Gastroenterol, 51(1): 70-76.
57. Lee SC, Hua CC, Yu TJ, et al (2005). Risk fac-tors of mortality for nosocomial pneumo-nia: importance of initial anti‐microbial ther-apy. Int J Clin Pract, 59(1): 39-45.
58. Rello J, Ausino V, Ricart M, et al (1993). Im-pact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest, 104(4): 1230-5.
59. Vardakas KZ, Siempos II, Falagas ME (2007). Short report Diabetes mellitus as a risk fac-tor for nosocomial pneumonia and associ-ated mortality. Diabet Med, 24(10): 1168–71.
60. Cavalcanti M, Ferrer M, Ferrer R, et al (2006). Risk and prognostic factors of ventilator-associated pneumonia in trauma patients. Crit Care Med, 34(4): 1067-72.
61. Liang SY, Mackowiak PA (2007). Infections in the elderly. Clin Geriatr Med, 23(2): 441-56.
62. D'Agata EM, Mount DB, Thayer V, Schaffner W (2000). Hospital-acquired infections among chronic hemodialysis patients. Am J Kidney Dis, 35(6): 1083-8.
63. Ylipalosaari P, Ala‐Kokko T, Laurila J, Ohto-nen P, Syrjälä H (2006). Epidemiology of in-tensive care unit (ICU)‐acquired infections in a 14‐month prospective cohort study in a single mixed Scandinavian university hospi-tal ICU. Acta Anaesthesiol Scand, 50(10): 1192-7.
| Files | ||
| Issue | Vol 50 No 1 (2021) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v50i1.5072 | |
| Keywords | ||
| Nosocomial infection Military hospital; Predictive factors | ||
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How to Cite
1.
TEYMOURZADEH E, BAHADORI M, FATTAHI H, RAHDAR HA, MIRZAEI MOGHADAM S, SHOKRI A. Prevalence and Predictive Factors for Nosocomial Infection in the Military Hospitals: A Systematic Review and Meta-Analysis. Iran J Public Health. 2020;50(1):58-68.
