Prevention and control strategies for carbapenem-resistant organism in medical institutions in China:a meta-analysis
Objective To evaluate the efficiency of prevention and control strategies of carbapenem-resistant organism(CRO)in medical institutions in China using meta-analysis method.Methods PubMed,Embase,Medline(Ovid),Web of Science,China National Knowledge Infrastructure,Chongqing VIP and Wanfang Database were systematically searched for studies on CRO prevention and control in Chinese medical institutions from the establishment of databases to 2023 for meta-analysis.Results A total of 21 studies were included,consisting of 3 randomized controlled studies and 18 non-randomized controlled studies.The meta-analysis results showed that compared with standard prevention and control measures,strengthened intervention measures(including active screening,information-based transparent supervision mode,comprehensive intervention,and bundled prevention and control strategies)could effectively reduce the CRO infection rate[relative risk(RR)=0.40,95％confidence interval(CI)(0.25,0.65),P＜0.05].Proactive screening could effectively reduce the CRO infection rate[RR=0.52,95％CI(0.30,0.91),P＜0.05]and carbapenem-resistant Enterobacteriaceae(CRE)infection rate[RR=0.47,95％CI(0.24,0.93),P＜0.05].Information-based transparent supervision could reduce the CRE infection rate by improving compliance with standard prevention and control measures[RR=0.42,95％CI(0.28,0.62),P＜0.05].Conclusions Compared with standard prevention and control measures,strengthened intervention measures can effectively reduce the risk of in-hospital transmission and infection of CRO.In clinical practice,bundled comprehensive intervention can be combined with information-based transparent supervision,and if necessary,proactive screening of CRO in high-risk populations should be carried out.
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