Global Burden of Infections: a Systematic Review and Meta-analysis

Overview

Journal J Glob Health

Specialties Health Services
Public Health

Date 2019 Jan 4

PMID 30603078

Citations 141

Authors

Evelyn Balsells

Ting Shi

Callum Leese

Iona Lyell

John Burrows

Camilla Wiuff

Harry Campbell

Moe H Kyaw

Harish Nair

Affiliations

Soon will be listed here.

Abstract

Background: is a leading cause of morbidity and mortality in several countries. However, there are limited evidence characterizing its role as a global public health problem. We conducted a systematic review to provide a comprehensive overview of infections (CDI) rates.

Methods: Seven databases were searched (January 2016) to identify studies and surveillance reports published between 2005 and 2015 reporting CDI incidence rates. CDI incidence rates for health care facility-associated (HCF), hospital onset-health care facility-associated, medical or general intensive care unit (ICU), internal medicine (IM), long-term care facility (LTCF), and community-associated (CA) were extracted and standardized. Meta-analysis was conducted using a random effects model.

Results: 229 publications, with data from 41 countries, were included. The overall rate of HCF-CDI was 2.24 (95% confidence interval CI = 1.66-3.03) per 1000 admissions/y and 3.54 (95%CI = 3.19-3.92) per 10 000 patient-days/y. Estimated rates for CDI with onset in ICU or IM wards were 11.08 (95%CI = 7.19-17.08) and 10.80 (95%CI = 3.15-37.06) per 1000 admission/y, respectively. Rates for CA-CDI were lower: 0.55 (95%CI = 0.13-2.37) per 1000 admissions/y. CDI rates were generally higher in North America and among the elderly but similar rates were identified in other regions and age groups.

Conclusions: Our review highlights the widespread burden of disease of , evidence gaps, and the need for sustainable surveillance of CDI in the health care setting and the community.

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