Dataset Information

Does copper treatment of commonly touched surfaces reduce healthcare-acquired infections? A systematic review and meta-analysis.

ABSTRACT:

Background

Healthcare-acquired infections (HAIs) cause substantial morbidity and mortality. Copper appears to have strong antimicrobial properties under laboratory conditions.

Aim

To examine the potential effect of copper treatment of commonly touched surfaces in healthcare facilities.

Methods

Controlled trials comparing the effect of copper-treated surfaces (furniture or bed linens) in hospital rooms compared with standard rooms on HAIs were included in this systematic review. Two reviewers independently screened retrieved articles, extracted data, and assessed the risk of bias of included studies. The primary outcome was the occurrence of HAIs.

Findings

In total, 638 records were screened, and seven studies comprising 12,362 patients were included. All included studies were judged to be at high risk of bias in two or more of the seven domains. All seven studies reported the effect of various copper-treated surfaces on HAIs. Overall, this review found low-quality evidence of potential clinical importance that copper-treated hard surfaces and/or bed linens and clothes reduced HAIs by 27% (risk ratio 0.73, 95% confidence interval 0.57-0.94; I² = 44%, P=0.01).

Conclusion

Given the clinical and economic costs of HAIs, the potentially protective effect of copper treatment appears to be important. The current evidence is insufficient to make a strong positive recommendation. However, it would appear worthwhile and urgent to conduct larger publicly funded clinical trials into the impact of copper treatment.

SUBMITTER: Albarqouni L

PROVIDER: S-EPMC7480678 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Does copper treatment of commonly touched surfaces reduce healthcare-acquired infections? A systematic review and meta-analysis.

Albarqouni L L Byambasuren O O Clark J J Scott A M AM Looke D D Glasziou P P

The Journal of hospital infection 20200909 4

<h4>Background</h4>Healthcare-acquired infections (HAIs) cause substantial morbidity and mortality. Copper appears to have strong antimicrobial properties under laboratory conditions.<h4>Aim</h4>To examine the potential effect of copper treatment of commonly touched surfaces in healthcare facilities.<h4>Methods</h4>Controlled trials comparing the effect of copper-treated surfaces (furniture or bed linens) in hospital rooms compared with standard rooms on HAIs were included in this systematic rev ...[more]

PMID: 32916212

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Project description:BACKGROUND:Healthcare-associated infections (HAI) are a significant burden on the healthcare system. Recent research has suggested the role of copper in reducing HAI. The purpose of this study was to systematically search literature and pool data from studies evaluating the efficacy of copper-impregnated hospital linen in reducing HAI. METHODS:We carried out a systematic electronic search of PubMed, ScienceDirect, BioMed Central, Springer, Embase, and Google Scholar databases for controlled studies evaluating the efficacy of copper-impregnated linen in reducing the incidence of HAI. The last search was carried out on 15th February 2020. RESULTS:Six studies were included. There was no restriction on the type of organism causing HAI in three studies while three trials reported HAI from Clostridioides difficile and multi-drug resistant organisms (MDRO). A meta-analysis of six studies indicated the use of copper-impregnated linen did not reduce the risk of HAI [Incidence rate ratio (IRR):0.66, 95% CI:0.28-1.58, p = 0.36, I2 = 100%)]. On subgroup analysis, while pooled data from three studies HAI indicated a statistical significant reduction in all-HAI with copper-impregnated linen (IRR:0.76, 95% CI:0.75-0.77, p<0.00001, I2 = 0%), no such difference was seen when HAI was defined as infection by Clostridioides difficile and MDROs only (IRR:0.57, 95% CI:0.12-2.75, p = 0.48, I2 = 99%). Meta-regression analysis for study duration and number of days of hospitalization did not demonstrate any influence on the overall effect size. On sensitivity analysis, there was no change in the significance of results after the sequential exclusion of every study. CONCLUSION:Current evidence on the use of copper-impregnated linen to reduce HAI is conflicting. Our results indicate that copper-impregnated linen may reduce HAI, but there is still no evidence of such an effect regarding infections caused by MDRO or Clostridioides difficile. The overall quality of evidence is not high. Homogenous high-quality studies are required to strengthen the evidence on this subject.

Project description:BACKGROUND:Overall reduction of antibiotic use is a widely adopted public health goal. Given evidence that consuming probiotics reduce the incidence, duration and/or severity of certain types of common acute infections, we hypothesized that probiotics are associated with reduced antibiotic use. This systematic review of randomized controlled trials (RCTs) assessed the impact of probiotic supplementation (any strain, dose or duration), compared to placebo, on antibiotic utilization for common, acute infections in otherwise healthy people of all ages. METHODS:We searched 13 electronic databases including MEDLINE, Embase and CENTRAL from inception to 17th January 2017. Backward and forward citation searches were also conducted. Two reviewers independently selected studies for inclusion and extracted study data. We assessed risk of bias for individual studies using criteria adapted from the Centre for Reviews and Dissemination, and the quality of evidence for each outcome was assessed using the GRADE system. Studies that evaluated similar outcomes were pooled statistically in meta-analyses using a random-effects model. RESULTS:We screened 1533 citations, and of these, 17 RCTs met our predefined inclusion criteria. All 17 were conducted in infants and/or children with a primary aim of preventing acute respiratory tract infections, acute lower digestive tract infections or acute otitis media. Included studies used 13 probiotic formulations, all comprising single or combination Lactobacillus and Bifidobacterium delivered in a range of food or supplement products. Mean duration of probiotic supplementation ranged from 4 days to 9 months. Trial quality was variable. Meta-analysis demonstrated that infants and children who received probiotics to prevent acute illnesses had a lower risk of being prescribed antibiotics, relative to those who received placebo (Pooled Relative Risk = 0.71, 95% CI: 0.54-0.94). When restricted to five studies with a low risk of bias, the pooled relative risk was 0.46 (95% CI: 0.23-0.97). Significant statistical heterogeneity was present in effect size estimates, which appeared to be due to one trial which could partly be considered as an outlier. CONCLUSIONS:Probiotics, provided to reduce the risk for common acute infections, may be associated with reduced antibiotic use in infants and children. Additional well-designed studies are needed to substantiate these findings in children and explore similar findings in other population groups.

Project description:BackgroundChlorhexidine gluconate (CHG) bathing of hospitalized patients may have benefit in reducing hospital-acquired bloodstream infections (HABSIs). However, the magnitude of effect, implementation fidelity, and patient-centered outcomes are unclear. In this meta-analysis, we examined the effect of CHG bathing on prevention of HABSIs and assessed fidelity to implementation of this behavioral intervention.MethodsWe undertook a meta-analysis by searching Medline, EMBASE, CINAHL, Scopus, and Cochrane's CENTRAL registry from database inception through January 4, 2019 without language restrictions. We included randomized controlled trials, cluster randomized trials and quasi-experimental studies that evaluated the effect of CHG bathing versus a non-CHG comparator for prevention of HABSIs in any adult healthcare setting. Studies of pediatric patients, of pre-surgical CHG use, or without a non-CHG comparison arm were excluded. Outcomes of this study were HABSIs, patient-centered outcomes, such as patient comfort during the bath, and implementation fidelity assessed through five elements: adherence, exposure or dose, quality of the delivery, participant responsiveness, and program differentiation. Three authors independently extracted data and assessed study quality; a random-effects model was used.ResultsWe included 26 studies with 861,546 patient-days and 5259 HABSIs. CHG bathing markedly reduced the risk of HABSIs (IRR = 0.59, 95% confidence interval [CI]: 0.52-0.68). The effect of CHG bathing was consistent within subgroups: randomized (0.67, 95% CI: 0.53-0.85) vs. non-randomized studies (0.54, 95% CI: 0.44-0.65), bundled (0.66, 95% CI: 0.62-0.70) vs. non-bundled interventions (0.51, 95% CI: 0.39-0.68), CHG impregnated wipes (0.63, 95% CI: 0.55-0.73) vs. CHG solution (0.41, 95% CI: 0.26-0.64), and intensive care unit (ICU) (0.58, 95% CI: 0.49-0.68) vs. non-ICU settings (0.56, 95% CI: 0.38-0.83). Only three studies reported all five measures of fidelity, and ten studies did not report any patient-centered outcomes.ConclusionsPatient bathing with CHG significantly reduced the incidence of HABSIs in both ICU and non-ICU settings. Many studies did not report fidelity to the intervention or patient-centered outcomes. For sustainability and replicability essential for effective implementation, fidelity assessment that goes beyond whether a patient received an intervention or not should be standard practice particularly for complex behavioral interventions such as CHG bathing.Trial registrationStudy registration with PROSPERO CRD42015032523 .

Dataset Information

Does copper treatment of commonly touched surfaces reduce healthcare-acquired infections? A systematic review and meta-analysis.

Background

Aim

Methods

Findings

Conclusion

Publications

Does copper treatment of commonly touched surfaces reduce healthcare-acquired infections? A systematic review and meta-analysis.

Similar Datasets

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