Risk factors on healthcare-associated infections among tuberculosis hospitalized patients in China from 2001 to 2020: a systematic review and meta-analysis.

BACKGROUND: China has been still suffering from high burden attributable to tuberculosis (TB) and healthcare-associated infections (HAIs). TB patients are at high risk to get HAIs. Evidence-based guidelines or regulations to constrain the rising HAIs among TB hospitalized patients are needed in China. The aim of this systematic review and meta-analysis is to investigate the risk factors associated with HAIs among TB hospitalized patients in Chinese hospitals. METHODS: Medline, EMBASE and Chinese Journals Online databases were searched. The search was limited to studies published from January 1st 2001 to December 31st 2020. Meta-analyses of ORs of the risk factors between patients with HAIs and patients without HAIs among TB hospitalized patients were estimated. Heterogeneity among studies was assessed based on the [Formula: see text]2 and I2 statistics to select the meta-analysis model. Review Manager 5.3 was employed and P < 0.05 was considered as statistical significance. RESULTS: 851 records were filtered from the databases, of which 11 studies were included in the quantitative meta-analysis. A total of 11,922 TB patients were included in the systematic review and meta-analysis, of which 1133 were diagnosed as having HAIs. Age older than 60 years (OR: 2.89 [2.01-4.15]), complications (OR: 3.28 [2.10-5.13]), diabetes mellitus (OR: 1.63 [1.22-2.19]), invasive procedure (OR: 3.80 [2.25-6.42]), longer than 15 hospitalization days (OR: 2.09 [1.64-2.64]), secondary tuberculosis (OR: 2.25 [1.48-3.42]), smoking (OR: 1.40[1.02-1.93]), underlying disease (OR: 2.66 [1.53-4.62]), and use of antibiotics (OR: 2.77 [2.35-3.27]) were the main risk factors associated with HAIs among TB hospitalized patients with a statistical significance (P < 0.05). CONCLUSIONS: Age older than 60 years, presence of complications, presence of diabetes mellitus, invasive procedure, longer than 15 hospitalization days, secondary tuberculosis, smoking, presence of underlying disease, and use of antibiotics were the main risk factors which had a negative impact on HAIs among TB hospitalized patients in Chinese hospitals. These findings provided evidence for policy makers and hospital managers to make effective infection prevention and control measures to constrain the rising HAIs. It is also required that more cost-effective infection prevention and control measures should be widely applied in routinely medical treatment and clinical management to reduce the occurrence of HAIs among TB hospitalized patients.

Estimating the Direct Medical Economic Burden of Health Care-Associated Infections in Public Tertiary Hospitals in Hubei Province, China.

This study estimated the attributable direct medical economic burden of health care-associated infections (HAIs) in China. Data were extracted from hospitals' information systems. Inpatient cases with HAIs and non-HAIs were grouped by the propensity score matching (PSM) method. Attributable hospitalization expenditures and length of hospital stay were measured to estimate the direct medical economic burden of HAIs. STATA 12.0 was used to conduct descriptive analysis, bivariate χ2 test, paired Z test, PSM ( r = 0.25σ, nearest neighbor 1:1 matching), and logistic regress analysis. The statistically significant level was set at .05. The HAIs group had statistically significant higher expenditures and longer hospitalization stay than the non-HAIs group during 2013 to 2015 ( P < .001). The annual average HAI attributable total expenditure, medicines expenditure, out-of-pocket expenditure, and number of hospitalization days per inpatient were (2015 US$) 6173.02, 2257.98, and 1958.25 and 25 days during 2013 to 2015. The direct medical cost savings was estimated at more than 2015 US$12 billion per year in Chinese tertiary hospitals across the country. The significant attributable direct medical economic burden of HAIs calls for more effective HAI surveillance and better control with appropriate incentives.

Disease development trends for maternal and child health care in Shenzhen, China.

Shenzhen in China has undergone rapid economic development over the years. The purpose of this study was to investigate disease development trends among women and children inpatients in Shenzhen. A maternal and child health care hospital in Futian District was chosen for this retrospective study. The data were collected from 55 246 inpatients' information from 2003 to 2012 and were classified into gynecological and pediatric diseases. Descriptive analysis was conducted with Microsoft Excel 2007. The results showed that the number of inpatients had increased year by year, and the constituents of disease had been substantially changed in the study period. More interventions and large-scale studies are needed to improve maternal and child health care in Shenzhen.