METHODS: This systematic review assessed 60 studies from 2018 to 2023 in PubMed, which used key words related to EAIs. Adherence to reporting data elements that may bias reporting, including the use of standardized rates of infections per 1,000 patient days, describing the use of antimicrobial prophylaxis, infection control, and culture practices, describing the definitions for infection by site, and listing pathogens by infection site were evaluated by study.
RESULTS: Our review revealed considerable heterogeneity in data elements and infection definitions. While 51 (85%) studies reported definition by site, only 17 (28%) reported infection control practices, and only 5 (8%) studies adhered to all the identified essential reporting elements. Variation in infection rates was also evident across the definitions, with studies using their own definition having the greatest variability in reported infection rates. Microbiological differences by geographic region further underscored the need for standardized reporting and challenges with generalizability in the EAI literature.
CONCLUSIONS: Our findings underscore the imperative for consensus on ECMO infection definitions and transparent reporting practices to facilitate meaningful comparisons and advance patient care protocols.
方法:这项系统评价评估了PubMed2018年至2023年的60项研究,这些研究使用了与ECMO相关感染相关的关键词。坚持报告数据元素,可能会导致报告偏差,包括使用每1000个患者天的标准化感染率,描述抗菌预防的使用,感染控制,和文化实践,描述按部位划分的感染定义,并通过研究评估了按感染部位列出的病原体。
结果:我们的综述揭示了数据元素和感染定义的显著异质性。虽然51项(85%)研究报告了按地点划分的定义,只有17个(28%)报告了感染控制措施,只有6项(8%)研究符合所有已确定的基本报告要素.在定义中,感染率的变化也很明显,使用自己定义的研究在报告的感染率中具有最大的变异性。地理区域的微生物学差异进一步强调了标准化报告的必要性,以及在ECMO相关感染文献中具有普遍性的挑战。
结论:我们的研究结果强调必须就ECMO感染定义和透明的报告实践达成共识,以促进有意义的比较和推进患者护理方案。