Health Care-Associated Infection Prevalence Among Grade a Tertiary Hospitals in China: A Meta-Analysis


      To assess the prevalence of health care-associated infection (HAI) in 2012 among grade A hospitals in China.


      Literatures were searched from PubMed, EMBASE, Cochrane Library, CNKI, cqvip, WANFANG, and SinoMed from Jan. 2012 to Mar. 2014. Literatures were screened and data was extracted by two independent reviewers, separately. Meta-analyses were conducted by R3.0.3 with random effect models.


      Fifty studies with 91,763 patients met the inclusion criteria and were included. The overall prevalence rate of HAI among all studies was 3.4% (95% CI: 3.1%-3.8%). Among the 50 studies, 25 were performed in Grade A tertiary hospitals and the rest 25 in grade A level 2 hospitals. The 25 studies performed in Grade A tertiary hospitals including 26,700 participants reported the pooled HAI prevalence as 3.5% (95% CI: 3.0%-4.1%). The aggregated HAI prevalence of the other 25 studies with 65,063 patients in grade A level 2 hospitals was 3.2% (95% CI: 2.7%-3.8%), which was not significantly different from that in Grade A tertiary hospitals (P=0.32). In the analyses of different infection sites, 18 studies targeting at lower respiratory infection (19,035 participants) revealed the highest combined constituent ratio as 46.6% (95% CI: 40.1%-52.3%). The pooled constituent ratio of 17 studies targeting at urinary system infection (19,949 participants) was 16.1% (95% CI: 11.5%-22.1%) and that of 19 studies targeting at upper respiratory infection (20,924 participants) was 15.2% (95% CI: 11.2%-20.2%). In the analyses of antibiotics using, 18 studies were identified (19,090 participants) in grade A tertiary hospitals and revealed pooled antibiotics using ratio as 42.96% (95% CI: 38.3%-47.8%).


      The aggregated prevalence rate of HAI was 3.4% across all general hospitals. The pooled prevalence rate among grade A tertiary hospitals and grade A level 2 hospitals showed no significant difference. Among all infection sites, lower respiratory infection accounts for the highest proportion.