10 janvier 2024

Faiblesse des travaux publiés sur les risques infectieux lors de soins de ville et leur prévention

Interventions for preventing or controlling healthcare-associated infection amongst healthcare workers or patients within primary care facilities: a scoping review

Background. This review aimed to synthesize the evidence on infection prevention and control (IPC) interventions for the prevention of healthcare-associated infection (HAI) amongst healthcare workers (HCW) or patients within primary care facilities. Methods. PubMed, CINAHL, EMBASE and CENTRAL databases were searched for quantitative studies published between 2011-2022. Study selection, data extraction and quality assessment using Cochrane and Joanna Briggs tools, were conducted by independent review with additional sensitivity checking performed on study selection. Results. Four studies were included. A randomized trial and a cross-sectional survey, respectively, found no statistical difference in laboratory-confirmed influenza in HCW wearing N95 versus medical masks (p=0.18) and a significant inverse association between the implementation of tuberculosis (TB) control measures and TB incidence (p=0.02). For the prevention of surgical site infections following minor surgery, randomized trials found non-sterile gloves (8.7%; 95% CI, 4.9%-12.6%) to be non-inferior to sterile gloves (9.3%; 95% CI, 7.4%-11.1%) and no significant difference between prophylactic antibiotics compared to placebo (p=0.064). All studies had a high risk of bias. Conclusion. Evidence for IPC interventions for prevention of HAI in primary care is very limited and insufficient to make practice recommendations. Nevertheless, the findings highlight the need for future research.

Gozdzielewska L, Kc D, Butcher J, et al. Am J Infect Control 2023:S0196-6553(23)00768-X. Doi : 10.1016/j.ajic.2023.10.011. Online ahead of print.