Health care associated infection in Iran a systematic review and meta-analysis

Background and objective: Nosocomial infections are a major worldwide public health problem. These infections are related to a high rate of mortality and morbidity in hospitalized patients. The aim of this meta-analysis survey was to evaluate the prevalence of nosocomial infections among hospitalized patients in Iran. Materials and Methods: We searched Iranian electronic databases (SID, IRANMEDEX, IRANDOC, and MAGIRAN) and MEDLINE for studies that were related to nosocomial infections in Iran. Random effect meta-analysis was applied to pool the prevalence of nosocomial infections as well as the frequency of bacterial pathogens. Data has been interpreted considering, rate of nosocomial infections, frequency of nosocomial pathogens and type of nosocomial infections. Findings: Twenty eight studies from 1997 to 2011, involving 22775 patients were included in the analysis. Among them, 3267 patients (28.8%) were infected by nosocomial pathogens (CI 95%: 23.8%-33.7%). Burn wound infections were the most prevalence infection (53.2%) followed by respiratory infection (49.5%), bacteremia (20.7%), Urinary tract infection (19.7%), and surgical wound infections (15.2%). Among nosocomial pathogens, acinetobacterspp (22%) was the most frequent pathogen followed by staphylococcus aurous (21.3%), Klebsiella spp. (20.4%), E.coli (20.3%) and pseudomonas aeruginosa (20.2%). Conclusion: According to the results of this meta-analysis, the prevalence of nosocomial infections was high; therefore an intervention program for control of hospital acquired infections across Iran is needed.