[Distribution of the of nosocomial infection pathogens among general hospital in China: a Meta analysis].

Objective: To provide basic and direction for nosocomial infection prevention and control through evaluation the distribution of nosocomial infection pathogens and understand current situation of pathogens among general hospital in China.

Methods: Articles were searched and collected from CBM, CNKI,VIP database and Wanfang database published between creating database to March. 2013 about investigation of nosocomial infection. Those literatures were screened and extracted according to the inclusion and exclusion criteria by two reviewers independently. The analysis of pathogens distribution was performed by using comprehensive Meta analysis software and stratified by factor as year, hospital level and region of the study. The distribution rate of different pathogens were merged according to statistical tests for the heterogeneity test.

Results: The 345 trials were included. The results show 1)the pooled distribution rates of common pathogens in 1987-2000 were as follows:18.6% (95% CI:13.7%-24.9%), 18.1% (95% CI:15.4%-21.0%), 14.8% (95% CI: 12.2%-17.9%), 5.2% (95%CI:4.1%-6.6%) for Fungus, Staphylococcus, Pseudomonas, and Klebsiella respectively;the pooled rates of common pathogens in 2001-2012 were as follows:17.6% (95% CI: 16.4%-18.8%), 15.0% (95% CI:14.2%-15.8%), 13.9% (95% CI:13.1%-14.7%), 10.4% (95% CI: 9.9%-11.0%)for Fungus, Staphylococcus, Pseudomonas, and Klebsiella respectively. 2)The pooled distribution rates of pathogens in second and below grade hospital were 3.2% (95%CI:0.3%-29.9%), 4.7% (95% CI:3.4%-6.3%), 7.2% (95% CI:1.7%-26.1%)for Mycoplasma, Shigella and Alkaligenes respectively;the pooled distribution rates of pathogens in third grade hospital were 1.1% (95% CI: 0.1%-15.4%), 1.8% (95%CI:0.6%-5.1%), 4.3% (95%CI:2.3%-8.0%)for Mycoplasma, Shigella and Alkaligenes respectively. 3)The pooled rate of Mycoplasma for Yangtze River Economic Area was 14.3% (95%CI:2.0%-58.1%)and for Southwest Economic Area was 0.3% (95%CI:0.1%-1.1%). The pooled rate of Corynebacterium for Yangtze River Economic Area was 0.4% (95%CI:0.1%-1.4%)and for Southeast Economic Area was 9.5% (95% CI:2.4%-31.1%). The pooled rate of Haemophilus for Northern Economic Area was 0.5% (95%CI:0.2%-0.9%)and for Southeast Economic Area was 9.2% (95% CI:7.3%-11.6%). The pooled rate of Salmonella for Yangtze River Economic Area was 6.3% (95% CI:4.6%-8.6% ) and for Southeast Economic Area was 0.4% (95% CI:0.1%-3.0% ).

Conclusion: The common nosocomial infection pathogens were Fungus, Staphylococcus, Pseudomonas and Escherichia among general hospitals in China. A remarkable note is that Klebsiella was increased significantly in recent years and becomes one of the most common pathogens. There were differences in the distribution rate of nosocomial infection pathogens among general hospitals between levels and regions in China.