Infection prevention and control in cystic fibrosis: a systematic review of interventions

Rowbotham, Nicola J.; Palser, Sally C.; Smith, Sherie J.; Smyth, Alan R.

Abstract

Introduction: Cystic fibrosis is a life-limiting genetic condition characterized by recurrent pulmonary infection. Acquisition of infection can occur from environmental reservoirs, person-to-person transmission and from the healthcare environment. Primary prevention of infections through infection prevention and control measures is an important strategy in cystic fibrosis care.

Areas covered: Here we present a systematic review of the evidence base around infection prevention and control in cystic fibrosis. We found 36 studies and 7 guidelines that met our inclusion criteria. Strategies covered include cohort segregation, individual segregation, hand hygiene, facemasks, combination strategies, equipment strategies, and adherence. Quality of evidence overall was deemed low or very low. Most guideline recommendations have little or no evidence to support them.

Expert opinion: Although low quality, there is an abundance of evidence suggesting segregation is beneficial in reducing pathogen spread. Undertaking high-quality studies may, therefore, be ethically challenging. Large-scale registry studies may provide a better strategy for answering questions on the efficacy of infection control policy. With the rise of antibiotic resistance, effective eradication of cystic fibrosis pathogens is becoming more difficult so primary prevention through infection control will become increasingly important over the coming years.

Citation

Rowbotham, N. J., Palser, S. C., Smith, S. J., & Smyth, A. R. (2019). Infection prevention and control in cystic fibrosis: a systematic review of interventions. Expert Review of Respiratory Medicine, 13(5), 425-434. https://doi.org/10.1080/17476348.2019.1595594

• Journal Article Type: Article
• Acceptance Date: Mar 12, 2019
• Online Publication Date: Mar 20, 2019
• Publication Date: Mar 26, 2019
• Deposit Date: Mar 28, 2019
• Publicly Available Date: May 10, 2019
• Journal: Expert Review of Respiratory Medicine
• Print ISSN: 1747-6348
• Electronic ISSN: 1747-6356
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 5
• Pages: 425-434
• DOI: https://doi.org/10.1080/17476348.2019.1595594
• Keywords: Immunology and Allergy; Public Health, Environmental and Occupational Health; Pulmonary and Respiratory Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/1697271
• Publisher URL: https://www.tandfonline.com/doi/abs/10.1080/17476348.2019.1595594
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ierx20; Received: 2018-12-20; Accepted: 2019-03-12; Published: 2019-03-20