Effect of pocket irrigation with antimicrobial on prevention of pacemaker pocket infection: a meta-analysis.
Effect of pocket irrigation with antimicrobial on prevention of pacemaker pocket infection: a meta-analysis.
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抗菌药物袋冲洗对预防起搏器袋感染的效果：荟萃分析
DOI：
10.1186/s12872-017-0689-9
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发表时间：
2017-09-30
影响因子：
2.1
通讯作者：
Wang JF
中科院分区：
文献类型：
--
作者：
Kang FG;Liu PJ;Liang LY;Lin YQ;Xie SL;He Y;Liang BS;Zhang HF;Chen YX;Wang JF
背景心脏植入电子设备（CIED）袋感染的存在很难治疗，会导致严重的临床后果，但对其预防知之甚少。一些研究的结果表明，袖珍灌溉可以减少感染，而其他研究则显示出相互矛盾的结果。我们通过荟萃分析方法汇总了口袋冲洗对预防口袋感染的效果。方法主要通过计算机检索PubMed、Cochrane、EMBASE、Web of Science、Chinese BioMedical、Global Health和BIOSIS Previews数据库检索2017年6月之前发表的相关研究。汇总相对比 (RR) 和 95% 置信区间 (95% CI) 的估计值。根据影响效果的潜在关键因素进行亚组分析，并通过荟萃回归得到证实。还进行了敏感性分析和发表偏倚测试。结果我们确定了 10 项研究，提供了 5467 名接受 CIED 植入的患者的数据。药物组和盐水冲洗组的合并感染率分别为 1.48% 和 3.49%。 Meta分析显示，药物冲洗对口袋感染具有保护作用（RR = 0.44，95% CI：0.31-0.63）。亚组分析表明，抗生素而非非抗生素（防腐剂）发挥了保护作用。一线和二线抗生素针对袋状感染的主要病原体金黄色葡萄球菌均有效（一线和二线治疗分别为 RR = 0.42, 95% CI: 0.24-0.75 和 RR = 0.34, 95% CI: 0.20-0.58）。元回归显示，灌溉药物的区域和类别完全解释了研究之间的差异，并暗示区域的影响被药物类型掩盖。敏感性分析未显示结果有任何显着变化，发表偏倚无统计学意义。结论抗生素袋冲洗可有效减少袋感染，应鼓励在CIED植入中使用。
BackgroundThe presence of cardiac implantable electronic devices (CIEDs) pocket infection is difficult to treat, causing serious clinical outcomes, but little is known for prevention. Results from some studies suggested that pocket irrigation could reduce infection while others showed conflicting results. We pooled the effects of pocket irrigations on the prevention of pocket infection by meta-analysis methods.MethodRelevant studies published before June, 2017 were retrieved mainly by the computer-based search of PubMed, Cochrane, EMBASE, Web of Science, Chinese BioMedical, Global Health and BIOSIS Previews databases. Estimations of relative ratios (RRs) and 95% confidence intervals (95% CIs) were pooled. Subgroup analyses according to potential key factors affecting the effects were conducted, which was confirmed by meta-regression. Sensitivity analysis and test for publication bias were also performed.ResultsWe identified 10 studies providing data of 5467 patients receiving CIEDs implantations. Pooled infection rates were 1.48 and 3.49% respectively for medication and saline irrigation groups. Meta-analysis showed that medication irrigation conferred protection to pocket infection (RR = 0.44, 95% CI: 0.31-0.63). Subgroup analysis showed that antibiotics, rather than non-antibiotics (antiseptics) exerting the protection. The first and second lines antibiotics againststaphylococcus aureus, which is the main pathogen for pocket infection, were both effective (RR = 0.42, 95% CI: 0.24-0.75 and RR = 0.34, 95% CI: 0.20-0.58 respectively for first line and second line therapies). Meta-regression revealed that region and class of irrigation medication completely explained the variance among studies and implied that effects of region were masked by medication types. Sensitivity analysis did not showed any significant change of the result and publication bias were not statistical significance.ConclusionPocket irrigation with antibiotics were effective for reducing pocket infection and should be encouraged in CIEDs implantation.
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DOI：
10.1111/j.1540-8159.2010.02931.x
发表时间：
2011-02-01
影响因子：
1.8
作者：
Bloom, Heather L.;Constantin, Luis;Sohail, Muhammad R.
通讯作者：
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影响因子：
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作者：
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Thompson, SG
影响因子：
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作者：
Lai, KK;Fontecchio, SA
通讯作者：
Fontecchio, SA