Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis,Expert Review of Anti-infective Therapy

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Associations of infection control measures and norovirus outbreak outcomes in healthcare settings: a systematic review and meta-analysis
Expert Review of Anti-infective Therapy ( IF 4.2 ) Pub Date : 2021-08-04 , DOI: 10.1080/14787210.2021.1949985
Carly Adams ₁ , Shenita R Peterson ₂ , Aron J Hall ₃ , Umesh Parashar ₃ , Benjamin A Lopman ₁

Affiliation

ABSTRACT

Background

Although most norovirus outbreaks in high-income countries occur in healthcare facilities, information on associations between control measures and outbreak outcomes in these settings is lacking.

Methods

We conducted a systematic review/meta-analysis to assess associations between norovirus outbreak control measures and outcomes in hospitals and long-term care facilities (LTCFs), globally. Using regression analyses stratified by setting (hospital/LTCF), we compared durations, attack rates, and case counts for outbreaks in which control measures were reportedly implemented to those in which they were not.

Results

We identified 102 papers describing 162 norovirus outbreaks. Control measures were reportedly implemented in 118 (73%) outbreaks and were associated with 0.6 (95% CI: 0.3–1.1) times smaller patient case counts and 0.7 (95% CI: 0.4, 1.0) times shorter durations in hospitals but 1.5 (95% CI: 1.1-2.2), 1.5 (95% CI: 1.0–2.1) and 1.6 (95% CI: 1.0–2.6) times larger overall, resident and staff case counts, respectively, and 1.4 (95% CI: 1.0–2.0) times longer durations in LTCFs.

Conclusions

Reported implementation of control measures was associated with smaller/shorter outbreaks in hospitals but larger/longer outbreaks in LTCFs. Control measures were likely implemented in response to larger/longer outbreaks in LTCFs, rather than causing them. Prospective observational or intervention studies are needed to determine effectiveness.

中文翻译：

医疗机构中感染控制措施与诺如病毒爆发结果的关联：系统评价和荟萃分析

摘要

背景

尽管高收入国家的大多数诺如病毒暴发发生在医疗机构，但缺乏关于这些环境中控制措施与暴发结果之间关联的信息。

方法

我们进行了系统评价/荟萃分析，以评估诺如病毒爆发控制措施与全球医院和长期护理机构 (LTCF) 的结果之间的关联。使用按设置（医院/LTCF）分层的回归分析，我们比较了据报道已实施控制措施与未实施控制措施的暴发的持续时间、发病率和病例数。

结果

我们确定了 102 篇描述 162 次诺如病毒爆发的论文。据报道，在 118 次 (73%) 暴发中实施了控制措施，并与 0.6 (95% CI: 0.3–1.1) 倍的患者病例数和 0.7 (95% CI: 0.4, 1.0) 倍的医院持续时间缩短但 1.5 ( 95% CI: 1.1-2.2)、1.5 (95% CI: 1.0–2.1) 和 1.6 (95% CI: 1.0–2.6) 倍于总体、居民和工作人员病例数，分别为 1.4 (95% CI: 1.0) –2.0) 倍 LTCF 中更长的持续时间。