BACKGROUND Immunocompromised patients are at increased risk of acquiring healthcare-associated infections (HAIs) and often require specialized models of care. Surveillance of HAIs is essential for effective infection-prevention programmes. However, little is known regarding standardized or specific surveillance methods currently employed for high-risk hospitalized patients. METHODS A systematic review adopting a narrative synthesis approach of published material between 1 January 2000 and 31 March 2018 was conducted. Publications describing the application of traditional and/or electronic surveillance of HAIs in immunocompromised patient settings were identified from the Ovid MEDLINE®, Ovid Embase® and Elsevier Scopus® search engines [PROSPERO international prospective register of systematic reviews (registration ID: CRD42018093651)]. RESULTS In total, 2708 studies were screened, of whom 17 fulfilled inclusion criteria. Inpatients diagnosed with haematological malignancies were the most-represented immunosuppressed population. The majority of studies described manual HAI surveillance utilizing internationally accepted definitions for infection. Chart review of diagnostic and pathology reports was most commonly employed for case ascertainment. Data linkage of disparate datasets was performed in two studies. The most frequently monitored infections were bloodstream infections and invasive fungal disease. No surveillance programmes applied risk adjustment for reporting surveillance outcomes. CONCLUSIONS Targeted, tailored monitoring of HAIs in high-risk immunocompromised settings is infrequently reported in current hospital surveillance programmes. Standardized surveillance frameworks, including risk adjustment and timely data dissemination, are required to adequately support infection-prevention programmes in these populations.

中文翻译：

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住院免疫功能低下患者医疗保健相关感染监测活动的当前范围：系统综述。

背景技术免疫受损的患者患医疗保健相关感染（HAIs）的风险增加，并且经常需要专门的护理模型。HAIs的监测对于有效的预防感染计划至关重要。但是，对于目前用于高危住院患者的标准化或特殊监测方法知之甚少。方法在2000年1月1日至2018年3月31日期间，采用发表材料的叙述性综合方法进行了系统评价。可以从OvidMEDLINE®，OvidEmbase®和ElsevierScopus®搜索引擎[PROSPERO国际性系统评价前瞻性注册系统（注册ID：CRD42018093651）]中找到描述描述HAIs在免疫受损患者中的传统和/或电子监视应用的出版物。结果总共筛选了2708项研究，其中17项符合纳入标准。被诊断为血液系统恶性肿瘤的住院患者是免疫抑制最多的人群。大多数研究描述了手动HAI监测，利用国际公认的感染定义。诊断和病理报告的图表审查最常用于确定病例。在两项研究中进行了不同数据集的数据链接。监测最频繁的感染是血流感染和侵袭性真菌病。没有监视程序将风险调整应用于报告监视结果。结论在当前的医院监测计划中，很少有针对性的，针对性的，针对高危免疫功能低下人群的HAIs监测。