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Association between universal gloving and healthcare-associated infections: A systematic literature review and meta-analysis

  • Nai-Chung N. Chang (a1) (a2) (a3), Ashley E. Kates (a4) (a5), Melissa A. Ward (a6), Elizabeth J. Kiscaden (a7), Heather Schacht Reisinger (a2) (a6), Eli N. Perencevich (a2) (a6), Marin L. Schweizer (a1) (a2) (a6) and for the CDC Prevention Epicenters Program (a6)...

Abstract

Objective:

Healthcare-associated infections (HAIs) are a significant burden on healthcare facilities. Universal gloving is a horizontal intervention to prevent transmission of pathogens that cause HAI. In this meta-analysis, we aimed to identify whether implementation of universal gloving is associated with decreased incidence of HAI in clinical settings.

Methods:

A systematic literature search was conducted to find all relevant publications using search terms for universal gloving and HAIs. Pooled incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using random effects models. Heterogeneity was evaluated using the Woolf test and the I2 test.

Results:

In total, 8 studies were included. These studies were moderately to substantially heterogeneous (I2 = 59%) and had varied results. Stratified analyses showed a nonsignificant association between universal gloving and incidence of methicillin-resistant Staphylococcus aureus (MRSA; pooled IRR, 0.94; 95% CI, 0.79–1.11) and vancomycin-resistant enterococci (VRE; pooled IRR, 0.94; 95% CI, 0.69–1.28). Studies that implemented universal gloving alone showed a significant association with decreased incidence of HAI (IRR, 0.77; 95% CI, 0.67–0.89), but studies implementing universal gloving as part of intervention bundles showed no significant association with incidence of HAI (IRR, 0.95; 95% CI, 0.86–1.05).

Conclusions:

Universal gloving may be associated with a small protective effect against HAI. Despite limited data, universal gloving may be considered in high-risk settings, such as pediatric intensive care units. Further research should be performed to determine the effects of universal gloving on a broader range of pathogens, including gram-negative pathogens.

Copyright

Corresponding author

Author for correspondence: Marin L. Schweizer, Email: Marin-schweizer@uiowa.edu

Footnotes

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PREVIOUS PRESENTATION. This study was presented in part as an abstract at the European Congress for Clinical Microbiology and Infectious Diseases (ECCMID) Conference on April 11, 2016, in Amsterdam, Netherlands. Chang NN, Kates AE, Ward MA, Kiscaden E, Reisinger HS, Perencevich EN, Edmond M, Schweizer ML. “Association between universal glove use, MDRO acquisition and healthcare-associated infections: a meta-analysis.”

Footnotes

References

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