Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis

Stiller, Andrea; Salm, Florian; Bischoff, Peter; Gastmeier, Petra

We identified 3 613 records and located 17 additional articles through hand-searching and by consulting reference lists. After the removal of 1 129 duplicates, we excluded 2 464 articles that were not relevant to the research question. Applying the inclusion criteria, we screened the remaining 37 full articles assessed for eligibility (Fig. 2) . We excluded 28 studies on the basis of the criteria explained above. Ultimately, we identified a total of nine studies, in which single-patient bedrooms are compared with multiple patient bedrooms or with an open ward design with regard to the patient's acquisition of a healthcare-associated colonization with MDRO or infection with any pathogen. These nine studies examined the infectious outcomes of bacteremia, ventilator associated pneumonia, lower respiratory tract infection, gastrointestinal infection, infection of the eye and urinary tract infections (Table 1) [16] [17] [18] [19] [20] [21] [22] [23] [24] .