title: Protective isolation precautions for the prevention of nosocomial colonisation and infection in burn patients: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the impact of protective isolation precautions on nosocomial colonisation and infection rates in burn patients.
  
  
  METHODS
  A systematic review and meta-analysis were performed of studies identified through Pubmed and Web of Science. Only articles in English were considered. The Downs and Black tool was used to evaluate their methodological quality. Random-effects meta-analysis obtained pooled risk ratios (RRs) and 95% confidence intervals (CIs) of nosocomial colonisation and infection rates.
  
  
  RESULTS
  Five eligible before-after studies were identified, encompassing a total of 3033 patients (1192 in the experimental group; 1841 in the control group). Varying protective isolation precautions were investigated, resulting in high clinical heterogeneity. Quality assessment revealed overall poor methodological quality. Protective isolation significantly reduces combined colonisation and infection rates compared to baseline care (RR 0.52, 95% CI 0.40-0.69; P<0.0001). Subgroup analyses indicated significant reductions in both nosocomial colonisation (RR 0.65, 95% CI 0.51-0.83; P=0.02) and infection rates (RR 0.53, 95% CI 0.49-0.58; P<0.0001).
  
  
  CONCLUSIONS
  Protective isolation precautions appear to decrease the risk of colonization and infection in burn patients. Because of the absence of higher quality study designs, clinical heterogeneity and the small number of studies involved, these results must be interpreted cautiously.
authors.affiliation: Faculty of Medicine & Health Science, Ghent University, Ghent, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Raes
authors.affiliation: Faculty of Medicine & Health Science, Ghent University, Ghent, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Blot
authors.affiliation: Faculty of Medicine & Health Science, Ghent University, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Vogelaers
authors.affiliation: Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium.
authors.forename: Sonia
authors.initials: S
authors.lastname: Labeau
authors.affiliation: Faculty of Medicine & Health Science, Ghent University, Ghent, Belgium; Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium; Burns Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia. Electronic address: Stijn.Blot@UGent.be.
authors.forename: Stijn
authors.initials: S
authors.lastname: Blot
mesh_terms: D002056:Burns / Q000150:complications / Q000451:nursing*; D003428:Cross Infection / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards; D010356:Patient Isolation / Q000379:methods* / Q000592:standards
keywords: Burn patient; Colonisation; Infection; Meta-analysis; Nosocomial; Prevention; Protective isolation precautions; Systematic review