Infection prevention and control in cystic fibrosis: An update of a systematic review of interventions

Nicola J Rowbotham; Sherie Smith; Nikki Jahnke; Sarah Milczanowski; Zoe C Elliott; Andrew P Prayle; Alan R Smyth

doi:10.1016/j.jcf.2024.08.004

Infection prevention and control in cystic fibrosis: An update of a systematic review of interventions

J Cyst Fibros. 2024 Aug 27:S1569-1993(24)00830-0. doi: 10.1016/j.jcf.2024.08.004. Online ahead of print.

Authors

Nicola J Rowbotham¹, Sherie Smith², Nikki Jahnke², Sarah Milczanowski³, Zoe C Elliott⁴, Andrew P Prayle⁵, Alan R Smyth⁶

Affiliations

¹ Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK. Electronic address: nicola.rowbotham@nottingham.ac.uk.
² Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.
³ Person with CF, Bradford, UK.
⁴ Parent of children with CF, Nottingham, UK.
⁵ Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK; Nottingham Biomedical Research Centre and School of Medicine, University of Nottingham, Nottingham, UK.
⁶ Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK; Nottingham Biomedical Research Centre and School of Medicine, University of Nottingham, Nottingham, UK; School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK.

PMID: 39198075
DOI: 10.1016/j.jcf.2024.08.004

Abstract

Preventing transmissible infection is a priority in cystic fibrosis (CF) care. This is an update of a systematic review of the evidence for infection prevention and control interventions in CF. Our full protocol can be found on PROSPERO (CRD42018109999). We searched for studies and guidelines which included interventions for infection prevention and control in CF. We included 39 studies and 7 guidelines. Strategies included: cohort or individual segregation, hand hygiene, facemasks, equipment, enhanced adherence or a combination of these. Many studies showed a reduction in transmission with segregation. However, the certainty of evidence (using GRADE) was low or very low. Most guideline recommendations have little evidence to support them, with no updates since our original review. Undertaking RCTs in this area is ethically difficult. Large-scale registry-based studies may be the best pragmatic approach. Benefits of infection control must be balanced against the intrusion in the lives of people with CF.

Keywords: Cystic fibrosis; Evidence based medicine; Facemasks; Infection control; Infection prevention; Segregation; Systematic review.