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

Infect Control Hosp Epidemiol. 2019 Jul;40(7):755-760. doi: 10.1017/ice.2019.123. Epub 2019 May 17.

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.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Systematic Review

MeSH terms

  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Gloves, Protective / statistics & numerical data*
  • Gram-Positive Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / prevention & control*
  • Humans
  • Infection Control / methods*
  • Intensive Care Units, Pediatric
  • Methicillin-Resistant Staphylococcus aureus
  • Randomized Controlled Trials as Topic
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / prevention & control*
  • Vancomycin-Resistant Enterococci