Appendix. C difficile in Neonatal Intensive Care Unit Patients: A Systematic Review
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Table 1. MEDLINE® Search Strategy
| # | Search History | Results |
|---|---|---|
| 1 | exp Clostridium difficile/ | 6,719 |
| 2 | exp Intensive Care Units, Neonatal/ or exp Intensive Care, Neonatal/ | 15,068 |
| 3 | exp Infant, Newborn/ | 541,022 |
| 4 | 2 or 3 | 542,198 |
| 5 | 1 and 4 | 152 |
| 6 | limit 5 to (English language and humans) | 139 |
Order of search, Medline search terms, and number of results for each search.
Table 2. EMBASE® Search Strategy
| # | Search History | Results |
|---|---|---|
| 1 | ‘clostridium difficile’/exp or ‘clostridium difficile infection’/exp | 9,594 |
| 2 | ‘newborn’/exp or ‘newborn intensive care’/exp | 351,852 |
| 3 | 1 and 2 | 68 |
| 4 | Limit 3 to (English language and humans and EMBASE®) | 59 |
Order of search, EMBASE search terms, and number of results for each search
Table 3. Cochrane Library Search Strategy
| # | Search History | Results |
|---|---|---|
| 1 | MeSH descriptor Clostridium difficile explode all trees | 186 |
| 2 | MeSH descriptor Infant, Newborn explode all trees | 14,329 |
| 3 | MeSH descriptor Intensive Care Units, Neonatal explode all trees | 559 |
| 4 | MeSH descriptor Intensive Care, Neonatal explode all trees | 307 |
| 5 | 2 or 3 or 4 | 14,370 |
| 6 | 1 and 5 | 1 |
Order of search, Cochrane Library search terms, and number of results for each search
Table 4. CINAHL® Search Strategy
| # | Search History | Results |
|---|---|---|
| 1 | (MH “Infant, Newborn+”) or (MH “Intensive Care Units, Neonatal”) or (MH “Intensive Care, Neonatal+”) | 72,510 |
| 2 | MH “Clostridium Difficile” | 1,525 |
| 3 | 1 and 2 | 17 |
| 4 | Limit 3 to (English language; exclude MEDLINE records) | 2 |
Order of search, CINAHL search terms, and number of results for each search
2. Study Exclusion Criteria
- Meeting abstract only
- No full text available
- Not in English
- Not primary research
- Examines fewer than 10 C. difficile-infected infants
- Majority of study population not comprised of infants in NICUs
- Mixed patient population and study does not include subanalysis of NICU patients
- Only describes methods for surveillance of healthcare-associated infections
- Study conducted outside the US and only describes epidemiology of C. difficile
- Only describes molecular biology of C. difficile
- Only describes molecular epidemiology of C. difficile without any clinical information
- Does not include comparison group (e.g., case series of C. difficile infection)
- Does not provide a clear description of the intervention(s) and statistical analysis that compares time points before and after intervention
- Not relevant to any Question
- Question A: What clinical, demographic, or other criteria have been shown to prompt diagnostic testing for difficile that results in identifying symptomatic C. difficile-infected NICU patients?
- Question B: What tests or sequence of tests for C. difficile perform best in detecting CDI among NICU patients?
- Question C: What is the significance of a positive C. difficile test in NICU patients?
- Addresses Key Question B but does not report test performance characteristics (sensitivity, specificity, positive predictive value, negative predictive value) or data that could be used to calculate these performance characteristics
Page last reviewed: December 27, 2018