Effectiveness of national and subnational infection prevention and control interventions in high-income and upper-middle-income countries: a systematic review

Evidence-based guidance for national infection prevention and control (IPC) programmes is needed to support national and global capacity building to reduce healthcare-associated infection and antimicrobial resistance. This systematic review evaluated the evidence on the effectiveness of IPC interventions implemented at national or sub-national level to inform the development of World Health Organization’s guidelines on the core components of national IPC programmes. CENTRAL, CINAHL, EMBASE, MEDLINE, and WHO IRIS were searched from January 1, 2000 to April 19, 2017. Twenty-nine studies meeting the eligibility criteria were categorised according to intervention type: multimodal; care bundles; policies; and surveillance, monitoring, and feedback. There was evidence of effectiveness in all categories but the best quality evidence was on multimodal interventions and surveillance, monitoring, and feedback. We call for improvements in study design, reporting of research and robust evidence, in particular from low income countries, to strengthen the uptake and international relevance of IPC interventions.