How we made the decision

We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance 4 years after the publication of healthcare-associated infections (2012) NICE guideline CG139.

For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in 'Developing NICE guidelines: the manual'.

Previous surveillance update decisions for the guideline are on our website.

New evidence

We found 38 new studies in a search for randomised controlled trials and systematic reviews published between 14 April 2014 and 01 April 2016. We also considered 1 additional study identified by members of the guideline committee who originally worked on this guideline. A further 3 studies were identified through post-publication communications.

Evidence identified in a previous surveillance and an evidence update 2 years after publication of the guideline was also considered. This included 6 studies identified by search.

From all sources, 48 studies were considered to be relevant to the guideline.

We also checked for relevant ongoing research, which will be evaluated again at the next surveillance review of the guideline.

See appendix A: summary of new evidence from surveillance and references for all new evidence considered.

Views of topic experts

We considered the views of topic experts, including those who helped to develop the guideline and other correspondence we have received since the publication of the guideline.

Views of stakeholders

Stakeholders commented on the decision not to update the guideline and to transfer the guideline to the static list. Overall, 11 stakeholders commented. See appendix B for stakeholders' comments and our responses.

Eleven stakeholders commented on the proposal not to update the guideline and to transfer the guideline to the static list. Four agreed with the decision or did not make a specific comment, 1 requested a footnote to be added and 6 disagreed. The reasons stakeholders did not agree with the proposal of the guideline not being updated related to:

  • evidence from hospital settings, which is outside the remit of this guideline and is covered by the epic3 guidelines

  • other NICE guidance or evidence from outside the search dates of this surveillance review, which was considered during previous surveillance reviews.

Stakeholders also raised that gram-negative organisms should be included in the guideline as well as Clostridium difficile; however, Clostridium difficile is only an example in the recommendations, and therefore the guideline is not specific to that organism.

One stakeholder queried the rationale of transferring the guideline to the static list given the importance of the area. However, no evidence was identified that would impact on the current guidance and no major ongoing studies or research have been identified as due to be published in the near future. Six stakeholders agreed with the proposal to transfer the guideline to the static list, 4 stakeholders did not agree citing the same reasons as that for not updating the guideline. No new ongoing or published studies were identified by the consultees. Four stakeholders disagreed with the decision to remove 3 of the research recommendations from the NICE version of the guideline and NICE research database; therefore, these recommendations will be retained.

See ensuring that published guidelines are current and accurate in 'Developing NICE guidelines: the manual' for more details on our consultation processes.

NICE Surveillance programme project team

Sarah Willett
Associate Director

Philip Alderson
Consultant Clinical Adviser

Katrina Sparrow
Technical Adviser

Andrea Juliana Sanabria
Technical Analyst

The NICE project team would like to thank the topic experts who participated in the surveillance process.

ISBN: 978-1-4731-2159-1

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