FIGURE 1
Flowchart of Records for Scoping Review for the Role of the Household Environment in the Transmission of Clostridioides difficile Infection
Records Identified Through Database Searches and Gray Literature Searches ( n = 1,320)
Additional Records Identified Through Hand Searching ( n = 10)
Records After Duplicates Removed ( n = 867)
Records Screened ( n = 867)
Records Excluded ( n = 607) Level 1 Screening ( n = 607)
Full Text Articles Assessed for Eligibility ( n = 260)
Full Text Articles Excluded, With Reason ( n = 206) Level 2 Screening ( n = 206) • Not about exposure, contamination, or transmission
in household environment ( n = 199) • No English version available ( n = 7)
Studies Included in Data Extraction ( n = 54)
Articles Excluded During Data Extraction, With Reason ( n = 15) • Animals were assessed in veterinary clinics, pet shops, or public lands ( n = 8) • Food but not in household ( n = 3) • Editorials that did not include outcome data ( n = 2) • Domestic animals were not pets ( n = 1) • Insufficient information specific to C. difficile ( n = 1)
Studies Meeting Inclusion Criteria ( n = 39)
Review Articles Removed From Synthesis of Results ( n = 20) Articles Included in Synthesis ( n = 19)
Methods This scoping review followed guidelines by Arksey and O’Malley (2005) and is reported using the Preferred Reporting Items for Sys- tematic Reviews and Meta-Analysis Exten- sion for Scoping Reviews (PRISMA-ScR) guidelines (Tricco et al., 2018). Prior to beginning the literature search, a protocol was registered in the University of Guelph institutional repository called the Atrium (https://hdl.handle.net/10214/21319). Studies were eligible if they described some aspect of transmission of C. dicile in the
household environment. Studies of humans and domestic animals within the household along with studies of the household environ- ment itself were eligible. Keyword searches included variations of the concepts for “household” and “trans- mission,” in addition to terms for C. dicile . We conducted searches using the following electronic databases through the McLaughlin Library, University of Guelph: CAB Direct, Web of Science(all database option), and CINAHL. We also searched PubMed via NCBI and conducted a search of the gray
literature. Then we searched Google Scholar for dissertation abstracts, government docu- ments, and other reports; only the first 200 citations in Google Scholar were screened for relevance due to the large number of citations identified (Bramer et al., 2017). Hand searching was conducted of the arti- cles’ reference lists where the study popula- tion included all three of the populations of interest. Authors were not contacted to iden- tify additional studies. All searches were conducted by the first author on September 27, October 15, and
9
January/February 2023 • Journal of Environmental Health
Powered by FlippingBook