Evaluation of the knowledge of hematologists about the management of infectious complications in hematologic patients

Mariana Guarana, Marcio Nucci
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Abstract

Introduction

Infection is a serious complication among patients with hematologic malignancies (HMs) and in hematopoietic cell transplant (HCT) recipients. In most centers, the management of these complications is provided by the hematologist in person, thus demanding a knowledge of basic aspects of infection.

Methods

To evaluate the knowledge of the hematologist on infections, we invited clinicians to answer two questionnaires with 20 multiple-choice questions covering epidemiology, prophylaxis, diagnosis and treatment of infection in patients with HMs and HCT.

Results

We obtained 289 answers: 223 in survey 1 (febrile neutropenia) and 66 in survey 2 (infection in HCT). The median score was 5.0 in both surveys (range 0.5 - 9.0). In survey 1, the questions with the lowest number of correct answers were Q3 (8%), concerning the cefepime dose, and Q1 (9%), which asked about the epidemiologic link between the use of high dose cytarabine and viridans streptococcal bacteremia. In survey 2, two questions about cytomegalovirus (CMV) infection had the lowest percentage of correct answers (Q4, 12% and Q11, 18%). Clinicians attending to HCT recipients had higher scores, compared to clinicians attending to patients with HM only (median score of 5.0 and 4.5, p = 0.03, in survey 1 and 6.0 and 4.5, p = 0.001, in survey 2). In both surveys staff clinicians, residents and professors had similar scores.

Conclusion

This is the first study in Brazil assessing the knowledge of hematologists on infectious complications. The low median score overall indicates an urgent need for continuous education. Such initiatives will eventually result in better patient care.

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评估血液科医生对血液病患者感染性并发症的处理知识。
导言:感染是血液系统恶性肿瘤(HMs)患者和造血细胞移植(HCT)受者的一种严重并发症。在大多数中心,这些并发症都由血液科医生亲自处理,因此需要具备基本的感染知识:为了评估血液科医生对感染的了解程度,我们邀请临床医生回答了两份问卷,其中包含 20 道选择题,内容涉及 HMs 和 HCT 患者感染的流行病学、预防、诊断和治疗:我们获得了 289 份答案:223 份回答了调查 1(发热性中性粒细胞减少症),66 份回答了调查 2(HCT 感染)。两次调查的中位数均为 5.0 分(范围为 0.5 - 9.0)。在调查 1 中,回答正确率最低的问题是 Q3(8%),涉及头孢吡肟的剂量,以及 Q1(9%),询问使用大剂量阿糖胞苷与病毒性链球菌菌血症之间的流行病学联系。在调查 2 中,关于巨细胞病毒 (CMV) 感染的两个问题的正确答案比例最低(Q4,12%;Q11,18%)。与只负责 HM 患者的临床医生相比,负责 HCT 接受者的临床医生得分更高(调查 1 的中位数分别为 5.0 和 4.5,p = 0.03;调查 2 的中位数分别为 6.0 和 4.5,p = 0.001)。在这两项调查中,临床医生、住院医师和教授的得分相近:这是巴西首次对血液科医生的感染性并发症知识进行评估。总体得分中位数偏低表明迫切需要开展持续教育。这些举措最终将带来更好的患者护理。
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来源期刊
CiteScore
2.40
自引率
4.80%
发文量
1419
审稿时长
30 weeks
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