Surveillance of Healthcare-Associated Infections Rates in Hematology-Oncology Patients

Abstract

Background: Healthcare-associated infections (HAIs) consist of a major cause of morbidity and mortality among patients with hematologic malignancies, resulting in high length of stay and healthcare costs. The aim of this study was to assess the HAIs rates in adult hematology-oncology patients.Patients and Methods: A prospective surveillance study was performed in a hematology-oncology unit in Athens, Greece. All patients who remained for ≥ 48 hours were studied. A standardized surveillance system based on the National Healthcare Safety Network of the Centers for Disease Control and Prevention was implemented.Results: During 1,156 patient-days, 16 of 85 patients acquired 20 HAIs resulting in an overall rate of 18.8% of patients or 17.3 HAIs per 1,000 patient-days. FUO rate was 42.5 per 1,000 patient-days with neutropenia. Most of HAIs was laboratory confirmed (80%) than clinically documented (20%). Central line-associated bloodstream infection was the most commonly encountered type of infection, accounting for 25% of all HAIs, followed by soft tissue infections (20%). The rates of neutropenia, blood transfusion and presence of central venous catheter were significantly greater among patients with HAI, compared with patients without HAI (p<0.05). The crude mortality rate for patients with and without HAI was 12.5% and 2.9%, respectively (p=0.234).The mean length of stay was statistically longer for patients with HAI compared with patients without HAI (29.6 ± 28.5 vs. 9.8 ± 6.8 days, p<0.001). Gram-negative bacteria were the most prevalent pathogens (73.3%).Conclusions: Our findings highlight the problem of HAIs in hematology-oncology patients and emphasize the importance of a comprehensive education program focused on evidence-based approaches for all healthcare workers and continuing active surveillance program, which will contribute to reducing the consequences of HAIs and improving patient safety.