Healthcare-acquired Infections (HAI) Rates in Oncology Patients Undergoing Hematopoietic Stem Cell Transplant (HSCT) in Tertiary Hospital in Brazil

Background

Healthcare-acquired infections (HAI) in oncology patients undergoing hematopoietic stem cell transplant (HSCT) are associated with an increased risk of morbidity and mortality. Increased risks are attributed, in part, to immunosuppression caused by chemotherapy, prolonged neutropenia and mucosal damage. The increased risk is knowing, but data are lacking. The objective of this study is to know the HAI rate in patients undergoing hematopoietic stem cell transplant and the most prevalence HAI.

Methods

This prospective study included all patients that were between 0–360 days after received autologous or allogeneic HSCT when were hospitalized in a HSCT unity in a tertiary hospital in Brazil. The surveillance occurred between July 1, 2020, and July 31 2021. The United States National Healthcare Safety Network guideline were used to define HAI. The HAI were stratified by bloodstream, respiratory, and urinary tract infections.

Results

The oncology patients undergoing HSCT surveillance has found twelve HAI episodes among two thousand and four hundred seventy patient days, resulting in a HAI rate of 4.8 per 1,000 patient-days. Bloodstream infection was the most common healthcare-acquired infection (n=9) followed by urinary tract infection (n=2) and respiratory infection (n=1). The most common organism isolate was Stenotrophomonas maltophilia (n = 4) followed by Klebsiella pneumoniae (n = 3) and Staphylococcus epidermidis (N=3). 5 episodes of HAI was detected in the first 3 months following transplant. Of the 12 patients who presented HAI, 4 died with noninfection-related causes.

Conclusions

HAI rate in the oncology patient undergoing HSCT found our study is similar to international rates and the bloodstream infection is the most common healthcare-acquired infection. A surveillance program is recommended to monitor outcomes, adherence prevention strategies and identify quality improvement opportunities and strategically targeting interventions especially to oncology patient undergoing hematopoietic stem cell transplant.

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