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2017, Number 1

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Rev Sanid Milit Mex 2017; 71 (1)

Nosocomial infections in patients with hematologic cancer. Experience of Hospital General Naval de Alta Especialidad

Ruiz GAC, Peña-Pérez CA, Vargas-Ruiz ÁG, Hernández-Castañeda B, Domínguez-Sandoval ZNC, Villagómez-García, I, Bandala C

Language: Spanish
References: 15
Page: 22-30
PDF size: 338.15 Kb.


ABSTRACT

Background: In Mexico the hematologic malignancies (NH) constitute 9.6% of all cancer cases per year. Nosocomial infections (IN) are reported with a frequency 9.72% nationally. It has been reported in patients with NH and hematopoietic cell transplantation (HCT) has increased susceptibility to acquire IN, which increases their mortality. The purpose of this study was to establish the prevalence of IN, the most frequent infections and their relation to different types of NH.
Materials and methods: The information of patients treated in the Hematology and Transplantation service of Hospital General Naval de Alta Especialidad was collected; all with a diagnosis of hematologic malignancies treated with chemotherapy or hematopoietic cell transplantation. Statistical analysis was performed using χ2, U de Mann-Whitney, ANOVA, and Kruskall Wallis (IC 95%).
Results: We registered 169 patients with mean age of 51.44 ± 15.12 years. 32% he presented IN, with urinary tract infection was the most frequent (P ‹ 0.05) was associated with the type of NH diagnosis of IN, with patients with non-Hodgkin lymphoma (NHL), the most affected. Escherichia coli was the main pathogen isolated. Fever was the main clinical sign associated with IN (p ‹ 0.05).
Conclusions: We observed that 3 of 10 patients has diagnosed with a IN NH, patients with NHL and multiple myeloma (MM) were the most likely. Fever is the clinical sign most related to nosocomial infection, gram-negative bacilli being the most frequently isolated pathogens.


REFERENCES

  1. Dirección General de Epidemiología (DGE). Base de datos del Registro Histopatológico de Neoplasias Malignas 2004- 2006 (RHNM). Sistema Nacional de Vigilancia Epidemiológica (SINAVE). [México]: Secretaría de Salud. Dirección URL: www.epidemiologia.salud.gob.mx/dgae/boletin/ intd_boletin.html

  2. Norma Oficial Mexicana para diagnóstico y detección de infecciones nosocomiales NOM-045-SSA2-2005. Dirección URL: http://dof.gob.mx/nota_detalle.php?codigo=512094 3&fecha=20/11/2009

  3. López-Herrera JR, Méndez-Cano AF, Bobadilla-Espinosa RI, Maldonado-Torres L. Infecciones nosocomiales, mortalidad atribuible y sobre estancia hospitalaria. Rev Enferm Inst Mex Seguro Soc. 2012;20(2):85-90.

  4. El-Sharif A, Elkhatib WF, Ashour HM. Nosocomial infections in leukemic and solid-tumor cancer patients: distribution, outcome and microbial spectrum of anaerobes. Future Microbiol. 2012 Dec;7(12):1423-1429.

  5. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Intensive Care Med. 2013;41(2):580-637.

  6. Safdar A, Armstrong D. Infections in patients with hematologic neoplasms and hematopoietic stem cell transplantation: neutropenia, humoral, and splenic defects. Clin Infect Dis. 2011;53(8):798-806.

  7. Courtney DM, Aldeen AZ, Gorman SM, Handler JA, Trifilio SM, Parada JP, et al. Cancer-associated neutropenic fever: clinical outcome and economic costs of emergency department care. Oncologist. 2007;12(8):1019-1026.

  8. Goldszmid RS, Dzutsev A, Host immune response to infection and cancer: unexpected commonalities. Cell Host Microbe. 2014; 15(3):295-305.

  9. Gustinetti G, Mikulska M. Bloodstream infections in neutropenic cancer patients: A practical update. Virulence. 2016;7(3):280-297.

  10. Huoi C, Vanhems P, Nicolle MC, Michallet M, Benet T. Incidence of hospital-acquired pneumonia, bacteraemia and urinary tract infections in patients with haematological malignancies, 2004-2010: a surveillance-based study. PLoS One. 2013;8(3):e58121.

  11. Liu H, Zhao J, Xing Y, Li M, Du M, Suo J, et al. Nosocomial infection in adult admissions with hematological malignancies originating from different lineages: A prospective observational study. PLoS One. 2014;9(11):e113506.

  12. Bos MM, Smeets LS, Dumay I, de Jonge E. Bloodstream infections in patients with or without cancer in a large community hospital. Infection 2013; 41:e949-e958.

  13. Larson RA, Dodge RK, Linker CA, Stone RM, Powell BL, Lee EJ, et al. A randomized controlled trial of filgrastim during remission induction and consolidation chemotherapy for adults with acute lymphoblastic leukemia: CALGB study 9111. Blood. 1998;92(5):1556-1564.

  14. Ruhnke M, Arnold R, Gastmeier P. Infection control issues in patients with haematological malignancies in the era of multidrug-resistant bacteria. Lancet Oncol. 2014;15(13):e606-e619.

  15. Gedik H, Simşek F, Kantürk A, Yildirmak T, Arica D, Aydin D, et al. Bloodstream infections in patients with hematological malignancies: which is more fatal - cancer or resistant pathogens?. Ther Clin Risk Manag. 2014;10:743-752




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