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Comparative incidence of fungal and bacterial infections in haematological patients occurring before, during and after the installation of HEPA filters in individual patient rooms

Abstract number: 1733_1189

Araujo R., Carneiro A., Guimaraes J., Rodrigues A.

Objective: Extensive intervention was undertaken in the Haemato-Oncology Unit of the Department of Clinical Haematology, Hospital S. Joao, in June 2005: 8 rooms with high efficiency particulate air (HEPA) filters and two 3-bed rooms were built, in order to prevent infections in high risk neutropenic patients. The objective of this study was to evaluate the incidence of fungal and bacterial infections in haematological patients admitted before, during and after the installation of the new wards.

Methods: All patients admitted in the department from April 2004 to December 2005 were enrolled. Data regarding haematological disease, length of stay, reason of admission, hospital acquired-infections, therapeutic options and, whenever, origin of infection were registered. Air surveillance was simultaneously performed using the Andersen one stage sieve impactor.

Results: A total of 287 admissions were registered in the department, corresponding to 171 patients, during the surveillance period. The incidence of fungal and bacterial infections was higher in the group of patients with acute leukaemia and aplastic anaemia, infections being associated to prolonged neutropenia. Mould infections, mostly due to Aspergillus spp., were reduced after the renovation works and installation of HEPA filters, as well as Staphylococcus infections. The period after renovation works also revealed a reduction of 16.7% of central venous catheter related infections and of 47.9% of microbial agents isolated from bronchial secretions of patients with acute leukaemia and aplastic anaemia. Interestingly, in the last period Candida infections were more common in patients admitted in wards with no air filtration system versus rooms with HEPA filters. The new rooms with HEPA filters showed large improvements on air quality, especially after the first week.

Conclusions: Patients with hospital stays longer than 3–4 weeks and with prolonged neutropenia are more susceptible to develop fungal infections, usually associated to the isolation of other microbial agents and the administration of wide spectrum antibiotics. The improvement of indoor air quality in hospital environment after the installation of HEPA filters in individual rooms effectively reduced invasive infections in haematology patients, mainly caused by Aspergillus spp. and Staphylococcus spp.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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