Prospective surveillance of hospital associated infections epidemiology in a haematology-oncology department

  • Nabiha Bouafia Hospital Hygiene Department, Farhat Hached university Hospital, Sousse, Tunisia. Ibn Al Jazzar University of Medecine, Sousse University, Avenue Mohamed Karoui. Infection Prevention and Control Department, King Faycal medical complex,Taief, Saudi Arabia.
  • Asma Ammar Hospital Hygiene Department, Farhat Hached university Hospital, Sousse, Tunisia. Ibn Al Jazzar University of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.
  • Olfa Ezzi Hospital Hygiene Department, Farhat Hached university Hospital, Sousse, Tunisia. Ibn Al Jazzar University of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.
  • Asma Ben Chiekh Department of Prevention and Safety care, Sahloul University hospital,Sousse , Tunisia Ibn Al Jazzar School of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.
  • Mohamed Mahjoub Hospital Hygiene Department, Farhat Hached university Hospital,Sousse, Tunisia. Ibn Al Jazzar Universityl of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.
  • Wadiaa Bannour Hospital Hygiene Department, Farhat Hached university Hospital, Sousse, Tunisia.
  • Radhia Helali Hospital Hygien Department, Farhat Hached university Hospital, Sousse, Tunisia.
  • Bechir Achour Clinical Hematology service, University Hospital. Farhat Hached,Sousse, TunisiaIbn Al Jazzar School of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.
  • Arwa Ben Salah Department of Epidemiology and Preventive Medicine, University Hospital of Monastir
  • Ben Slimene Dalel Clinical Hematology service, University Hospital. Farhat Hached,Sousse, Tunisia
  • Abderrahim Khelif Clinical Hematology service, University Hospital. Farhat Hached,Sousse, Tunisia Ibn Al Jazzar School of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.
  • Mansour Njah Hospital Hygiene Department, Farhat Hached university Hospital, Sousse, Tunisia. Ibn Al Jazzar School of Medecine, Sousse University, Avenue Mohamed Karoui, Sousse, Tunisia.

Abstract

In haematology-oncology, intensified procedures have been associated with higher risk of healthcare associated infections (HAIs).This study aimed to estimate the incidence and to identify risk factors of HAIs in a haematology-oncology unit in a Tunisian university hospital. We conducted a prospective study, during 06 months from Mars through September 2016 in the department of hematology- oncology in a tertiary teaching hospital in Tunisia. Patients, admitted for ≥48 h, were followed until hospital discharge. The (CDC) criteria for site-specific infections were used to define HAIs. Bivariate and multivariate analyses were performed to identify risk factors of HAIs. P<0.05 was considered as significant. A total of 150 patients were included in this study with mean age; 23.12 ±18.36 years. The overall HAI attack rate of HAIs was 32.6/100 patients with an incidence 15.7 per 1000 patient-days at risk. Nosocomial Fever of Unknown Origin was the most frequent infection (42.9% of total HAI’s). Independent risk factors for developing HAIs were male gender (OR[CI]95%= 4.60[1.43-14.61]; p=0.01), neutropenia (OR[CI]95%=10.20[2.26-45.72],p=0.002), aplasia inducing chemotherapy (OR[CI]95%=6.0 [1.07-33.19], p=0.004) and bone marrow aspiration and biopsy (OR[CI]95%=3.0 [1.10-8.03], p=0.03). In conclusion, our study highlights the burden of HAIs in this unit and the role of surveillance for specific HAIs and analyzing its risk factors. A comprehensive education program focused on evidence-based approaches for all healthcare workers should be implemented in this unit.
Published
2019-01-04
Section
Original Articles