La tunisie Medicale - 2021 ; Vol 99 ( n°05 ) : 552-559
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Background : Healthcare-associated infections (HAIs) are with high rates of mortality and an additional cost, in onco-hematology patients.
Aim : The study aims to assess the prevalence trends of HAIs in the onco-hematology ward of the Tunisian National Bone Marrow Transplant Center (NBMTC), and to determine the principal associated risk factors.
Methods: Six repeated point prevalence surveys were conducted, from May 2018 to March 2019, using a two months interval. All patients hospitalized in the day of the survey were included. Risk factors of HAIs were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). They were assessed using a logistic regression model.
Results: Nineteen patients out of a total of 74 patients have been diagnosed with 19 HAIs, representing a prevalence of 25.7%. No significant downward or upward trend of prevalence was revealed over time (p=0.3). The most common HAI was respiratory tract infection (57.9%) with a prevalence of 14.9%. Multiple logistic regression analysis revealed that HAI was significantly associated with neutropenia (Adjusted OR: 14; 95% CI: 1.5-127; p=0.01) and duration of central venous catheter (Adjusted OR: 1.1; 95% CI: 1-1.2; p=0.005).  
Conclusion: High prevalence of HAIs in our center with a high rate of mortality, requiring identifying potential problems in infection control practices.

Mots Clés
  1. 1. Dettenkofer M, Wenzler‐Rottele S, Babikir R, et al. Surveillance of nosocomial sepsis and pneumonia in patients with a bone marrow or peripheral blood Stem cell transplant: A multicenter project. Clin Infect Dis 2005 ; 40(7) :926‑31. DOI : 10.1086/428046. 2. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. AJIC 2008 ; 36(5) :309‑32. DOI : 10.1016/j.ajic.2008.03.002. 3. Société française d’anesthésie et de réanimation (SFAR), Société de réanimation de langue française (SRLF). Prévention des infections nosocomiales en réanimation (transmission croisée et nouveau-né exclus). Ann Fr Anesth Réanim [Internet] 2009 october 13 [cited 2020 May 5] ; 28(10). Available from : 4. Simon A, Ammann RA, Bode U, et al. Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland. BMC Infect Dis 2008 ; 8(1) :70. DOI : 10.1186/1471-2334-8-70. 5. Al-Tonbary YA, Soliman OE, Sarhan MM, et al. Nosocomial infections and fever of unknown origin in pediatric hematology/oncology unit: a retrospective annual study. World J Pediatr 2011 ; 7(1) :60‑4. DOI : 10.1007/s12519-010-0212-1. 6. The Korean Network for Study of Infectious Diseases (KONSID), Kang C-I, Chung DR, Ko KS, Peck KR, Song J-H. Risk factors for infection and treatment outcome of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae bacteremia in patients with hematologic malignancy. Ann Hematol 2012 ; 91(1) :115‑21. DOI : 10.1007/s00277-011-1247-7. 7. Société Française de Microbiologie. Remic : Referentiel en microbiologie medicale. 6ème édition. Paris: Société Française de Microbiologie; 2018. 8. EUCAST technical note on the method for the determination of broth dilution minimum inhibitory concentrations of antifungal agents for conidia–forming moulds. Clin Microbiol Infect 2008 ; 14(10) :982‑4. DOI : 10.1111/j.1469-0691.2008.02086.x. 9. Huoi C, Vanhems P, Nicolle M-C, Michallet M, Bénet T. Incidence of hospital-acquired pneumonia, bacteraemia and urinary tract infections in patients with haematological malignancies, 2004–2010 : A surveillance-based study. Plos One [Internet] 2013 march 28 [Cited 2020 May 13] ; 8(3). Available from : 10. Ciofi degli Atti ML, Cuttini M, Ravà L, et al. Trend of healthcare-associated infections in children: Annual prevalence surveys in a research hospital in Italy, 2007–2010. J Hosp Infect 2012 ; 80(1) :6‑12. DOI : 10.1016/j.jhin.2011.11.004. 11. Balletto E, Mikulska M. BACTERIAL INFECTIONS IN HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS. Mediterr J Hematol Infect Dis [Internet] 2015 july 16 [Cited 2020 May 12] ; 7(1). Available from : 12. Yemişen M, Balkan İİ, Salihoğlu A, et al. The changing epidemiology of bloodstream infections and resistance in hematopoietic Stem Cell Transplantation Recipients. JTH 2016 ; 33(3) :216‑22. DOI : 10.4274/tjh.2014.0378. 13. Freeman J, McGowan JE. Risk factors for nosocomial infection. J Infect Dis 1978 ; 138(6) :811‑9. DOI : 10.1093/infdis/138.6.811. 14. Godbole G, Gant V. Respiratory tract infections in the immunocompromised. J Infect Dis 2013 ; 19(3) :7. DOI: 10.1002/jmv.25432. 15. Küpeli E, Eyüboğlu FÖ, Haberal M. Pulmonary infections in transplant recipients : Current Opinion in Pulmonary Medicine. Curr Opin Pulm Med 2012 ; 18(3) :202‑12. DOI : 10.1097/MCP.0b013e328352104f. 16. Kafazi A, Stylianou C, Zwmas A, et al. Surveillance of healthcare-associated infections rates in hematology-oncology patients. J Integr Oncol 2017 ; 06 (04). 200-7. DOI : 10.4172/2329-6771.1000200. 17. Buchheidt D, Böhme A, Cornely OA, et al. Diagnosis and treatment of documented infections in neutropenic patients: Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 2003 ; 82(S2) :S127‑32. DOI : 10.1007/s00277-003-0766-2. 18. Harbarth S, Garbino J, Pugin J, Romand JA, Lew D, Pittet D. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med 2003 ; 115(7) :529‑35. DOI : 10.1016/j.amjmed.2003.07.005. 19. Urrea M, Rives S, Cruz O, Navarro A, José Garcı́a J, Estella J. Nosocomial infections among pediatric hematology/oncology patients : Results of a prospective incidence study. AJIC 2004 ; 32(4) :205‑8. DOI : 10.1016/j.ajic.2003.10.013. 20. Rodloff AC, Goldstein EJC, Torres A. Two decades of imipenem therapy. J Antimicrob Chemother 2006 ; 58(5) :916‑29. DOI : 10.1093/jac/dkl354.
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