Minimizing Hospital Acquired Infections in Post- Hematopoietic Stem Cell Transplant Pediatric Recipients: Impact on Hospital - Metrics of a Tertiary Care Centre
التفاصيل البيبلوغرافية
العنوان:
Minimizing Hospital Acquired Infections in Post- Hematopoietic Stem Cell Transplant Pediatric Recipients: Impact on Hospital - Metrics of a Tertiary Care Centre
Introduction Hematopoietic Stem Cell Transplantation (HSCT) recipients are at an increased risk of infections including but not limited to Hospital-acquired infections (HAIs), extrinsic factors such as health-care workers and visitors plays a vital role in minimizing HAIs. Pediatric Stem Cell Transplant Program at King Faisal Specialist Hospital & Research Centre, Riyadh is the national referral center for malignant and non-malignant cases indicative of a transplant, an average of 140 transplants performed per year Method Stringent compliance to institutional visiting hour's policy and hand-hygiene campaign in pediatric post-HSCT inpatient unit was reinforced in early 2017; a pre -/post intervention HAI rate is being reported as data analyzed retrospectively Results A total of 269 transplants performed on 260 recipients during 2015 to 2016 (pre-intervention), while 279 transplants on 262 recipients during 2017 to 2018 (post-intervention), a 33% decrease in HAI episodes (57 vs. 38) was observed with a decrease in HAI rate of 2.5% (4% vs. 6.5%); while the incidence density of HAI post-intervention was 2.69 per 1,000 patient-days, which reduced by 36% (4.2 per 1,000 patient-days). An increase in Average Length of Stay by 19% (19.15 days vs. 16.14 days) in relation to 4% increase in transplant episodes was observed; a decrease in long- stay (>60 days) patients by 2%, while the Bed Turnover rate improved by 4%. A major drop in Drug-resistant bacteremia, 60% (4 vs. 10) followed by C.difficile infection, 50% (16 vs 32 infections) observed, HAI-related mortality was not observed pre-/post intervention Conclusion Visits from family and friends eases some of the isolation experienced, in our experience strict adherence to policies coordinated by health-care professionals with cooperation from families help keep balance between the emotional well-being of the patient and risk associated with such visits. Further, analysis of HAIs during neutropenic vs. non-neutropenic stage of the patient, in addition to transplant-related outcomes is warranted.
