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Infection control for oncology

  • Chapter
Infectious Complications of Cancer

Part of the book series: Cancer Treatment and Research ((CTAR,volume 79))

Abstract

A program to prevent nosocomial infections is vital for the cancer patient. As has been thoroughly illustrated in prior chapters, infection is a major cause of morbidity and mortality (Table 1). Soon after admission, hospital-acquired organisms, mainly gram-negative bacilli, rapidly replace patients’ endogenous flora [1–3]. These colonizing organisms are responsible for one half to two thirds of infections occurring during hospitalization [1,2,4,5]. Between 9 percent and 12 percent of cancer patients as a whole develop nosocomial infection. Infections of the bloodstream, respiratory tract, urinary tract, and surgical wounds predominate [6,7]. Patients with leukemia, neutropenia, or recent bone marrow transplants are especially susceptible. Carlisle et al, found a rate of 46.3 infections per 1,000 days at risk in neutropenic patients, corresponding to 48.3 percent of these patients developing a nosocomial infection [8]. In some series, between 18 percent and 20 percent of patients with leukemia or undergoing bone marrow transplant developed nosocomial bacteremia [7,9]. Twenty percent of bone marrow transplant patients acquire nosocomial pneumonia [10]. Although mortality from infection has improved from earlier very high levels (70–90 percent) with better antibiotics and supportive care [1,11,12], it nevertheless remains a significant burden. Cancer patients with nosocomial bacteremia have a crude mortality of 31 percent [13], whereas bone marrow transplant patients with pneumonia have a crude mortality of 75 percent and a direct (attributable) mortality of 61.8 percent [10,14].

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  1. R. Todd Wiblin
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  2. Richard P. Wenzel
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  1. Service de Medecine Interne et Laboratoire d’Inverstigation, Clinique, H.J. Tagnon, Institut Jules Bordet, Centre des Tumeurs de L’Universite, Libre de Bruxelles, Belgium

    Jean Klastersky

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Wiblin, R.T., Wenzel, R.P. (1995). Infection control for oncology. In: Klastersky, J. (eds) Infectious Complications of Cancer. Cancer Treatment and Research, vol 79. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1239-0_4

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