In-Hospital Transfer Is a Risk Factor for Invasive Filamentous Fungal Infection among Hospitalized Patients with Hematological Malignancies: A Matched Case-Control Study

Article Article scientifique Article In-Hospital Transfer Is a Risk Factor for Invasive Filamentous Fungal Infection among Hospitalized Patients with Hematological Malignancies: A Matched Case-Control Study eng 2015 author Gayet-Ageron Angèle 668551 author Iten Anne author Van Delden Christian 24088 author Farquet Natacha 593420 author Masouridi Levrat Stavroula 844685 author Von Dach Elodie 591850 Elodie Von Dach-Saouter author Chalandon Yves 644957 author Pittet Didier 117792 320-328 10.1017/ice.2014.69 25695174 0899-823X OBJECTIVE Immunocompromised patients now benefit from a longer life expectancy due to advanced medical techniques, but they are also weakened by aggressive treatment approaches and are at high risk for invasive fungal disease. We determined risk factors associated with an outbreak of invasive filamentous fungal infection (IFFI) among hospitalized hemato-oncological patients. METHODS A retrospective, matched, case-control study was conducted between January 1, 2009, and April 31, 2011, including 29 cases (6 proven, 8 probable, and 15 possible) of IFFI and 102 matched control patients hospitalized during the same time period. Control patients were identified from the hospital electronic database. Conditional logistic regression was performed to identify independent risk factors for IFFI. RESULTS Overall mortality associated with IFFI was 20.7% (8.0%-39.7%). Myelodysplastic syndrome was associated with a higher risk for IFFI compared to chronic hematological malignancies. After adjustment for major risk factors and confounders, >5 patient transfers outside the protected environment of the hematology ward increased the IFFI risk by 6.1-fold. The risk increased by 6.7-fold when transfers were performed during neutropenia. CONCLUSION This IFFI outbreak was characterized by a strong association with exposure to the unprotected environment outside the hematology ward during patient transfer. The independent associations of a high number of transfers with the presence of neutropenia suggest that affected patients were probably not sufficiently protected during transport in the corridors. Our study highlights that a heightened awareness of the need for preventive measures during the entire care process of at-risk patients should be promoted among healthcare workers. Infect Control Hosp Epidemiol 2014;00(0): 1-9. Dewey 613 Dewey 616 54 Département de microbiologie et médecine moléculaire 21B 56 Département de médecine 221 64 Département de santé et médecine communautaires 22A false 88 Epidémiologie clinique et biostatistique 115 1216 Leucémie et transplantation allogénique de cellules souches hématopoïétiques 982 235 Quorom-sensing et gènes de virulence 301 251 Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière 330 Infection control and hospital epidemiology 36 3 5e29571c-3ad2-4620-bb98-acfa7beac62a Article (Published version) Restricted Hum. Mol. Genet.-2015-Taneera-1945-55.pdf 888868 application/pdf restrictedAccess Faculté de médecine / Section de médecine fondamentale / Département de microbiologie et médecine moléculaire Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires

Title	Published in	Year	Views	Downloads

In-Hospital Transfer Is a Risk Factor for Invasive Filamentous Fungal Infection among Hospitalized Patients with Hematological Malignancies: A Matched Case-Control Study	Infection control and hospital epidemiology	2015	563	1
Caregivers' perceptions of patients as reminders to improve hand hygiene	Archives of internal medicine	2012	629	509

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Farquet, Natacha