RISK FACTORS FOR DEVELOPMENT OF HEALTH CARE-ASSOCIATED INFECTIONS IN PATIENTS OF ONCOGEMATOLOGY AND BONE MARROW TRANSPLANTATION UNITS

Abstract

Aim. To reveal the risk factors for the development of health care-associated infections (HCAI) in oncohematological units. One of the main problems of failure of treatment among oncohematological patients are infectious complications, first of all, associated with medical care. Materials and methods. The study “case-control” was carried out on the bases of three units of bone marrow transplantation and Research Institute of Pediatric Oncology, Hematology and Transplantation named after R.M. Gorbacheva. The study involved 102 patients, treated over the period from 01.12.14 to 30.11.15. The group “cases” included patients with HCAI. Health care-associated infections were detected using standard determination of a case for each of nosological forms; the group “control” - patients without HCAI, treated at the studied units during the same period. Each group joined 51 patients. Results. The common risk factors for all the considered types of infectious complications were duration of neutropenic fever for more than 3 days, polychemotherapeutic scheme “fludarabine+busulfan”, all schemes of polychemotherapy, including fludarabine. The greatest number of risk factors was detected for such severe and nosological HCAI forms as sepsis and pneumonia. Fludarabine is an independent risk factor for the development of HCAI, its influence is growing against the background of presence of another risk factors, such as neutropenic fever. Conclusions. Until now, fludarabine, as a factor, causing the development of severe forms of infectious complications was described only for patients with chronic lymphatic leukemia. It was revealed that this chemical is an independent risk factor for patients with acute leucosis as well.

Keywords

Risk factors / health care-associated infections / oncohematology / fludarabine

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RIGHTS & PERMISSIONS

Ryakhovskikh S.A., Lyubimova A.V.