1019O - Healthcare associated infections in head and neck carcinoma patients treated with chemotherapy and/or radiotherapy

Date 01 October 2012
Event ESMO Congress 2012
Session Head and neck cancer
Topics Head and Neck Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Aurora Mirabile
Authors A. Mirabile1, C. Vismara2, P. Bossi3, L. Locati1, C. Bergamini4, R. Granata3, C. Resteghini5, D. Morelli6, P. Scarpellini7, L. Licitra3
  • 1Head & Neck Unit, Istituto Nazionale Tumori Milano, 20133 - Milano/IT
  • 2Medicine Laboratory Unit, Istituto Nazionale Tumori di Milano, 20133 - Milano/IT
  • 3Oncologia Medica, Istituto Nazionale Tumori Milano, 20133 - Milano/IT
  • 4Head And Neck Unit, Istituto Nazionale Tumori Milano, 20133 - Milano/IT
  • 5Medical Oncology, Istituto Nazionale Tumori di Milano, Milano/IT
  • 6Medicine Laboratory Unit, istituto Nazionale Tumori di Milano, Milano/IT
  • 7Infectious Disease, San Raffaele Scientific Institute, Milano/IT

 

Abstract

Background

Healthcare associated infections (HAIs) cause prolonged hospitalization, treatment delay and/or interruption, mortality in cancer patients (pts). Head and neck carcinoma (HNC) pts are predisposed to infections due to risk factors such as malnutrition, comorbidity, immunocompromission, life-style, site of tumour and often the presence of CVC, trach- and gastrostomy. We aimed at HAIs, typing and reporting antibiotics susceptibility. Table: 1019O

Infectious Site Gram + N 49 (35%) Gram - N 69 (49%) Fungi N 22 (16%) Total 140 (100%)
Respiratory tract S. aureus 9 (15%) P. aeruginosa 18 (30%) Aspergillus species 2 (3%) 60 (43%)
Corinebacterium species 3 (5%) Enterobacteriaceae 16 (27%)
S. pneumoniae 3 ( 5%) H. influentiae 6 (10%)
Others 3 (5%)
Surgical S. aureus 5 (13%) P. aeruginosa 6 (15%) C. albicans 9 (22%) 40 (29%)
Others 6 (15%) Enterobacteriaceae 5 (12%) C. species 5 (13%)
C. glabrata 4 (10%)
Blood S. epidermidis 9 (26%) Enterobacteriacae 12 (34%) C. tropicalis 2 (6%) 35 (25%)
S. aureus 4 (12%) P. aeruginosa 4 (11%)
Others 4 (11%)
Other S. aureus 4 (80%) G. vaginalis 1 (20%) 5 (3%)

Materials and methods

We analyzed retrospectively 2288 HNC hospital admissions at our dept between 2005 and 2009. Pts admitted with a suspected infection were studied microbiologically. Contaminants were excluded.

Results

One hundred forty HAIs were confirmed in 84 admissions out of 71 pts. Thirty-three pts had more than 1 HAI (range 2-7) and 25 pts had concomitant HAIs (range 2-4). HAIs occurred in pts with advanced disease (56% stage III/IV) or recurrence (33%), during chemoradiotherapy (60%) or CT alone (28%). Moreover 74% of pts had CVC, 47% gastrostomy and 16% tracheostomy. We isolated 140 colonizers pathogens: 49% Gram -, 35% Gram + and 16% fungi. Table1 reports the frequency and site of infection by microrganisms. Eighty-eight percent of P. aeruginosa and 100% of Enterobacteriaceae were sensible to meropenem and piperacillin/tazobactam. Methicillin-resistant S. aurei (MRSA) were 42%, all responsive to daptomycin, linezolid, rifampicin, tetracycline, teicoplanin, vancomycin.

Conclusions

We observed more Gram- related HAIs, especially into the respiratory tract. The high frequency of MRSA may require to tailor antibiotics first approach of HNC pts treated with CT and/or RT.

Disclosure

All authors have declared no conflicts of interest.