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
Surgical Oncology
Therapy
Radiation Oncology
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.