1019O - Healthcare Associated Infections in Head and Neck Carcinoma Patients Treated with Chemotherapy and/or Radiotherapy

Abstract

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. 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. 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%)