Effects of cleaning and disinfection of thermoplastic masks on hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma

Abstract

Objective To investigate the effects of cleaning and disinfection of thermoplastic masks on the hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma (NPC). Methods A prospective study was performed among 102 patients receiving precise radiotherapy for NPC from 2013 and 2016, consisting of 18 patients with early-stage (I, Ⅱ) disease and 84 patients with advanced (Ⅲ, IV) disease. All patients were randomly divided into group A and group B using a random number table. For group A, the marker lines of thermoplastic masks were sandwiched by double plastic tapes; cleaning and disinfection plus ultraviolet (UV) disinfection were applied to the masks 1 h prior to radiotherapy and immediately after radiotherapy. For group B, only conventional UV disinfection was applied to the masks. The surface of the masks was examined and hospital infection during radiotherapy was evaluated. Results At the 18th radiotherapy, group A had a significantly lower mask surface colony count than group B (7.90±6.50 vs. 139.05±129.29 CFU/cm2,P=0.000). Group A also had a significantly lower incidence of hospital infection than group B (72.5% vs. 88.2%, P=0.046). For the patients with early stage NPC, particularly, there was no significant difference in the incidence of infection between the two groups (55.6% vs. 66.7%, P=0.629). For patients with advanced NPC, group A had a significantly lower incidence of infection than group B (76.2% vs. 92.9%, P=0.035). There were no significant differences in incidence rates of oral mucosal, skin, and respiratory system infections between the two groups (47.1% vs. 51.0%, P=0.692; 17.6% vs. 23.5%, P=0.463; 7.8% vs. 13.7%, P=0.338). In both groups A and B, the incidence of oral mucosal infection was significantly higher than the incidence rates of skin infection (P=0.001, 0.000) and respiratory system infection (P=0.004, 0.000). Conclusions Thermoplastic mask is one of the risk factors for hospital infection in patients receiving precise radiotherapy for NPC. Timely cleaning and disinfection plus UV disinfection can significantly reduce the surface colony count and the incidence of hospital infection in patients with NPC, particularly in those with advanced NPC receiving precise radiotherapy. The incidence of hospital infection is the highest in the oral mucosa, followed by the skin and the respiratory system. Key words: Thermoplastic mask; Cleaning disinfection; Hospital infection; Nasopharyngeal neoplasms/radiotherapy