title: The availability of HEPA-filtered rooms and the incidence of pneumonia in patients after haematopoietic stem cell transplantation (HSCT): results from a prospective, multicentre, eastern European study.
abstract: OBJECTIVE
  To establish the availability of High Efficiency Particulate Air (HEPA)- and nonHEPA-filtered rooms in eastern European transplant centres and to investigate the impact on incidence of pneumonia and mortality after haematopoietic stem cell transplantation (HSCT).
  
  
  BACKGROUND
  Barrier nursing in HEPA-filtered rooms is generally recommended for patients undergoing HSCT. There are only limited data on the availability of HEPA-filtered rooms and the impact on incidence of pneumonia and mortality.
  
  
  METHODS
  A prospective, observational, international study.
  
  
  METHODS
  Monitoring cards were distributed within the East Forum EBMT-Nurses Group cooperating centres, and 689 consecutive patients were registered in 1/2010-6/2012. Patients were monitored for 100 days post-transplant.
  
  
  RESULTS
  In patients undergoing autologous HSCT, pneumonia developed in 14/400 (3·5%) and was the cause of death in 2/14 (14%) of patients. There was no significant difference in mortality between HEPA-filtered and nonHEPA-filtered groups (4·5% vs. 4·9%, respectively). 239/400 (59%) transplantations were performed in single-bed rooms [190/239 (79%) HEPA-filtered] and 161 (41%) in two-bed rooms [28/161 (17%) HEPA-filtered]. In allogeneic transplantation, pneumonia developed in 24/289 (8·3%) and was the cause of death in 11/24 (45%) of patients. There was no significant difference in mortality between HEPA-filtered and non-HEPA-filtered groups (14% vs. 17%, respectively). 281/289 (97%) of allogeneic transplantations were performed in single-bed rooms [254/281 (90%) HEPA-filtered], and pneumonia was more frequent in patients on corticosteroids and in rooms without HEPA.
  
  
  CONCLUSIONS
  The incidence of pneumonia in the autologous transplantation setting is low. More pneumonia was observed in the allogeneic HSCT group, especially in patients on corticosteroids. There was a trend towards a lower incidence of pneumonia in allogeneic HSCT patients treated in HEPA-filtered rooms.
  
  
  CONCLUSIONS
  Autologous HSCT transplantation may safely be performed without HEPA filtration. HEPA filtration might be preferable in patients undergoing allogeneic transplantation.
authors.affiliation: Haematology-Oncology, University Hospital in Pilsen, Plzen (Pilsen), Czech Republic.
authors.forename: Samuel
authors.initials: S
authors.lastname: Vokurka
authors.forename: Eva
authors.initials: E
authors.lastname: Bystrická
authors.forename: Tomáš
authors.initials: T
authors.lastname: Svoboda
authors.forename: Irena Katja
authors.initials: IK
authors.lastname: Škoda Gorican
authors.forename: Matjaz
authors.initials: M
authors.lastname: Sever
authors.forename: Ewa
authors.initials: E
authors.lastname: Mazur
authors.forename: Anna
authors.initials: A
authors.lastname: Kopinska
authors.forename: Vladislava
authors.initials: V
authors.lastname: Pavlicová
authors.forename: Otilia
authors.initials: O
authors.lastname: Mocanu
authors.forename: Alina
authors.initials: A
authors.lastname: Tanase
authors.forename: Rodica
authors.initials: R
authors.lastname: Ghelase
authors.forename: Marie
authors.initials: M
authors.lastname: Zítková
authors.forename: Monika
authors.initials: M
authors.lastname: Labudíková
authors.forename: Ludek
authors.initials: L
authors.lastname: Raida
authors.forename: Darja
authors.initials: D
authors.lastname: Hrabánková-Navrátilová
authors.forename: Jana
authors.initials: J
authors.lastname: Bocková
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005060:Europe / Q000453:epidemiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation; D010362:Patients' Rooms; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing / Q000517:prevention & control; D011446:Prospective Studies; D055815:Young Adult
keywords: HEPA; barrier nursing; isolation; nursing; pneumonia; protection; stem cell; transplantation