title: Health care-associated infections in patients with head and neck cancer treated with chemotherapy and/or radiotherapy.
abstract: The incidence of health care-associated infections in patients with head and neck cancer receiving chemotherapy and/or radiotherapy (RT) is unknown. This retrospective study investigated the most common pathogens and their antibiotic sensitivity/resistance patterns in patients with head and neck cancer.
  
  
  
  Infection rates in patients with head and neck cancer were analyzed over 2 periods (January 2005 to December 2009 and January 2010 to November 2012).
  
  
  
  In the first period, 140 health care-associated infections were observed among 2288 admissions, mostly because of gram-negative pathogens affecting the respiratory tract. In the second period, 212 health care-associated infections were observed. An increase in antibiotic resistance was reported. Health care-associated infections were more frequent with: male sex, age <65 years, important comorbidities, smoking, proton pump inhibitors (PPIs), prophylaxis, and/or central venous catheter (CVC), locally advanced disease, and chemotherapy/RT, especially after the third week of treatment.
  
  
  
  Health care-associated infections increased over time, with corresponding increases in gram-negative pathogens and resistant strains. Prevention and treatment protocols should be implemented in institutions treating patients with head and neck cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1009-E1013, 2016.
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Mirabile
authors.affiliation: Medicine Laboratory Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Vismara
authors.affiliation: Department of Health Sciences, Unit of Infectious and Tropical Diseases San Paolo Hospital, Milan, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Crippa
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bossi
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Locati
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Bergamini
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Granata
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Resteghini
authors.affiliation: Medicine Laboratory Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Eutilia
authors.initials: E
authors.lastname: Conte
authors.affiliation: Medicine Laboratory Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Morelli
authors.affiliation: Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Scarpellini
authors.affiliation: Head and Neck Cancer Medical Oncology Unit, Department of Medical Oncology, Fondazione IRCCS "Istituto Nazionale dei Tumori,", Milan, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Licitra
mesh_terms: D000368:Aged; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D012189:Retrospective Studies; D012907:Smoking
keywords: chemotherapy; head and neck cancer; healthcare-acquired infections; nosocomial; radiotherapy