Practices of infectious control management during neutropenia: A survey from 149 French hospitals.
OBJECTIVE
Neutropenic patients represent a growing and fragile population in our hospitals. Numerous treatments induce neutropenia in haematology wards and elsewhere. Although strict isolation is recommended during post-haematopoietic stem cell transplantation neutropenia, this may not be the current practice in other situations. In this study, our objective was to analyse what protective measures are applied in neutropenic patients in a French survey.
A questionnaire was sent out to infection control teams of 400 public and private French hospitals to enquire about their local recommendations regarding infection prevention in neutropenic patients.


RESULTS
Among the 166 (41%) responders, 134 (81%) managed neutropenic patients. All of the centres recommended protective isolation for neutropenic patients. However, only 46 (34%) had clearly defined patients warranting specific isolation measures in terms of the level of neutropenia. All of the centres recommended several barrier measures, but these were highly variable according to the type of air treatment in the wards (note that only 72% of haematology wards are equipped with air treatment). Gowns, gloves, masks, hats and shoe covers were respectively recommended in 128 (95%), 79 (59%), 132 (98%), 87 (65%), and 34 (25%) of the establishments. Surprisingly, the recommendations vary both among hospitals and within the same hospital among different clinical wards.


CONCLUSIONS
In conclusion, protective measures for neutropenic patients are applied variably and urgently require a consensus to homogenize practices.
Unité d'hygiène hospitalière, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France.
N
N
Lequilliec
Agence régionale de lutte contre les infections nosocomiales, Pays de La Loire CHU Hôtel-Dieu, 5, rue Pr-Boquien, 44093 Nantes cedex, France.
R
R
Raymond
Équipe opérationnelle d'hygiène, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
D
D
Vanjak
Équipe opérationnelle d'hygiène, centre hospitalier régional universitaire de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
N
N
Baghdadi
Service d'hygiène hospitalière, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.
H
H
Boulestreau
IAME, UMR 1137, département de microbiologie clinique, unité de contrôle et de prévention du risque infectieux, université Paris 13, Sorbonne Paris Cité, groupe hospitalier Paris Nord Seine Saint-Denis, CHU Avicenne, AP-HP, 125, rue de Stalingrad, 93000 Bobigny, France. Electronic address: jrzahar@gmail.com.
J-R
JR
Zahar
Service de parasitologie-mycologie, centre hospitalier universitaire de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes cedex 09, France.
J-P
JP
Gangneux
D003428:Cross Infection / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D017053:Infection Control / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D009503:Neutropenia / Q000453:epidemiology / Q000628:therapy*; D010356:Patient Isolation / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
Aspergillose; Aspergillosis; HEPA; Infection control; Isolation; Isolement; Neutropenia; Neutropénie; Prévention des infections liées aux soins