Infection Prevention in Pediatric Oncology and Hematopoietic Stem Cell Transplant Recipients

Dutta, Ankhi; Flores, Ricardo J.

doi:10.1007/978-3-319-98122-2_16

Cited by 4 publications

(4 citation statements)

References 57 publications

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“…Los incentivos, estímulos y motivación de higiene brindados por el odontólogo juegan un papel indispensable en esta etapa de atención, debido a que se realizarán medidas preventivas y profilácticas necesarias para mantener la salud bucal en condiciones óptimas y contrarrestar cualquier complicación posterior que se desarrolle durante y después de la terapia oncológica. 10,11 El tratamiento dental de los pacientes con cáncer puede ser una tarea monumental para el dentista general e incluso el especialista pediátrico, dada la cantidad de factores involucrados en las decisiones clínicas, podría ser abrumador decidir cuál es la terapéutica más apropiada a cada caso. Aunque actualmente no se aceptan estándares universales considerando que cada paciente es único y presenta un propio conjunto de desafíos, se han desarrollado pautas como las establecidas en la figura 1 para ayudar en la toma de decisiones clínicas.…”

Section: Intervención Odontológica Previa a La Terapia Oncológicaunclassified

See 1 more Smart Citation

Tratamiento odontológico en pacientes pediátricos sometidos a tratamiento oncológico. Artículo de revisión.

Córdova-Vintimilla

Alvear-Córdova

2022

Odontol. Act.

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A menudo los tratamientos contra el cáncer implican la combinación de terapias dirigidas a mejorar la supervivencia, la calidad de vida y preservar la dignidad del paciente. La resección quirúrgica, la radioterapia y la quimioterapia crean una morbilidad sustancial. Además, el cáncer genera una gran carga psicosocial y financiera para el paciente, sus familias y la sociedad en general. El sistema inmunológico del infante durante la terapia oncológica puede estar gravemente afectado, estas terapias específicas si bien son benéficas para el proceso de recuperación traen consigo complicaciones orales con el transcurso del tiempo, producto de la aplicación citotóxica de los fármacos. La intervención dental previa, durante y después de la terapia, cumple un rol en la reducción de la incidencia y la gravedad de las complicaciones. Ante este contexto el objetivo principal de esta revisión es maximizar la calidad de vida del paciente pediátrico a través de la información actual disponible en las bases de datos digitales para lo cual se realizó una búsqueda integral. Esta revisión está dedicada a la discusión de la rehabilitación oral del paciente oncológico infantil, concluye que el papel del odontopediatra es un esfuerzo coordinado y multidisciplinario que requiere gran atención en los aspectos médicos, quirúrgicos y humanísticos del bienestar del paciente. Las mejoras en el tratamiento de la mucositis, las infecciones orales y la xerostomía podrían proporcionar un gran beneficio para la calidad de vida.

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Section: Intervención Odontológica Previa a La Terapia Oncológicaunclassified

“…Adicionalmente pretende integrar al clínico de odontología pediátrica en un equipo de trabajo multidisciplinario con el propósito de mantener al paciente en constante vigilancia y analizar cualquier tipo de complicaciones locales y sistémicas que se presenten antes, durante y después del tratamiento oncológico. [9][10][11]…”

Section: Introductionunclassified

Tratamiento odontológico en pacientes pediátricos sometidos a tratamiento oncológico. Artículo de revisión.

Córdova-Vintimilla

Alvear-Córdova

2022

Odontol. Act.

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“…Their increased vulnerability to infections arises from disturbances in skin and mucosal defenses (such as oral and gastrointestinal barriers), microbial movement across the gastrointestinal tract, compromised cell-mediated immunity, and deficiencies in both the quantity and functionality of phagocytes. In addressing infection control and prevention among this group, the focus is reducing risks associated with the underlying malignancy and its treatment (Dutta & Flores, 2019 ). The limitations of facilities and infrastructure in Indonesia, as a lower-middle-income nation (LMIC), where resources for the care of children with cancer are severely constrained, coupled with a minimal national health budget, require stakeholders to ensure that management is truly effective and efficient.…”

Section: Introductionmentioning

confidence: 99%

Infection-related mortality and infection control practices in childhood acute myeloid leukemia in a limited resource setting: Experience with the Indonesian national protocol

Supriyadi,

Purwanto,

Widiastuti

et al. 2024

Belitung Nurs J

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Background: In resource-limited settings, addressing infections remains a substantial challenge in the management of children with Acute Myeloid Leukemia (AML). In Indonesia, infection-related mortality (IRM) is thought to be high compared to high-income countries. However, there has been no previous study of infection profile and IRM in Indonesian patients with AML. Objective: This study aimed to describe infections and IRM in children with AML treated according to the Indonesian National AML protocol and to describe the implementation of infection control practices in resource-limited settings. Methods: This retrospective observational study used secondary data from the medical records of pediatric patients with AML treated with the National Protocol at Dr. Sardjito Hospital, Yogyakarta, Indonesia, from April 2012 to September 2018. Essential patient characteristics, time of IRM, and cause of death were recorded, and infection control practices were observed. Data were analyzed using descriptive statistics. Results: 113 patients with AML were treated with the National protocol, and 83 met the inclusion criteria. Infections occurred in 69 (83%) patients with a total of 123 episodes (mean 1.8/patient). Death was seen in 48 (58%) patients, with 19 (23%) IRM. The majority of infections were in the gastrointestinal tract (n = 51, 30.5%), sepsis (n = 29, 17%), and respiratory tract (n = 28, 17%). Infections mostly occurred during the first induction (41%). There were 90 (73%) episodes of clinically documented infection and 33 (27%) episodes of microbiologically documented infection. The positivity rate of blood cultures was only 27%. The majority of bacteria detected were gram-negative (n = 25, 69%), and among them were Klebsiella pneumonia (19%) and Escherichia coli (19%). Candida albicans was detected in 1 (2%) culture. Suboptimal infection prevention and control were found in the clinical practice. Conclusion: Infections and infection-related mortality in children with AML treated using the National protocol were frequent, mainly occurring during the first induction phase. Compliance with infection prevention and control measures needs improvement. Urgent attention is required for better supportive care, including isolation rooms, antibiotics, and antifungals. The predominance of Gram-negative bacterial infections highlights the necessity for further research into effective prophylaxis. Enhanced healthcare and nursing professional vigilance and tailored antibiotic strategies are vital. Improving compliance and ensuring adequate supportive care resources are essential, emphasizing nursing’s pivotal role. Further research is crucial to drive advancements in infection control strategies.

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“…Pediatric patients suffering from oncologic, hematologic or immunodeficiency diseases often experience infectious complications due to disease and/or therapy [5,25]. Immunosuppression induced by chemotherapy leads to a high susceptibility towards viral and bacterial infections [4,8,17].…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 Related Restrictions on Infections in Children with Cancer or after Hematopoietic SCT

et al. 2023

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Background Infections are a major concern for immunocompromised children. We investigated whether non-pharmaceutical interventions (NPIs) implemented in the general population during the coronavirus disease 2019 (COVID-19) pandemic in Germany had an impact on frequency, type and severity of infections in these patients. Patients and methods We analyzed all admissions to the clinic of pediatric hematology, oncology and stem cell transplantation (SCT) with (suspected) infection or fever of unknown origin (FUO) from 2018 to 2021. Results We compared a 27-month period before NPIs (Pre-COVID: 01/2018–03/2020; 1041 cases) with a 12-month period with underlying NPIs (COVID: 04/2020–03/2021; 420 cases). During the COVID period the number of in-patient stays with FUO or infections decreased (38,6 cases/month vs. 35,0 cases/month), the median duration of hospital stays was longer (8 d (CI95: 7–8 d) vs. 9 d (CI95: 8–10 d) P=0,02)), the mean number of antibiotics per case increased (2,1 (CI95: 2,0–2,2) vs. 2,5 (CI95: 2,3–2,7); P=0,003)) and a substantial reduction of viral respiratory and gastrointestinal infections per case was seen (0,24 vs. 0,13; P<0,001). Notably, there was no detection of respiratory syncytial virus, influenza and norovirus, between May 2020 and March 2021. Based on need of intensive care measures and further parameters we conclude that severe (bacterial) infections were not significantly reduced by NPIs. Conclusions Introduction of NPIs in the general population during the COVID-pandemic substantially reduced viral respiratory and gastrointestinal infections in immunocompromised patients, while severe (bacterial) infections were not prevented.

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Infection Prevention in Pediatric Oncology and Hematopoietic Stem Cell Transplant Recipients

Cited by 4 publications

References 57 publications

Tratamiento odontológico en pacientes pediátricos sometidos a tratamiento oncológico. Artículo de revisión.

Tratamiento odontológico en pacientes pediátricos sometidos a tratamiento oncológico. Artículo de revisión.

Infection-related mortality and infection control practices in childhood acute myeloid leukemia in a limited resource setting: Experience with the Indonesian national protocol

Impact of COVID-19 Related Restrictions on Infections in Children with Cancer or after Hematopoietic SCT

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