Adapting Infection Prevention Strategies: Insights from a Pediatric Oncology Center Study
A A Hernández Soto, G E Félix Bermúdez, L A Concha Mora, M Mata Castañeda, A M Acevedo Arroyo, M J Roldán SerranoAbstract
Background
Healthcare-associated infections (HAIs) continue to be a public health problem, impacting morbidity and mortality and costs for the health system. Due to the increased risk of transmission of communicable and preventable infectious diseases between patients and healthcare workers, there is a need for the development of preventive actions. Protective insulation aims to defend immunocompromised patients who are vulnerable and at high risk of infections that can be acquired. The objective was to demonstrate whether a modification of the protective insulation strategy had an impact on the number of HAIs and to evaluate the effectiveness and safety of these changes as adaptations to existing protocols.
Methods
This was an observational, descriptive, ambispective, unicentric study that included HAIs from 2022 and 2023, along with retrospective HAI data from January to March 2024, and prospective HAI cases from April to June 2024 in a pediatric oncology center in Queretaro including patients under 18 years of age. Protective insulation was defined as a single patient room, hand hygiene, masks, along with the removal of disposable gloves and coats to reduce healthcare costs. A descriptive analysis of the number of HAIs was conducted and reported in proportions and percentages.
Results
A total of 38 HAIs were found in 2022 and 2023, with rates of 3.03/100 discharges in 2022 and 2.67/100 in 2023. From January to March, there were a total of 7 HAIs, with rates of 4.8/100 in January, 2.5/100 in February, and 1.2/100 in March. After implementing the modification in protective insulation, the rates of HAIs were 2.08/100 in April, 6.38/100 in May, and 3.03/100 in June as part of the pilot trial of the measure. Following an observational and descriptive analysis showing no increase in HAIs, the modified measure continued until September 2024, with rates of 3.03/100 in June, 4.9/100 in July, 1.56/100 in August, and 4.4/100 in September. The total rate of HAIs over the six months with the modification was 3.3/100 discharges.
Conclusions
We observed no increase in the number of HAIs following the modification of the protective insulation. This measure emphasizes that hand hygiene, standard precautions and environmental safety continue to be key points in the prevention of HAIs, and that reducing the use of single-use health materials like gloves and coats may positively impact healthcare costs. This study encourages further research into adaptations in definitions of pediatric insulation, including analytic studies in larger populations to determine statistical significance.