Cancer Patients More Vulnerable to Dangers of Influenza

An article in The Washington Post highlights the increased risk cancer patients face if they contract the flu.

This topic is particularly timely as the Centers for Disease Control and Prevention (CDC) recently noted that seasonal influenza activity in the United States is increasing. We can anticipate this to remain the case for at least the next few months, if history holds true.

About 650,000 cancer patients receive chemotherapy in a U.S. outpatient oncology clinic annually. CDC states, "Patients receiving chemotherapy are at risk for developing infections that may lead to hospitalization, disruptions in chemotherapy schedules, and even death."

The Washington Post article notes, "Although chemo and radiation can extend cancer patients' lives and help stamp out the disease, the treatments can put their lives at risk. Chemo and radiation kill cancer cells, but they can also wipe out patients' immunity." Furthermore, patients are particularly susceptible between one week and 12 days following chemo — a time when even minor infections can quickly become serious and possibly deadly.

The article shares guidance on safe practices to help protect cancer patients from the risks of flu on matters including handwashing and vaccinations. An Infection Control Today article shares additional tips on issues including personal protective equipment (PPE) and medication handling.

Study: Probiotics Linked to Bloodstream Infections in ICU Patients

The results of a new study indicate that the use of probiotics in intensive care units (ICU) can cause bloodstream infections.

The study, published in Nature Medicine, was initiated following the detection of cases of bacteremia in Boston Children's Hospital's ICU caused by Lactobacillus, according to a news release. Lactobacillus a type of bacteria commonly found in probiotics.

A genomic investigation, coupled with bacterial DNA analysis, revealed that for a small percentage of ICU cases, the live bacteria in the probiotic formulations were associated with bloodstream infections. As the release notes, researchers suspect that the bacteria entered the bloodstream from the GI tract, but that it is also a possibility that they entered via patients' central lines.

To reduce the likelihood of probiotic-linked bloodstream infections, Boston Children's undertook a number of initiatives, including establishing new protocols requiring nurses to wear gloves before handling probiotic capsules, changing gloves before administering probiotics, covering central lines (when used) with a clean drape before opening the capsules and cleaning surfaces where the probiotic was prepared with a disinfectant.

It is commonplace for child and adult patients in the ICU to receive probiotics. As a Nutrition in Clinical Practice study notes, "Probiotics offer promise to ICU patients for the prevention of antibiotic-associated diarrhea, Clostridium difficile infections, multiple organ dysfunction syndrome and ventilator-associated pneumonia." 

More Seattle Children's Surgical Patients Contract Infections

Another surgical patient at Washington's Seattle Children's has contracted an infection from the presence of Aspergillus mold, according to news reports.

Furthermore, the hospital is monitoring another patient who might have contracted aspergillosis — the disease caused by the mold.

Seattle Children's has struggled to contain the fungus. Three patients were sickened by Aspergillus earlier this year, and three patients were infected in 2018. One of those patients died this past spring, notes The Seattle Times. The hospital has attempted to address the issue by closing its operating and procedure rooms and run tests.

Following this latest incident, Seattle Children's issued a statement, noting that routine air test results revealed the presence of Aspergillus in three of its operating rooms and two procedural areas. The hospital states, "The rooms in which Aspergillus was detected have been closed and out of an abundance of caution, we are only performing emergent surgeries in the operating rooms that have advanced in-room filtration."

The hospital has postponed or diverted some of its surgical cases and indicated plans to close all of its operating rooms soon to perform an investigation into its air handling system.

Infection Control Consulting Services (ICCS) emphasizes the importance of ongoing maintenance for air handling systems in the hospital environment, including facilities that provide services to immunocompromised patients and those undergoing surgery. If facilities identify contamination of air being fed into the hospital, it must be addressed immediately as even a small problem can snowball quickly.