Infection Control in Cancer Patients:Neutropenic Patients Precautions

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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INFECTION CONTROL IN CANCER PATIENTS

Dr Ira Shah
M.D, DCH(Gold Medalist), FCPS, DNB
Edited by Dr. Bharat R Agarwal
Consultant Pediatric Hematologist and Oncologist.

Q. Why is infection control important in cancer patients?

A. Infection control is important in cancer patients, as they are immunocompromised hosts on intense and invasive treatment protocols and in them intravascular devices are increasingly used.

Q. What are the ways to control infection?

A. Hand washing is the single most important measure in preventing the spread of infection. Routine hand wash requires that hands should be thoroughly lathered for 10-15 seconds and then washed in running water. They are then thoroughly dried with a "dry" towel. It is important to remember that wet hands are worse than unwashed hands.

A surgical hand wash is required before any procedure that involves penetration of normally sterile tissue. A suitable antimicrobial skin cleaner is 4% w/v chlorhexidine or detergent based povidone iodine. In emergencies where there may be insufficient time for routine or surgical hand wash, an alcoholic chlorhexidine preparation may be used. However, alcohol is not a good cleansing agent and is not recommended in the presence of physical dirt.

Other ways to control infection are based on cleanliness & sterility. Vacuum cleaning is recommended over brooming to prevent dispersal of dust. Alternatively, damp dusting or cleaning is acceptable, Patient care items viz. bedpans are stored dry.

Body fluid spills are disinfected with sodium hypochlorite (1% or 10,000 PPM available chlorine). Leave it for 3-10 min & then mop up with detergent & warm water.

Q. What additional precautions should be used for neutropenic patients?

A. In addition to general measures, the neutropenic patients should be in a private room as far as possible. Persons entering the room should wear masks. Persons with respiratory infections should not be allowed inside. Plant and flowers are not allowed in the room. The patient should wear a mask when travelling to other areas of the hospital.

Q. What are the precautions to be taken during intravenous injections?

A. Aseptic precautions should be taken while inserting the catheter & the insertion site should be kept dry and free from contamination. Thorough hand washing before insertion is recommended. The skin is disinfected with 0.5% alcoholic chlorhexidine or 10% alcoholic povidone iodine or ethyl alcohol (70%) or isopropyl alcohol. No touch technique during insertion, maintenance and removal should be maintained. The insertion site should be covered with a sterile dressing. Catheter should be removed at the first sign of infection.

Q. What is the role of immunization in infection control?

A. These children are immunocompromised and it is better to avoid all immunizations. Live vaccines are contraindicated during chemotherapy. In most cases, routine childhood vaccination can be given 3-6 months after the completion of chemotherapy.

Last created on 13-07-2001
Last updated on 01-07-2006

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