Presenting Author:

Steve Trifilio

Principal Investigator:

Steve Trifilio

Department:

Medicine

Keywords:

infection, stem cell transplant, facility change,

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C44 - Clinical

Impact of facilities change on infection in a SCT unit

Hospital-acquired infection (HAI) is a leading cause of death in the United States. Preventable transmission most often occurs from contact between contaminated surfaces and caregivers. In November 2007, the hematopoietic stem cell transplantation (HSCT) ward was moved to a new hospital building approximately two blocks away from the old facility. To assess whether an environmental change to a new contamination free medical facility would impact the epidemiology of infection in a HSCT ward, a retrospective study was conducted with the objective to assess infection rates prior to and after move to a new medical facility. Methods: Electronic medical record was used to identify HAI and change in VRE rectal colonization in HSCT recipients over a 4 year period, 2 years before and after moving to a new facility in 11/2007. All isolates were included except organisms associated with colonization with only 1 positive culture. Strict prevention control was maintained throughout the study period. Results All patients who underwent HSCT between 11/2005 and 11/2009 were included, 410 before and 470 after the move. Table 1 shows there was no difference in patient demographics for age, gender, diagnosis, or transplant type. Table 2 and Figure 1 show infections and VRE colonization, at 3, 6, 12, and 24 months before and after facilities move. Within the first 3 months after moving to the new hospital ward, there was a significant increase in HAI and a trend towards higher C. difficile infection. There was no difference in new VRE colonization cases. For the remainder of the study period, between 3 months and 2 years, there was no significant difference in the incidence, spectrum of infections, or new VRE colonization between the two study groups. Conclusion: Changing the physical location of a HSCT ward unexpectedly was associated with an initial increase in HAI, which plateaued after 3 months. Change in medical facility did not appear to impact infection rate.