SURVEILLANCE DES INFECTIONS ASSOCIEES AUX SOINS DANS UNE UNITE D’HEMATOLOGIE ADULTE A CASABLANCA.

Introduction: Infections in neutropenic patients are the major cause of morbidity and mortality. Definition of healthcare associated infections (HAI) is more used currently, but their data are less available. The rigging of a register for HAI monitoring in the Pediatric Hematology and Oncology Unit of Casablanca allow a better knowledge of care practices and develop a strategy to fight against HAI. Patients and methods: Prospectively, we conducted a study over a period of twelve months, between January and December 2012. Results: Of 682 admissions, 283 infectious episodes were diagnosed in 120 patients witch 81.6% were followed for Acute Myeloid Leukemia (AML). Incidence rate of HAI was 42.1% [37.4 -46.9%] against 29.9% for NI and incidence density of HAI per 1000 patients days was 31.6% against 24.6 for NI. Risk factors have implicated significantly were neutropenia in 87% (p<0.001), chemotherapy 83% (p<0.001), and central venous catheter 60% (p<0.001). HAI were documented microbiologically in 30.4% with bacteremia in 24.8% of all HAI cases. Pneumonia were noted in 31.1% witch 75% in AML infected patients. Infection was of unknown origin in 24%. 85.5% of isolated germs were bacteria with 42.8% of Staphylococci and 35.3% of Gram Negative Bacillus. Conclusion: These results constituted a fundamental step to release the constraints of implementation a register of HAI monitoring to develop a policy against HAI in our unit.