Page 140 - policy and procedure infection control

Policies and Procedures on Infection Control

6.9 Haematology and Oncology Unit

6.9.1. Introduction
1. Haemato-oncology patients are immunocompromised. The predisposing factors are
neutropaenia, monocytopaenia, lymphopaenia, qualitiative phagocytic defects and
complement deficiency, hyposplenism, humoral deficiency as well as cellular immune
dysfunction.
2. In addition, many patients have damage to their skin and mucous membranes as a
result of chemotherapy-induced mucosal barrier injury to the oro-gastrointestinal
tract.

6.9.2 Common pathogens and sites of infection
1. The common pathogens include bacterial commensals from the gastrointestinal
tract or skin and fungi including candida, aspergillus and other species.
2. Opportunistic infections include toxoplasma, crytococccus, pneumocystis and
cryptosporidium as well as infection or reactivation of viruses.
3. The common portals of infection include the oro-pharynx, periodontium, perianal,
colon skin, lung and esophagus.

6.9.3 Patient hygiene
1. Patients should be advised to rinse orally 4-6X/day with sterile water, normal saline
or sodium bicarbonate. Patients should be advised to brush their teeth at least twice
a day with a soft-bristled toothbrush. Fixed orthodonthics and space retainers should
not be worn.
2. Patients are advised to bath daily with a mild soap with attention to good perineal
hygiene.
3. Avoid the use of rectal thermometers, enemas, suppositories or rectal examinations.
4. Dental clearance should be performed 10-14days before induction of chemotherapy.

5. Skin sites should be inspected daily.

6.9.4 High risk neutropaenic diet
1. A low microbial diet is recommended to reduce the number of pathogens in food
2. Attention should be paid to food preparation. Raw meats should be handled on
separate surface.
3. Food handlers should wash their hands before and after handling food.

4. Consumption of raw or undercooked meats or eggs or foods that may contain these
e.g. mayonnaise, hollandaise sauce is not allowed.

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