Infection Control in Neutropenic AML Patients

Key Principles of Infection Control

Hand hygiene is the most effective means of preventing transmission of infection in the hospital setting and should be rigorously practiced by all healthcare workers and visitors, as recommended by the Infectious Diseases Society of America 1, 2
Standard barrier precautions are recommended for all neutropenic patients to protect them from acquiring infections from healthcare workers and the environment, according to the Centers for Disease Control and Prevention 1, 2
The neutropenic patient undergoing AML induction is at extreme risk for life-threatening bacterial, fungal, and viral infections due to profound immunosuppression, as stated by the European Hematology Association 3

Herpes simplex virus infections in neutropenic leukemia patients require antiviral treatment, not isolation of the patient, as indicated by the Infectious Diseases Society of America 1, 2
Antiviral treatment for HSV infection is indicated when there is clinical or laboratory evidence of active viral disease, as recommended by the American Society of Clinical Oncology 1, 2

Implement standard barrier precautions with emphasis on protecting the neutropenic patient from environmental pathogens, as recommended by the Centers for Disease Control and Prevention 1, 2
Ensure rigorous hand hygiene by all staff and visitors before and after patient contact, as stated by the World Health Organization 1, 2
Monitor for bacterial and fungal superinfections, as HSV lesions can serve as portals of entry for other pathogens in the profoundly neutropenic host, as indicated by the European Hematology Association 3

Empirical broad-spectrum antimicrobial therapy is mandatory for febrile neutropenic patients, as bacterial infections remain the major cause of morbidity and mortality during AML induction, as recommended by the Infectious Diseases Society of America 3, 4
Antifungal prophylaxis is recommended for patients undergoing intensive remission-induction chemotherapy for acute leukemia given the substantial risk of invasive fungal infections, as stated by the National Comprehensive Cancer Network 1, 2, 6