Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar 5;33(1):41-7.
doi: 10.4274/tjh.2014.0010. Epub 2014 May 21.

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction

Mehmet Özen  1 , Gülden Yılmaz, Belgin Coşkun, Pervin Topçuoğlu, Bengi Öztürk, Mehmet Gündüz, Erden Atilla, Önder Arslan, Muhit Özcan, Taner Demirer, Osman İlhan, Nahide Konuk, İsmail Balık, Günhan Gürman, Hamdi Akan
Affiliations

A Quasi-Experimental Study Analyzing the Effectiveness of Portable High-Efficiency Particulate Absorption Filters in Preventing Infections in Hematology Patients during Construction

Mehmet Özen et al. Turk J Haematol. .

Abstract
in English, Turkish

Objective: The increased risk of infection for patients caused by construction and renovation near hematology inpatient clinics is a major concern. The use of high-efficiency particulate absorption (HEPA) filters can reduce the risk of infection. However, there is no standard protocol indicating the use of HEPA filters for patients with hematological malignancies, except for those who have undergone allogeneic hematopoietic stem cell transplantation. This quasi-experimental study was designed to measure the efficacy of HEPA filters in preventing infections during construction.

Materials and methods: Portable HEPA filters were placed in the rooms of patients undergoing treatment for hematological malignancies because of large-scale construction taking place near the hematology clinic. The rates of infection during the 6 months before and after the installation of the portable HEPA filters were compared. A total of 413 patients were treated during this 1-year period.

Results: There were no significant differences in the antifungal prophylaxis and treatment regimens between the groups. The rates of infections, clinically documented infections, and invasive fungal infections decreased in all of the patients following the installation of the HEPA filters. When analyzed separately, the rates of invasive fungal infections were similar before and after the installation of HEPA filters in patients who had no neutropenia or long neutropenia duration. HEPA filters were significantly protective against infection when installed in the rooms of patients with acute lymphocytic leukemia, patients who were undergoing consolidation treatment, and patients who were neutropenic for 1-14 days.

Conclusion: Despite the advent of construction and the summer season, during which environmental Aspergillus contamination is more prevalent, no patient or patient subgroup experienced an increase in fungal infections following the installation of HEPA filters. The protective effect of HEPA filters against infection was more pronounced in patients with acute lymphocytic leukemia, patients undergoing consolidation therapy, and patients with moderate neutropenia.

Amaç: Hematoloji yatan hasta kliniklerinin yakınındaki inşaat ve tamiratların neden olduğu, hastalardaki artmış enfeksiyon riski büyük bir endişe kaynağıdır. Yüksek etkinlikte partikül emici (YEPE) filtrelerin kullanımı enfeksiyon riskini azaltabilir. Bununla birlikte allojenik hematopoetik kök hücre nakli yapılanlar dışında, YEPE filtrelerin hematolojik malignite hastalarında kullanımı konusunda standart bir öneri yoktur. Bu öncesi sonrası çalışma inşaat esnasında enfeksiyonların engellenmesinde YEPE filtrelerin etkinliğini ölçmek için kurgulandı. Gereç ve Yöntemler: Hematoloji kliniğinin yanında meydana gelen geniş çaplı bir inşaat nedeniyle hematolojik tümörlerin tedavisinin yapıldığı hasta odalarına portabl YEPE filtreler yerleştirildi. Portabl YEPE filtrelerin yerleştirilmesinden önceki ve sonraki 6 aydaki enfeksiyon oranları karşılaştırıldı. Bu 1 yıllık dönemde toplam 413 hasta tedavi edildi. Bulgular: Gruplar arasında antifungal profilaksi ve tedavi rejimleri açısından farklılık yoktu. YEPE filtrelerin yerleştirilmesini takiben tüm hastalarda enfeksiyon, klinik gösterilmiş enfeksiyon ve invaziv fungal enfeksiyon oranları azaldı. Ayrı ayrı analiz edildiğinde ise YEPE filtre yerleştirilmesi sonrası ve öncesi invaziv fungal enfeksiyon oranları nötropenisi olmayan veya uzun nötropeni süresi olan hastalarda benzerdi. Akut lenfoblastik lösemi hastalarının, konsolidasyon tedavisi alan hastaların ve 1 ile 14 gün arasında nötropenik kalan hastaların odalarına yerleştirilen YEPE filtreler enfeksiyonlara karşı belirgin bir şekilde koruyucuydu. Sonuç: Çevresel Aspergillus kontaminasyonunun daha sık olduğu yaz sezonuna ve ortaya çıkan inşaata rağmen, YEPE filtrelerin yerleştirilmesi sonrası dönemde ne hastalarda ne de hasta alt gruplarında fungal enfeksiyonlarda artış gözlenmedi. YEPE filtrelerin enfeksiyonlara karşı koruyucu etkisi akut lenfoblastik lösemi hastalarında, konsolidasyon tedavisi alan hastalarda ve orta derecede nötropenisi olanlarda daha belirgindi.

PubMed Disclaimer

Conflict of interest statement

The preliminary data included in this study were previously presented at the 2013 American Society of Clinical Oncology (ASCO) congress: Gurman G, Ozen M, Yilmaz G, Coskun B, Topcuoglu P, Ozturk B, Ozcan M, Arslan O, Ilhan O, Beksac M, Ismail B, Akan H. Hepa systems in hematology clinic to ameliorate the increased fungal infection risk owing to environmental changing. J Clin Oncol 2013;31 (Suppl; abstr e18009).

Conflict of Interest: The authors of this paper have no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included.

Similar articles

See all similar articles

Cited by

References

    1. Passweg JR, Rowlings PA, Atkinson KA, Barrett AJ, Gale RP, Gratwohl A, Jacobsen N, Klein JP, Ljungman P, Russell JA, Schaefer UW, Sobocinski KA, Vossen JM, Zhang MJ, Horowitz MM. Influence of protective isolation on outcome of allogeneic bone marrow transplantation for leukemia. Bone Marrow Transplant. 1998;21:1231–1238. - PubMed
    1. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, Raad II, Rolston KV, Young JA, Wingard JR Infectious Diseases Society of America. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52:56–93. - PubMed
    1. Cumbo TA, Segal BH. Prevention, diagnosis, and treatment of invasive fungal infections in patients with cancer and neutropenia. J Natl Compr Canc Netw. 2004;2:455–469. - PubMed
    1. Nihtinen A, Anttila VJ, Richardson M, Meri T, Volin L, Ruutu T. The utility of intensified environmental surveillance for pathogenic moulds in a stem cell transplantation ward during construction work to monitor the efficacy of HEPA filtration. Bone Marrow Transplant. 2007;40:457–460. - PubMed
    1. Krüger WH, Zöllner B, Kaulfers PM, Zander AR. Effective protection of allogeneic stem cell recipients against Aspergillosis by HEPA air filtration during a period of construction--a prospective survey. J Hematother Stem Cell Res. 2003;12:301–307. - PubMed

MeSH terms

Substances