Infectious complications in hematology: the effect of the implementation of modules a protective environment

Currently there was a lack of understanding of effect of protective environment systems of spectrum and characteristics of infections in hematology. Aim of this pilot clinical study is to study the changes in infections in patients receiving chemotherapy in innovative protective environment systems based on space filtration technologies. 60 adult high risk patients with hematological diseases receiving chemotherapy were included in the study. Clinical and microbiological outcomes were registered prospectively in standard and protective environments.Modules with protective environment systems had an impact on decrease of pneumonias and shifted the spectrum of bloodstream infections away from highly resistant gramnegative nonfermenting bacteria towards enteric commensal microorganisms. The results highlight the role of endogenous infections originating from the intestinal microbiome in modern hematology. Thus, when we increase the sterility of the environment in patients on chemotherapy, the dynamic composition of the intestinal microbiome should be evaluated to predict and prevent bacterial bloodstream infections. The introduction of innovative stationary protective environment modules leads to a change in the spectrum and characteristics of infections during chemotherapy, with reduction of a relative impact of exogenous infections, while the risks of endogenous infections originating from the gut bacterial community still remain in such patients.