CDC issues initiative to address infection in patients with cancer

Survey results indicated concern about infection and antibiotic resistance.

A three-year initiative to provide resources and educational tools to raise awareness about infection and antibiotic resistance in patients with cancer assigned to chemotherapy was recently developed by Amgen in partnership with the CDC Foundation and the Divisions of Healthcare Quality and Promotion, and Cancer Prevention and Control at the CDC.

“There is a serious need to foster and implement campaigns that help deliver resources to both patients and clinicians to help improve infection-control and appropriate antibiotic stewardship practices,” Roy Baynes, MD, PhD, vice president and therapeutic area head for hematology/oncology at Amgen, told HemOnc Today.

Infection in patients with cancer may lead to hospitalization, disruption of chemotherapy schedules and sometimes may be life-threatening, according to Lisa Richardson, MD, PhD, of the Division of Cancer Prevention and Control.

“Taking the right steps to identify infections and to begin appropriate treatment is vital to the health and well-being of patients with cancer,” she told HemOnc Today.

In the United States, approximately 60,000 patients with cancer are hospitalized for chemotherapy-related neutropenia, and one in 14 patients hospitalized die, according to study results presented by Richardson at a media telebriefing.

“Unfortunately, many patients with cancer are not aware of the risk for infection; additionally, patients and their caregivers are not always aware of what they can do to minimize their risk,” she said.

Infection is a growing concern

An interactive survey was conducted to examine concern about risk for infection in patients with cancer. It included 151 infectious disease specialists, 150 oncologists and 430 interviews with patients with cancer who are currently undergoing chemotherapy or have undergone chemotherapy within the last 12 months. Results from the survey and information about the new three-year initiative were presented during the telebriefing.

Survey results indicated that 92% of oncologists and infectious disease specialists were highly concerned about antibiotic resistance and the negative effect infection may have on chemotherapy treatment outcomes.

Antibiotic resistance is a pressing public health problem, and almost every type of bacteria has become less responsive to antibiotic treatment during the last decade, according to Richardson.

Results showed 79% of oncologists and 96% of infectious disease specialists reported an increase in antibiotic-resistant infections in patients with cancer during the last five years. The most commonly observed infection in patients treated with chemotherapy was methicillin-resistant Staphylococcus aureus.

The effect of infection on OS and DFS for patients treated with chemotherapy was an issue in which 87% of infectious disease specialists felt extremely or very concerned, according to the survey results.

“The survey findings show that one in four [patients treated with chemotherapy] report having an infection during treatment, with more than a third requiring a second course of antibiotics,” Sean Harper, MD, chief medical officer and head of global development at Amgen, said in a press release.

Among patients assigned to chemotherapy treatment, 37% had the start of their next treatment delayed, 37% had the amount of treatment reduced and 43% had treatment interrupted due to infection.

“This is significant because many studies have shown that for certain types of cancer, chemotherapy produces the best long-term results when patients receive a full dose of their chemotherapy on schedule,” Baynes said.

“This initiative will bring together experts in oncology and infectious disease to raise awareness of this public health concern and reduce the risk for infections, and ultimately, related deaths,” Charles Stokes, president and CEO of the CDC Foundation, said in a press release.

The three-year initiative includes evidence-based clinician curricula on infection control and appropriate antibiotic use among patients with cancer to be disseminated in outpatient and acute care settings. An interactive online program with information for patients and family members will be available as well. – by Christen Haigh