The INTERACT study: Infection prevention and surveillance practice in the care of the Australasian cancer and transplant population.

Background: Australasian cancer and transplant populations are expanding, with increased infection risk related to prolonged survivorship and broader use of novel immunosuppressants. To optimise care, standardised approaches to infection prevention and control (IPC) practices and surveillance for the high-risk immunocompromised host (ICH) are required in Australasian healthcare facilities (HCFs). We sought to evaluate current practices to inform future policy.

Methods: A cross-sectional survey was conducted among infectious disease (ID), microbiology, and IPC specialists caring for the high-risk ICH in Australasian HCFs.

Results: 140 healthcare-workers from all Australian jurisdictions and New Zealand responded, primarily employed within public (95.7%), non-specialist (77.9%) HCFs. Healthcare-associated infection (HAI) surveillance was common (75.7%) however monitoring for opportunistic infections (OIs) infrequent (22.9%). Although 51.4% reported a staff mask-wearing mandate on ICH wards, there was limited consensus on appropriate clinical setting for use, or application of other personal protective equipment (PPE). Strategies for multidrug-resistant organism (MDRO) screening were heterogeneous. Challenges to ICH-IPC including lack of infrastructure and ICH-adapted policy were identified.

Conclusions: This is the first survey of IPC/surveillance practice in the care of the Australasian cancer/transplant population, demonstrating multiple areas of variation including PPE use and approach to MDRO surveillance. Practice standardisation will help optimise clinical care and reduce preventable infection.