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Evaluation of the knowledge of hematologists about the management of infectious complications in hematologic patients

Introduction: Infection is a serious complication among patients with hematologic malignancies (HMs) and in hematopoietic cell transplant (HCT) recipients. In most centers, the management of these complications is provided by the hematologist in person, thus demanding a knowledge of basic aspects of infection.

Methods: To evaluate the knowledge of the hematologist on infections, we invited clinicians to answer two questionnaires with 20 multiple-choice questions covering epidemiology, prophylaxis, diagnosis and treatment of infection in patients with HMs and HCT.

Results: We obtained 289 answers: 223 in survey 1 (febrile neutropenia) and 66 in survey 2 (infection in HCT). The median score was 5.0 in both surveys (range 0.5 - 9.0). In survey 1, the questions with the lowest number of correct answers were Q3 (8%), concerning the cefepime dose, and Q1 (9%), which asked about the epidemiologic link between the use of high dose cytarabine and viridans streptococcal bacteremia. In survey 2, two questions about cytomegalovirus (CMV) infection had the lowest percentage of correct answers (Q4, 12% and Q11, 18%). Clinicians attending to HCT recipients had higher scores, compared to clinicians attending to patients with HM only (median score of 5.0 and 4.5, p = 0.03, in survey 1 and 6.0 and 4.5, p = 0.001, in survey 2). In both surveys staff clinicians, residents and professors had similar scores.

Conclusion: This is the first study in Brazil assessing the knowledge of hematologists on infectious complications. The low median score overall indicates an urgent need for continuous education. Such initiatives will eventually result in better patient care.

Comments:

It appears that the results of this study indicate a need for improvement in the knowledge of hematologists in Brazil regarding infectious complications in patients with hematologic malignancies and hematopoietic cell transplant recipients. The low median score of 5.0 in both surveys suggests that there may be gaps in the understanding of epidemiology, prophylaxis, diagnosis, and treatment of infections in these patient populations. Additionally, the finding that staff clinicians, residents, and professors had similar scores suggests that this is a widespread issue that affects all levels of the medical community.
The study highlights specific areas in which knowledge may be lacking, such as the use of cefepime and the epidemiologic link between the use of high-dose cytarabine and viridans streptococcal bacteremia in survey 1, and questions about cytomegalovirus infection in survey 2. These findings emphasize the importance of continuous education and training for hematologists to ensure that they are equipped with the knowledge and skills necessary to effectively manage infectious complications in their patients.
Overall, this study highlights the importance of continuous education for hematologists and the need for initiatives that will improve their knowledge and understanding of infectious complications. This will ultimately lead to better patient care and improved outcomes for patients with hematologic malignancies and HCT recipients.

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