Adherence to guidelines across different specialties to prevent infections in patients undergoing immunosuppressive therapies

Table 3 Audit outcomes for interventions to prevent infections

	Dermatology [n = 38]	Gastroenterolgy [n = 42]	Haematology [n = 30]	Nephrology [n = 45]	Rheumatology [n = 49]	Combined population [n = 204]
Tuberculosis screening, n[%]
Pre-treatment discussion	37 [97]	40 [93]	3 [10]	1 [4]	27 [57]	70 [34]
Pre-treatment chest x-ray	33 [87]	37 [88]	25 [83]	40 [89]	37 [76]	172 [84]
IGRA^a	30 [79]	34 [81]	1 [3]	4 [9]	23 [47]	90 [45]
Blood-borne virus screening, n[%]
HIV	16 [42]	36 [84]	19 [63]	39 [87]	4 [8]	114 [56]
Hepatitis B [HBsAg]	35 [92]	34 [81]	19 [63]	38 [84]	30 [61]	156 [76]
Hepatitis B exposure [HBcAb]	0 [0]	4 [10]	12 [40]	20 [44]	4 [8]	40 [20]
Hepatitis B immunity [HBsAb]	0 [0]	3 [8]	3 [10]	8 [18]	1 [2]	15 [7]
Hepatitis C	35 [92	35 [83]	18 [60]	39 [87]	29 [59]	156 [76]
Other viral immunity screen, n[%]
Varicella zoster immunity	37 [97]	26 [62]	6 [20]	23 [52]	33 [67]	133 [65]
Measles immunity	14 [38]	41 [98]	8 [27]	38 [84]	3 [6]	104 [51]
Hypogammaglobulinaemia screen, n[%]	4 [11]	1 [2]	23 [78]	21 [48]	32 [65]	81 [40]
Immunisation advice, n[%]
Influenza	38 [100]	37 [88]	23 [78]	0 [0]	49 [100]	148 [73]
Pneumococcal^b	0 [0]	37 [88]	0 [0]	0 [0]	7 [15]	44 [22]
Varicella zoster [if non-immune]	1 [25]	1 [20]	0 [0]	0 [0]	2 [50]	4 [30]
Hepatitis B [if non-immune]	0 [0]	0 [0]	0 [0]	1 [50]	0 [0]	1 [33]
Discussions on infection risk, n[%]
General infection risks	38 [100]	38 [90]	22 [75]	45 [100]	48 [98]	191 [94]
Live vaccine risk	38 [100]	37 [88]	23 [78]	45 [100]	49 [100]	192 [94]
Provision of PJP prophylaxis^c, n[%]	–	1/23 [4]	3/22 [14]	36/40 [90]	0/19 [0]	40/104 [38]

^aIGRA: interferon-gamma release assay; ^b either PPV-23 or PCV-13; ^c in those receiving potent immunosuppression

ISSN: 1471-2334