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Report Identifies Strategies for Preventing Infection in Stem Cell Transplantation

Jane L. Miller

Evidence-based recommendations for reducing the number and severity of opportunistic infections in patients who require hematopoietic stem cell transplants were released in October.

Three organizations—the Centers for Disease Control and Prevention, the Infectious Diseases Society of America, and the American Society of Blood and Marrow Transplantation—were cosponsors of the guidelines. The American Academy of Pediatrics and the International Society of Hematotherapy and Graft Engineering endorsed content specific to their members' areas of expertise.

Five broad topics are addressed:

  • Prevention of exposure to and disease from opportunistic pathogens, including Streptococcus pneumoniae, Streptococcus viridans, Haemophilus influenzae type b, cytomegalovirus, Epstein-Barr virus, herpes simplex virus, varicella-zoster virus, community-acquired respiratory viruses, yeasts and molds, Pneumocystis carinii, Toxoplasma gondii, Strongyloides stercoralis, and Trypanosoma cruzi
  • Hospital infection-control procedures, including construction, design, and ventilation issues; hygiene; isolation and barrier precautions; surveillance; patient skin and mouth care; prevention of catheter-related infections; and control of nosocomial infections caused by such pathogens as Legionella species, methicillin-resistant Staphylococcus aureus, staphylococci with reduced susceptibility to vancomycin, tuberculosis, community-acquired respiratory viruses, and Clostridium difficile 
  • Steps patients can take to avoid infections in the months following transplantation 
  • Vaccination schedules
  • Strategies for reducing the risk of pathogens being transmitted from donors to recipients

The guidelines were published in MMWR in the Recommendations and Reports supplement (PDF) to the October 20, 2000, issue.