Centers for Disease Control and Prevention, Infectious Disease Society of America, & American Society of Blood and Marrow Transplantation. (2000). Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recommendations and Reports, 49, 1–125, CE1–CE7.
To summarize the current data and provide comprehensive evidence-based recommendations for the prevention of opportunistic infections in adult and pediatric hematopoietic stem cell transplant (HSCT) recipients.
This was an evidence-based guideline. Evidence was reviewed by multiple professional groups and panels under Centers for Disease Control and Prevention (CDC) guidance.
No results were stated.
This guideline identified infection risks during preengraftment, postengraftment (30–100 days), and late phase (>100 days) for HSCT recipients, associated with immune system defects, device risks, and incidence of specific viral, bacterial, fungal, and mold infectious risks; very specific prevention strategies per treatment phase for allogeneic and autologous HSCT, as well as for both adult and pediatric patients; information on dosage and timing of prophylactic medication, vaccinations, and other specific medical interventions; recommendations for vaccination and behaviors of household members and close contacts; and recommendations for healthcare workers and environmental infection control practices in transplant centers. It identified phase-specific and life-long behavioral prevention, including food preparation, avoiding specific exposures, pet safety, sexual safety, travel safety, water safety, occupational exposures, and general areas to avoid for patients.
Evidence Rating System
A - Strong evidence and substantial clinical benefit (strongly recommended)
B - Strong or moderate evidence, but only limited clinical benefit (generally recommended)
C - Insufficient evidence for efficacy or efficacy does not outweigh possible adverse consequences (optional)
D - Moderate evidence against efficacy or for adverse outcome (generally not recommended)
E- Strong evidence against (never recommended)
I - Evidence from at least one well-executed randomized trial
II - Evidence from at least one well-designed clinical trial without randomization, cohort, or case controlled, time series
III - Evidence from opinions of respected authorities
Recommendations With at Least Optional Recommendation Level
Vaccinations
Other Recommendations
Food-Related
Environmental
Pet Safety
This summary is not intended to provide all content from these guidelines. The reader should refer to the original document for complete information.
Some recommendations are not supported by research data but are provided as best current knowledge in the area.
This was a comprehensive resource, with extensive specific recommendations and identification of the evidence classification of each recommendation. This is an excellent reference for individuals working with HSCT recipients.