Infection Control Issues After Hematopoietic Stem Cell Transplantation

  • Sarah A. Longworth
  • Robin K. Avery
  • Melanie S. Curless
  • David L. Longworth


Minimizing acquisition and transmission of infections is a priority among hospitalized hematopoietic stem cell transplant (HSCT) recipients. Updated evidence-based guidelines pertaining to infection control in HSCT centers were published in 2009. This chapter will review these guidelines and discuss issues pertaining to room ventilation; construction, renovation, and building cleaning; isolation and barrier precautions; hand hygiene; equipment management; plants, play areas, and toys; food and nutrition; animals; issues involving health care workers and visitors to HSCT centers; patient skin and oral care; prevention of bacterial intravascular catheter-related infections; infection control surveillance; and prevention and control of specific nosocomial infections. Despite growing experience with the management of infectious complications among HSCT recipients, many aspects of infection control in this at-risk population remain unclear. Many recommendations are based on expert opinion or are generic practices that are derived from, and applicable to, other clinical settings. Ongoing research in the field is needed to better define optimal infection control practices in this high risk population.


Room ventilation Building construction Isolation and barrier precautions Hand hygiene Disinfection Health care worker and visitor precautions Nosocomial infection prevention 


  1. 1.
    Tomblyn M, Chiller T, Einsele H, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant. 2009;15:1143–238.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Centers for Disease Control and Prevention; Infectious Diseases Society of America; American Society of Blood and Marrow Transplantation. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2000;6(6a):659–713, 715, 717–727; quiz 729–733.Google Scholar
  3. 3.
    Siegel JD, Rhinehart E, Jackson M, et al. 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10 suppl 2):S65–164.PubMedCrossRefGoogle Scholar
  4. 4.
    Sehulster L, Chinn RY. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the healthcare infection control practices advisory committee (HICPAC). MMWR Recomm Rep. 2003;52(RR-10):1–42.Google Scholar
  5. 5.
    Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings. Recommendations of the healthcare infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep. 2002;51(RR-16):1–45; quiz CE41–CE44.Google Scholar
  6. 6.
    Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Available at: Accessed 22 May 2015.
  7. 7.
    Dubberke ER, Carling P, Carrico R, et al. SHEA/IDSA practice recommendation: strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35 Suppl 2:S48–65.PubMedCrossRefGoogle Scholar
  8. 8.
    MacCannell T, Umscheid CA, Agarwal RK, et al. Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for prevention and control of norovirus gastroenteritis outbreaks in healthcare settings, 2011. Infect Control Hosp Epidemiol. 2011;32(10):939–69.PubMedCrossRefGoogle Scholar
  9. 9.
    Streifel A. Design and maintenance of hospital ventilator systems and the prevention of airborne nosocomial infections. In: Mayhall CG, editor. Hospital epidemiology and infection control. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 1211–21.Google Scholar
  10. 10.
    Humphreys H. Positive-pressure isolation and the prevention of invasive aspergillosis. What is the evidence? J Hosp Infect. 2004;56(2):93–100. quiz 163.PubMedCrossRefGoogle Scholar
  11. 11.
    Benet T, Nicolle MC, Thiebaut A, et al. Reduction of invasive aspergillosis incidence among immunocompromised patients after control of environmental exposure. Clin Infect Dis. 2007;45:682–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Hahn T, Cummings KM, Michalek AM, et al. Efficacy of high-efficiency particulate air filtration in preventing aspergillosis in immunocompromised patients with hematologic malignancies. Infect Control Hosp Epidemiol. 2002;23:525–31.PubMedCrossRefGoogle Scholar
  13. 13.
    Engelhart S, Hanfland J, Glasmacher A, et al. Impact of portable air filtration units on exposure of haematology-oncology patients to airborne Aspergillus fumigatus spores under field conditions. J Hosp Infect. 2003;54:300–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Rutala WA. APIC guideline for selection and use of disinfectants. 1994, 1995, and 1996 APIC Guidelines Committee. Association for Professionals in Infection Control and Epidemiology, Inc. Am J Infect Control. 1996;24:313–42.PubMedCrossRefGoogle Scholar
  15. 15.
    Petersen FB, Buckner CD, Clift RA, et al. Infectious complications in patients undergoing marrow transplantation: a prospective randomized study of the additional effect of decontamination and laminar air flow isolation among patients receiving prophylactic systemic antibiotics. Scand J Infect Dis. 1987;19(5):559–67.PubMedCrossRefGoogle Scholar
  16. 16.
    Storb R, Prentice RL, Buckner CD, et al. Graft-versus-host disease and survival in patients with aplastic anemia treated by marrow grafts from HLA-identical siblings. Beneficial effect of a protective environment. N Engl J Med. 1983;308(6):302–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Buckner CD, Clift RA, Thomas ED, et al. Early infectious complications in allogeneic marrow transplant recipients with acute leukemia: effects of prophylactic measures. Infection. 1983;11(5):243–50.PubMedCrossRefGoogle Scholar
  18. 18.
    Walter EA, Bowden RA. Infection in the bone marrow transplant recipient. Infect Dis Clin North Am. 1995;9(4):823–47.PubMedGoogle Scholar
  19. 19.
    Walsh TJ, Dixon DM. Nosocomial aspergillosis: environmental microbiology, hospital epidemiology, diagnosis and treatment. Eur J Epidemiol. 1989;5(2):131–42.PubMedCrossRefGoogle Scholar
  20. 20.
    American Institute of Architects Facility Guidelines Institute, AIA Academy of Architecture for Health, US Dept. of Health& Human Services, Guidelines for Design and Construction of Health Care Facilities. Washington DC: American Institute of Architects Press; 2006.Google Scholar
  21. 21.
    Thio CL, Smith D, Merz WG, et al. Refinements of environmental assessment during an outbreak investigation of invasive aspergillosis in a leukemia and bone marrow transplant unit. Infect Control Hosp Epidemiol. 2000;21(1):18–23.PubMedCrossRefGoogle Scholar
  22. 22.
    McCann S, Byrne JL, Rovira M, et al. Outbreaks of infectious diseases in stem cell transplant units: a silent cause of death for patients and transplant programmes. Bone Marrow Transplant. 2004;33(5):519–29.PubMedCrossRefGoogle Scholar
  23. 23.
    Carter CD, Barr BA. Infection control issues in construction and renovation. Infect Control Hosp Epidemiol. 1997;18(8):587–96.PubMedCrossRefGoogle Scholar
  24. 24.
    Weems Jr JJ, Davis BJ, Tablan OC, et al. Construction activity: an independent risk factor for invasive aspergillosis and zygomycosis in patients with hematologic malignancy. Infect Control. 1987;8:71–5.PubMedCrossRefGoogle Scholar
  25. 25.
    Bartley J. Prevention of infections related to construction, renovation, and demolition systems. In: Mayhall C, editor. Hospital epidemiology and infection control. Philadelphia, PA: Lippincott, Williams & Wilkins; 2004.Google Scholar
  26. 26.
    Kidd F, Buttner C, Kressel AB. Construction: a model program for infection control compliance. Am J Infect Control. 2007;35:347–50.PubMedCrossRefGoogle Scholar
  27. 27.
    Cooper EE, O’Reilly MA, Guest DI, Dharmage SC. Influence of building construction work on Aspergillus infection in a hospital setting. Infect Control Hosp Epidemiol. 2003;24:472–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Berthelot P, Loulergue P, Raberin H, et al. Efficacy of environmental measures to decrease the risk of hospital-acquired aspergillosis in patients hospitalised in haematology wards. Clin Microbiol Infect. 2006;12:738–44.PubMedCrossRefGoogle Scholar
  29. 29.
    Falvey DG, Streifel AJ. Ten-year air sample analysis of Aspergillus prevalence in a university hospital. J Hosp Infect. 2007;67:35–41.PubMedCrossRefGoogle Scholar
  30. 30.
    Lai KK. A cluster of invasive aspergillosis in a bone marrow transplant unit related to construction and the utility of air sampling. Am J Infect Control. 2001;29:333–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Morris G, Kokki MH, Anderson K, Richardson MD. Sampling of Aspergillus spores in air. J Hosp Infect. 2000;44:81–92.PubMedCrossRefGoogle Scholar
  32. 32.
    Gerson SL, Parker P, Jacobs MR, et al. Aspergillosis due to carpet contamination. Infect Control Hosp Epidemiol. 1994;15:221–3.PubMedCrossRefGoogle Scholar
  33. 33.
    Richet HM, McNeil MM, Davis BJ, et al. Aspergillus fumigatus sternal wound infections in patients undergoing open heart surgery. Am J Epidemiol. 1992;135:48–58.PubMedCrossRefGoogle Scholar
  34. 34.
    Pegues DF, Daar ES, Murthy AR. The epidemiology of invasive pulmonary aspergillosis at a large teaching hospital. Infect Control Hosp Epidemiol. 2001;22:370–4.Google Scholar
  35. 35.
    Guerra IC, Shearer WT. Environmental control in management of immunodeficient patients: experience with “David”. Clin Immunol Immunopathol. 1986;40(1):128–35.PubMedCrossRefGoogle Scholar
  36. 36.
    Legha SS. Are protected environments necessary for recipients of bone marrow transplants? Ann Intern Med. 1994;121(1):76.PubMedCrossRefGoogle Scholar
  37. 37.
    Slota M, Green M, Farley A, et al. The role of gown and glove isolation and strict handwashing in the reduction of nosocomial infection in children with solid organ transplantation. Crit Care Med. 2001;29(2):405–12.PubMedCrossRefGoogle Scholar
  38. 38.
    Munoz-Price LS, Banach DB, Bearman G, et al. SHEA Expert Guidance: isolation precautions for visitors. Infect Control Hosp Epidemiol. Available on CJO 2015 doi: 10.1017/ice.2015.67.
  39. 39.
    Klausner JD, Zukerman C, Limaye AP, et al. Outbreak of Stenotrophomonas maltophilia bacteremia among patients undergoing bone marrow transplantation: association with faulty replacement of handwashing soap. Infect Control Hosp Epidemiol. 1999;20(11):756–8.PubMedCrossRefGoogle Scholar
  40. 40.
    McNeil SA, Foster CL, Hedderwick SA, et al. Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers. Clin Infect Dis. 2001;32(3):367–72.PubMedCrossRefGoogle Scholar
  41. 41.
    Moolenaar RL, Crutcher JM, San Joaquin VH, et al. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol. 2000;21(2):80–5.PubMedCrossRefGoogle Scholar
  42. 42.
    Bernard L, Kereveur A, Durand D, et al. Bacterial contamination of hospital physicians’ stethoscopes. Infect Control Hosp Epidemiol. 1999;20(9):626–8.PubMedCrossRefGoogle Scholar
  43. 43.
    Wurtz R, Weinstein R. Microbiologic contamination and cleaning personal medical equipment. JAMA. 1998;280(6):519–20.PubMedCrossRefGoogle Scholar
  44. 44.
    Mitchell SJ, Gray J, Morgan ME, Hocking MD, Durbin GM. Nosocomial infection with Rhizopus microsporus in preterm infants: association with wooden tongue depressors. Lancet. 1996;348:441–3.PubMedCrossRefGoogle Scholar
  45. 45.
    Rhame FS, Streifel AJ, Kersey Jr JH, McGlave PB. Extrinsic risk factors for pneumonia in the patient at high risk of infection. Am J Med. 1984;76:42–52.PubMedCrossRefGoogle Scholar
  46. 46.
    Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004;53:1–36.PubMedGoogle Scholar
  47. 47.
    Rogers M, Weinstock DM, Eagan J, et al. Rotavirus outbreak on a pediatric oncology floor: possible association with toys. Am J Infect Control. 2000;28(5):378–80.PubMedCrossRefGoogle Scholar
  48. 48.
    Murthy R, Bearman G, Brown S, et al. Animals in healthcare facilities: recommendations to minimize potential risks. Infect Control Hosp Epidemiol. 2015;36(5):495–516.PubMedCrossRefGoogle Scholar
  49. 49.
    Centers for Disease Control and Prevention (CDC). Recommendations for preventing transmission of human immunodeficiency virus and hepatitis B virus to patients during exposure-prone invasive procedures. MMWR Recomm Rep. 1991;40:1–9.Google Scholar
  50. 50.
    Management of healthcare workers infected with hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or other bloodborne pathogens. AIDS/TB Committee of the Society for Healthcare Epidemiology of America. Infect Control Hosp Epidemiol. 1997;18:349–63.Google Scholar
  51. 51.
    Bolyard EA, Tablan OC, Williams WW, et al. Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1998;19(6):407–63.PubMedCrossRefGoogle Scholar
  52. 52.
    Stover BH, Bratcher DF. Varicella-zoster virus: infection, control, and prevention. Am J Infect Control. 1998;26:369–81. Quiz 382–384.PubMedCrossRefGoogle Scholar
  53. 53.
    Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 1997;46(RR-18):1–42.Google Scholar
  54. 54.
    Raad I, Abbas J, Whimbey E. Infection control of nosocomial respiratory viral disease in the immunocompromised host. Am J Med. 1997;102(3A):48–52. discussion 53–54.PubMedCrossRefGoogle Scholar
  55. 55.
    Avery RK. Immunizations in adult immunocompromised patients: which to use and which to avoid. Cleve Clin J Med. 2001;68(4):337–48.PubMedCrossRefGoogle Scholar
  56. 56.
    Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guidelines for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):309–18.PubMedCrossRefGoogle Scholar
  57. 57.
    Heimdahl A, Mattsson T, Dahllof G, et al. The oral cavity as a port of entry for early infections in patients treated with bone marrow transplantation. Oral Surg Oral Med Oral Pathol. 1989;68(6):711–6.PubMedCrossRefGoogle Scholar
  58. 58.
    Classen DC, Burke JP, Ford CD, et al. Streptococcus mitis sepsis in bone marrow transplant patients receiving oral antimicrobial prophylaxis. Am J Med. 1990;89(4):441–6.PubMedCrossRefGoogle Scholar
  59. 59.
    Graber CJ, de Almeida KN, Atkinson JC, et al. Dental health and viridans streptococcal bacteremia in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant. 2001;27(5):537–42.PubMedCrossRefGoogle Scholar
  60. 60.
    Marron A, Carratala J, Gonzalez-Barca E, et al. Serious complications of bacteremia caused by viridans streptococci in neutropenic patients with cancer. Clin Infect Dis. 2000;31(5):1126–30.PubMedCrossRefGoogle Scholar
  61. 61.
    Barker GJ. Current practices in the oral management of the patient undergoing chemotherapy or bone marrow transplantation. Support Care Cancer. 1999;7:17–20.PubMedCrossRefGoogle Scholar
  62. 62.
    Schubert MM, Peterson DE, Lloid ME. Oral complications. In: Thomas ED, Blume KG, Forman SJ, editors. Hematopoietic cell transplantation. Oxford, England: Blackwell Science, Inc.; 1999. p. 751–63.Google Scholar
  63. 63.
    Spielberger R, Stiff P, Bensinger W, et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med. 2004;351:2590–8.PubMedCrossRefGoogle Scholar
  64. 64.
    Ferretti GA, Ash RC, Brown AT, et al. Control of oral mucositis and candidiasis in marrow transplantation: a prospective, double blind trial of chlorhexidine digluconate oral rinse. Bone Marrow Transplant. 1988;3(5):483–93.PubMedGoogle Scholar
  65. 65.
    Wilkes JD. Prevention and treatment of oral mucositis following cancer chemotherapy. Semin Oncol. 1998;25(5):538–51.PubMedGoogle Scholar
  66. 66.
    Ferretti GA, Raybould TP, Brown AT, et al. Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial. Oral Surg Oral Med Oral Pathol. 1990;69(3):331–8.PubMedCrossRefGoogle Scholar
  67. 67.
    Schubert MM, Correa ME. Oral graft-versus-host disease. Dent Clin North Am. 2008;52:79–109. viii–ix.Google Scholar
  68. 68.
    Couriel D, Carpenter PA, Cutler C, et al. Ancillary therapy and supportive care of chronic graft-versus-host disease: national institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: V. Ancillary Therapy and Supportive Care Working Group Report. Biol Blood Marrow Transplant. 2006;12:375–96.PubMedCrossRefGoogle Scholar
  69. 69.
    Orth B, Frei R, Itin PH, et al. Outbreak of invasive mycoses caused by Paecilomyces lilacinus from a contaminated skin lotion. Ann Intern Med. 1996;125(10):799–806.PubMedCrossRefGoogle Scholar
  70. 70.
    Richard-Smith A, Buh S. Reducing central line catheter infections in bone marrow transplant patients. Nurs Clin North Am. 1995;30(1):45–52.PubMedGoogle Scholar
  71. 71.
    Lazarus HM, Trehan S, Miller R, et al. Multi-purpose silastic dual-lumen central venous catheters for both collection and transplantation of hematopoietic progenitor cells. Bone Marrow Transplant. 2000;25(7):779–85.PubMedCrossRefGoogle Scholar
  72. 72.
    Guerrato R, Biagi MC. The central venous catheter in a bone marrow transplant unit: an unresolved problem. Haematologica. 2000;85(11 suppl):62–5.PubMedGoogle Scholar
  73. 73.
    Mermel LA, Farr BM, Sherertz RJ, et al. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis. 2001;32(9):1249–72.PubMedCrossRefGoogle Scholar
  74. 74.
    Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1–45.PubMedPubMedCentralCrossRefGoogle Scholar
  75. 75.
    Marschall J, Mermel LA, Fakih M, et al. SHEA/ISDA practice recommendations: strategies to prevent central line-associated bloodstream infections in acute care hospitals 2014 Update. Infect Control Hosp Epidemiol. 2014;35 Suppl 2:S89–107.PubMedGoogle Scholar
  76. 76.
    Marschall J, Mermel LA, Classen D, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008;29 Suppl 1:S22–30.PubMedCrossRefGoogle Scholar
  77. 77.
    O’Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2002;51:1–29.PubMedGoogle Scholar
  78. 78.
    Do AN, Ray BJ, Banerjee SN, et al. Bloodstream infection associated with needleless device use and the importance of infection-control practices in the home health care setting. J Infect Dis. 1999;179:442–8.PubMedCrossRefGoogle Scholar
  79. 79.
    Trifilio S, Helenowski I, Giel M, et al. Questioning the role of a neutropenic diet following hematopoetic stem cell transplantation. Biol Blood Marrow Transplant. 2012;18:1385–90.PubMedCrossRefGoogle Scholar
  80. 80.
    Gardner A, Mattiuzzi G, Faderl S, et al. Randomized comparison of cooked and noncooked diets in patients undergoing remission induction therapy for acute myeloid leukemia. J Clin Oncol. 2008;26:5684–8.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    van Tiel F, Harbers MM, Terporten PH, et al. Normal hospital and low-bacterial diet in patients with cytopenia after intensive chemotherapy for hematological malignancy: a study of safety. Ann Oncol. 2007;18:1080–4.PubMedCrossRefGoogle Scholar
  82. 82.
    Murray SM, Pindoria S. Nutrition support for bone marrow transplant patients. Cochrane Database Syst Rev. 2009;1, CD002920.Google Scholar
  83. 83.
    Ziegler TR. Glutamine supplementation in bone marrow transplantation. Br J Nutr. 2002;87 suppl 1:S9–15.PubMedCrossRefGoogle Scholar
  84. 84.
    Lenssen P, Bruemmer BA, Bowden RA, et al. Intravenous lipid dose and incidence of bacteremia and fungemia in patients undergoing bone marrow transplantation. Am J Clin Nutr. 1998;67(5):927–33.PubMedCrossRefGoogle Scholar
  85. 85.
    Szyper-Kravitz M, Lang R, Manor Y, Lahav M. Early invasive pulmonary aspergillosis in a leukemia patient linked to aspergillus contaminated marijuana smoking. Leuk Lymphoma. 2001;42(6):1433–7.PubMedCrossRefGoogle Scholar
  86. 86.
    Hamadeh R, Ardehali A, Locksley RM, York MK. Fatal aspergillosis associated with smoking contaminated marijuana, in a marrow transplant recipient. Chest. 1998;94(2):432–3.CrossRefGoogle Scholar
  87. 87.
    Kool JL, Fiore AE, Kioski CM, et al. More than 10 years of unrecognized nosocomial transmission of legionnaires’ disease among transplant patients. Infect Control Hosp Epidemiol. 1998;19(12):898–904.PubMedCrossRefGoogle Scholar
  88. 88.
    Patterson WJ, Hay J, Seal DV, et al. Colonization of transplant unit water supplies with Legionella and protozoa: precautions required to reduce the risk of legionellosis. J Hosp Infect. 1997;37(1):7–17.PubMedCrossRefGoogle Scholar
  89. 89.
    Palmore TN, Stock F, White M, et al. A cluster of cases of nosocomial legionnaires disease linked to contaminated hospital decorative water fountain. Infect Control Hosp Epidemiol. 2009;30(8):764–8.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Squier CL, Stout JE, Krsytofiak S, et al. A proactive approach to prevention of health care-acquired Legionnaires’ disease: the Allegheny County (Pittsburgh) experience. Am J Infect Control. 2005;33:360–7.PubMedCrossRefGoogle Scholar
  91. 91.
    Stout JE, Muder RR, Mietzner S, et al. Role of environmental surveillance in determining the risk of hospital-acquired legionellosis: a national surveillance study with clinical correlations. Infect Control Hosp Epidemiol. 2007;28:818–24.PubMedCrossRefGoogle Scholar
  92. 92.
    Muraca PW, Yu VL, Goetz A. Disinfection of water distribution systems for legionella: a review of application procedures and methodologies. Infect Control Hosp Epidemiol. 1990;11(2):79–88.PubMedCrossRefGoogle Scholar
  93. 93.
    Muto CA, Jernigan JA, Ostrowsky BE, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol. 2003;24:362–86.PubMedCrossRefGoogle Scholar
  94. 94.
    Dutch Workingparty Infection Prevention. Policy for Methicillin-resistant Staphylococcus aureus. Lancet Infect Dis. 2005;5(10):653–63.CrossRefGoogle Scholar
  95. 95.
    Siegel JD, Rhinehart E, Jackson M, Chiarello L. Healthcare Infection Control Practices Advisory Committee, Management of multidrug-resistant organisms in healthcare settings, 2006. Atlanta, GA: CDC; 2006.Google Scholar
  96. 96.
    Coia JE, Duckworth GJ, Edwards DI, et al. Guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect. 2006;63:S1–44.PubMedCrossRefGoogle Scholar
  97. 97.
    Huang SS, Yokoe DS, Hinrichsen VL, et al. Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis. 2006;43:971–8.PubMedCrossRefGoogle Scholar
  98. 98.
    Robicsek A, Beaumont JL, Paule SM, et al. Universal surveillance for methicillin-resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med. 2008;148:409–18.PubMedCrossRefGoogle Scholar
  99. 99.
    Ridenour G, Lampen R, Federspiel J, et al. Selective use of intranasal mupirocin and chlorhexidine bathing and the incidence of methicillin resistant Staphylococcus aureus colonization and infection among intensive care unit patients. Infect Control Hosp Epidemiol. 2007;28:1155–61.PubMedCrossRefGoogle Scholar
  100. 100.
    Harbarth S, Dharan S, Liassine N, et al. Randomized, placebo-controlled, double-blind trial to evaluate the efficacy of mupirocin for eradicating carriage of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1999;43:1412–6.PubMedPubMedCentralGoogle Scholar
  101. 101.
    Simor AE, Loeb M. The management of infection and colonization due to methicillin-resistant Staphylococcus aureus: a CIDS/CAMM position paper. Can J Infect Dis. 2004;15:39–48.PubMedPubMedCentralCrossRefGoogle Scholar
  102. 102.
    Schmitz F, Lindenlauf E, Hofmann B, et al. The prevalence of low- and high-level mupirocin resistance in staphylococci from 19 European hospitals. J Antimicrob Chemother. 1998;42:489–95.PubMedCrossRefGoogle Scholar
  103. 103.
    Udo EE, Jacob LE, Mathew B. The spread of a mupirocin-resistant/methicillin-resistant Staphylococcus aureus clone in Kuwait hospitals. Acta Trop. 2001;80:155–61.PubMedCrossRefGoogle Scholar
  104. 104.
    Bastos MD, Mondino PJ, Azevedo ML, et al. Molecular characterization and transfer among Staphylococcus strains of a plasmid conferring high-level resistance to mupirocin. Eur J Clin Microbiol Infect Dis. 1999;18:393–8.PubMedCrossRefGoogle Scholar
  105. 105.
    Fridkin SK. Vancomycin-intermediate and -resistant Staphylococcus aureus: what the infectious disease specialist needs to know. Clin Infect Dis. 2001;32(1):108–15.PubMedCrossRefGoogle Scholar
  106. 106.
    Centers for Disease Control. Vancomycin-Intermediate/Resistant Staphylococcus aureus Laboratory Testing Algorithm. Atlanta, GA: CDC; 2009: p. 1.Google Scholar
  107. 107.
    Centers for Disease Control and Prevention (CDC). Recommendations for preventing the spread of vancomycin resistance. Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 1995;22:1–13.Google Scholar
  108. 108.
    NCCLS. Performance standards for antimicrobial disk susceptibility testing. Fourteenth informational supplement. NCCLS document. 2004; M100–514.Google Scholar
  109. 109.
    Centers for Disease Control and Prevention. Interim guidelines for prevention and control of Staphylococcal infection associated with reduced susceptibility to vancomycin. MMWR Morb Mortal Wkly Rep. 1997;46:626–8.Google Scholar
  110. 110.
    Centers for Disease Control and Prevention. Staphylococcus aureus resistant to vancomycin—United States, 2002. MMWR Morb Mortal Wkly Rep. 2002;51:565–7.Google Scholar
  111. 111.
    Avery R, Kalaycio M, Pohlman B, et al. Early vancomycin-resistant enterococcus (VRE) bacteremia after allogeneic bone marrow transplantation is associated with a rapidly deteriorating clinical course. Bone Marrow Transplant. 2005;35:497–9.PubMedCrossRefGoogle Scholar
  112. 112.
    Dubberke ER, Hollands JM, Georgantopoulos P, et al. Vancomycin- resistant enterococcal bloodstream infections on a hematopoietic stem cell transplant unit: are the sick getting sicker? Bone Marrow Transplant. 2006;38:813–9.PubMedCrossRefGoogle Scholar
  113. 113.
    Montecalvo MA, Shay DK, Patel P, et al. Bloodstream infections with vancomycin-resistant enterococci. Arch Intern Med. 1996;156:1458–62.PubMedCrossRefGoogle Scholar
  114. 114.
    Kirkpatrick BD, Harrington SM, Smith D, et al. An outbreak of vancomycin-dependent Enterococcus faecium in a bone marrow transplant unit. Clin Infect Dis. 1999;29:1268–73.PubMedCrossRefGoogle Scholar
  115. 115.
    Donskey CJ, Chowdhry TK, Hecker MT, et al. Effect of antibiotic therapy on the density of vancomycin-resistant enterococci in the stool of colonized patients. N Engl J Med. 2000;343:1925–32.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Montecalvo MA, de Lencastre H, Carraher M, et al. Natural history of colonization with vancomycin-resistant Enterococcus faecium. Infect Control Hosp Epidemiol. 1995;16:680–5.PubMedCrossRefGoogle Scholar
  117. 117.
    Baden LR, Thiemke W, Skolnik A, et al. Prolonged colonization with vancomycin-resistant Enterococcus faecium in longterm care patients and the significance of “clearance”. Clin Infect Dis. 2001;33:1654–60.PubMedCrossRefGoogle Scholar
  118. 118.
    Centers for Disease Control and Prevention (CDC). Recommendations for preventing the spread of vancomycin resistance: recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 1995; 44 (RR1-12): 1–13.Google Scholar
  119. 119.
    Byers KE, Anglim AM, Anneski CJ, Farr BM. Duration of colonization with vancomycin-resistant Enterococcus. Infect Control Hosp Epidemiol. 2002;23(4):207–11.PubMedCrossRefGoogle Scholar
  120. 120.
    Centers for Disease Control and Prevention (CDC). Guidance for control of infections with carbapenem-resistant or carbapenemase- producing Enterobacteriaceae in acute care facilities. MMWR Morb Mortal Wkly Rep. 2009;58:256–60.Google Scholar
  121. 121.
    Troche G, Joly LM, Guibert M, Zazzo JF. Detection and treatment of antibiotic-resistant bacterial carriage in a surgical intensive care unit: a 6-year prospective survey. Infect Control Hosp Epidemiol. 2005;26:161–5.PubMedCrossRefGoogle Scholar
  122. 122.
    Reddy P, Malczynski M, Obias A, et al. Screening for extended spectrum beta-lactamase-producing Enterobacteriaceae among high-risk patients and rates of subsequent bacteremia. Clin Infect Dis. 2007;45:846–52.PubMedCrossRefGoogle Scholar
  123. 123.
    Gardam MA, Burrows LL, Kus JV, et al. Is surveillance for multidrug-resistant Enterobacteriaceae an effective infection control strategy in the absence of an outbreak? J Infect Dis. 2002;186:1754–60.Google Scholar
  124. 124.
    Gerding DN, Johnson S, Peterson LR, et al. Clostridium difficile-associated diarrhea and colitis. Infect Control Hosp Epidemiol. 1995;16:459–77.PubMedCrossRefGoogle Scholar
  125. 125.
    Johnson S, Gerding DN. Clostridium difficile-associated diarrhea. Clin Infect Dis. 1998;26:1027–34.PubMedCrossRefGoogle Scholar
  126. 126.
    Niault M, Thomas F, Prost J, et al. Fungemia due to Saccharomyces species in a patient treated with enteral Saccharomyces boulardii. Clin Infect Dis. 1999;28(4):930.PubMedCrossRefGoogle Scholar
  127. 127.
    Mayfield JL, Leet T, Miller J, et al. Environmental control to reduce transmission of Clostridium difficile. Clin Infect Dis. 2000;31(4):995–1000.PubMedCrossRefGoogle Scholar
  128. 128.
    Champlin RE, Whimbey E. Community respiratory virus infections in bone marrow transplant recipients: the M.D. Anderson Cancer Center experience. Biol Blood Marrow Transplant. 2001;7(suppl):8S–10.PubMedCrossRefGoogle Scholar
  129. 129.
    La Rosa AM, Champlin RE, Mirza N, et al. Adenovirus infections in adult recipients of blood and marrow transplants. Clin Infect Dis. 2001;32(6):871–6.PubMedCrossRefGoogle Scholar
  130. 130.
    Nichols WG, Corey L, Gooley T, et al. Parainfluenza virus infections after hematopoietic stem cell transplantation: risk factors, response to antiviral therapy, and effect on transplant outcome. Blood. 2001;98(3):573–8.PubMedCrossRefGoogle Scholar
  131. 131.
    Dykewicz CA. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients: focus on community respiratory virus infections. Biol Blood Marrow Transplant. 2001;7(Suppl):19S–22.PubMedCrossRefGoogle Scholar
  132. 132.
    Centers for Disease Control and Prevention. Prevention strategies for seasonal influenza in healthcare Settings. Available at: Updated 9 Jan 2013; Accessed 15 July 2015.
  133. 133.
    Hayden FG. Prevention and treatment of influenza in immunocompromised patients. Am J Med. 1997;102:55–60. Discussion 75–76.PubMedCrossRefGoogle Scholar
  134. 134.
    Fox JP, Brandt CD, Wassermann FE, et al. The virus watch program: a continuing surveillance of viral infections in metropolitan New York families. VI. Observations of adenovirus infections: virus excretion patterns, antibody response, efficiency of surveillance, patterns of infections, and relation to illness. Am J Epidemiol. 1969;89:25–50.PubMedCrossRefGoogle Scholar
  135. 135.
    Hillis WO, Cooper MR, Bang FB. Adenovirus infection in West Bengal. I: persistence of viruses in infants and young children. Indian J Med Res. 1973;61:980–8.PubMedGoogle Scholar
  136. 136.
    Harrington RD, Hooton TM, Hackman RC, et al. An outbreak of respiratory syncytial virus in a bone marrow transplant center. J Infect Dis. 1992;165:987–93.PubMedCrossRefGoogle Scholar
  137. 137.
    Garcia R, Raad I, Abi-Said D, et al. Nosocomial respiratory syncytial virus infections: prevention and control in bone marrow transplant patients. Infect Control Hosp Epidemiol. 1997;18(6):412–6.PubMedCrossRefGoogle Scholar
  138. 138.
    Hohenthal U, Nikoskelainen J, Vainionpaa R, et al. Parainfluenza virus type 3 infections in a hematology unit. Bone Marrow Transplant. 2001;27(3):295–300.PubMedCrossRefGoogle Scholar
  139. 139.
    Weinstock DM, Eagan J, Malak SA, et al. Control of influenza A on a bone marrow transplant unit. Infect Control Hosp Epidemiol. 2000;21(11):730–2.PubMedCrossRefGoogle Scholar
  140. 140.
    Centers for Disease Control and Prevention. Influenza antiviral drugs: Recommendations of the Advisory Committee on Immunization Practices (ACIP): Information for Health Care Professionals. Available at: Updated March 4, 2015; Accessed 25 May 2015.
  141. 141.
    Jalal H, Bibby DF, Tang JW, et al. First reported outbreak of diarrhea due to adenovirus infection in a hematology unit for adults. J Clin Microbiol. 2005;43:2575–80.PubMedPubMedCentralCrossRefGoogle Scholar
  142. 142.
    Ison MG. Adenovirus infections in transplant recipients. Clin Infect Dis. 2006;43:331–9.PubMedCrossRefGoogle Scholar
  143. 143.
    Musher DM. How contagious are common respiratory tract infections? N Engl J Med. 2003;348:1256–66.PubMedCrossRefGoogle Scholar
  144. 144.
    Sattar SA, Abebe M, Bueti AJ, et al. Activity of an alcohol-based hand gel against human adeno-, rhino-, and rotaviruses using the fingerpad method. Infect Control Hosp Epidemiol. 2000;21:516–9.PubMedCrossRefGoogle Scholar
  145. 145.
    Rutala WA, Peacock JE, Gergen MF, et al. Efficacy of hospital germicides against adenovirus 8, a common cause of epidemic keratoconjunctivitis in health care facilities. Antimicrob Agents Chemother. 2006;50:1419–24.PubMedPubMedCentralCrossRefGoogle Scholar
  146. 146.
    Sattar SA, Lloyd-Evans N, Springthorpe VS, Nair RC. Institutional outbreaks of rotavirus diarrhoea: potential role of fomites and environmental surfaces as vehicles for virus transmission. J Hyg (Lond). 1986;96:277–89.CrossRefGoogle Scholar
  147. 147.
    Gallimore CI, Taylor C, Gennery AR, et al. Environmental monitoring for gastroenteric viruses in a pediatric primary immunodeficiency unit. J Clin Microbiol. 2006;44:395–9.PubMedPubMedCentralCrossRefGoogle Scholar
  148. 148.
    Ansari SA, Sattar SA, Springthorpe VS, et al. Rotavirus survival on human hands and transfer of infectious virus to animate and nonporous inanimate surfaces. J Clin Microbiol. 1988;26:1513–8.PubMedPubMedCentralGoogle Scholar
  149. 149.
    Lages SL, Ramakrishnan MA, Goyal SM. In-vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for norovirus. J Hosp Infect. 2008;62:159–63.CrossRefGoogle Scholar
  150. 150.
    Duizer E, Bijkerk P, Rockx B, et al. Inactivation of caliciviruses. Appl Environ Microbiol. 2004;70:4538–43.PubMedPubMedCentralCrossRefGoogle Scholar
  151. 151.
    Centers for Disease Control and Prevention (CDC). Norovirus in healthcare facilities fact sheet. Atlanta, GA: National Center for Preparedness, Detection, and Control of Infectious Diseases; 2006.Google Scholar
  152. 152.
    Targeted tuberculin testing and treatment of latent tuberculosis infection. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. This is a Joint Statement of the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC). This statement was endorsed by the Council of the Infectious Diseases Society of America. (IDSA), September 1999, and the sections of this statement. Am J Respir Crit Care Med. 2000;161(4 pt 2): S221–47.Google Scholar
  153. 153.
    Lee YM, Lee SO, Choi SH, et al. A prospective longitudinal study evaluating the usefulness of the interferon-gamma releasing assay for predicting active tuberculosis in allogeneic hematopoietic stem cell transplant recipients. J Infect. 2014;69(2):165–73.PubMedCrossRefGoogle Scholar
  154. 154.
    Moon SM, Lee SO, Choi SH, et al. Comparison of the QuantiFERON-TB gold In-Tube test with the tuberculin skin test for detecting latent tuberculosis infection prior to hematopoietic stem cell transplantation. Transpl Infect Dis. 2013;15(1):104–9.PubMedCrossRefGoogle Scholar
  155. 155.
    Talbot EA, Perkins MD, Silva SF, et al. Disseminated bacille Calmette-Guerin disease after vaccination: case report and review. Clin Infect Dis. 1997;24(6):1139–46.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  • Sarah A. Longworth
    • 1
  • Robin K. Avery
    • 2
  • Melanie S. Curless
    • 3
  • David L. Longworth
    • 4
    • 5
  1. 1.Division of Infectious DiseaseHospital of University of PennsylvaniaPhiladelphiaUSA
  2. 2.Division of Infectious DiseaseJohns Hopkins UniversityBaltimoreUSA
  3. 3.Hospital Epidemiology and Infection ControlJohns Hopkins UniversityBaltimoreUSA
  4. 4.Division of Primary CareLahey HealthBurlingtonUSA
  5. 5.Tufts University School of MedicineBurlingtonUSA

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