There is a desire to standardize Infection Prevention and Control (IPAC) strategies among Hemtopoetic Stem Cell Transplant (HSCT) centers.
Methods: A survey was performed of members of the American Society of Transplantation Infection Diseases Community of Practice on 11/14 and 2/15 on institutional IPAC policies on HSCT patients.
There were 38 providers from 28 centers from the United States, Canada, Switzerland, India, South Korea, and Taiwan who responded to the survey. Most use HEPA-filtered rooms for allogeneic HSCT patients (all times [44%], within 3 months of HSCT [28%], or when clinically indicated [8%]). In contrast, 28% do not provide HEPA-filtered rooms after autologous HSCT. Positive pressure rooms are used after allogeneic HSCT in majority of centers (all times [25%], immediate post-transplant [37.5%], when clinically indicated [16.7%]); usage after autologous HSCT are 24%, 16%, and 20%, respectively. A quarter (26.1%) requires health care providers to perform additional hand hygiene beyond standard handwashing, such as use of gloves during all patient contact (12% and 15.4%, respectively). Only a small number of centers have dedicated medical equipment for use at all times (8.3% allogeneic, 7.7% autologous) or perform measures beyond standard room cleaning (13% allogeneic, 8.3% autologous), mostly with terminal bleach cleaning. A fifth does not require patient room doors to be closed (20.8% allogeneic, 20% autologous). No center requires routine use of isolation gowns, and all recommend using them only when clinically indicated. No center allows for plants or flowers in HSCT units. The majority allows use of personal belongings (62.5 % allogeneic, 73.1% autologous). All centers require patients to wear masks when leaving the hospital room or hospital, most commonly during the first 3 or 6 months after HSCT. Majority does not allow animals in hospital rooms (81.8% allogeneic, 80% autologous), and for those that do, these are limited to personal pets (dogs, cats) and service animals. Visitor age restriction varied from <5 years to <15 years in a third of the allogeneic and autologous HSCT centers (32% and 29.6%).
Conclusion: This survey highlights varying degrees of implementation of IPAC strategies after HSCT. National guidelines exist to guide many IPAC strategies, but their clinical implementation is variable.
M. Keating, None
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