title: Environmental prevention of infection in stem cell transplant recipients: a survey of the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation.
abstract: BACKGROUND
  The developments of peripheral blood stem cells in autologous hematopoietic stem cell transplantation (auto-HCT), and of reduced-intensity conditioning (RIC) regimens in allogeneic HCT (allo-HCT), have considerably changed the transplant approach. Prolonged neutropenia combined with severe mucosal damage and organ dysfunction is no longer the rule in the early post-HCT pancytopenic phase. Although strict isolation during pancytopenia was followed by most HCT units in the past, this may not be the current practice.
  
  
  METHODS
  In 2008, a questionnaire was sent out to the 463 European Group for Blood and Marrow Transplantation centers, enquiring about their current environmental protection procedures; 89 (20%) returned the questionnaire.
  
  
  RESULTS
  Most centers housed auto-HCT recipients in high-efficiency particulate air (HEPA)-filtered rooms without (52%) or with laminar air flow (LAF) (29%) after total body irradiation (TBI), whereas HEPA-filtered rooms were used in 53% of auto-HCT conditioned without TBI. During the initial pancytopenic phase after allo-HCT, patients were housed in HEPA/LAF rooms in 50% and 42% of the centers, if a high-dose myeloablative conditioning regimen or a RIC regimen was used, respectively. Surprisingly, 8-24% of the centers reported that no isolation procedures were used in patients colonized or infected with highly transmissible pathogens (i.e., Clostridium difficile, respiratory viruses, and varicella zoster virus).
  
  
  CONCLUSIONS
  In conclusion, universal recommendations for infected or colonized patients may be poorly known or applied in many HCT units.
authors: Haematology Department, Henri Mondor Teaching Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) and Paris Est-Créteil University, Créteil, France.
authors: Y
authors: Y
authors: Hicheri
authors: H
authors: H
authors: Einsele
authors: R
authors: R
authors: Martino
authors: S
authors: S
authors: Cesaro
authors: P
authors: P
authors: Ljungman
authors: C
authors: C
authors: Cordonnier
mesh_terms: D061808:Air Filters; D003140:Communicable Disease Control / Q000379:methods*; D006306:Health Surveys; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010356:Patient Isolation; D010362:Patients' Rooms; D017410:Practice Guidelines as Topic