CDC, the Infectious Disease Society of America, and the American Society of Blood and Marrow Transplantation have cosponsored these guidelines for preventing opportunistic infections (OIs) among hematopoietic stem cell transplant (HSCT) recipients.The guidelines were drafted with the assistance of a working group of experts in infectious diseases, transplantation, and public health.For the purposes of this report, HSCT is defined as any transplantation of blood-or marrow-derived hematopoietic stem cells, regardless of transplant type (i.e., allogeneic or autologous) or cell source (i.e., bone marrow, peripheral blood, or placental or umbilical cord blood).Such OIs as bacterial, viral, fungal, protozoal, and helminth infections occur with increased frequency or severity among HSCT recipients.These evidence-based guidelines contain information regarding preventing OIs, hospital infection control, strategies for safe living after transplantation, vaccinations, and hematopoietic stem cell safety.The disease-specific sections address preventing exposure and disease for pediatric and adult and autologous and allogeneic HSCT recipients.The goal of these guidelines is twofold: to summarize current data and provide evidence-based recommendations regarding preventing OIs among HSCT patients.The guidelines were developed for use by HSCT recipients, their household and close contacts, transplant and infectious diseases physicians, HSCT center personnel, and public health professionals.For all recommendations, prevention strategies are rated by the strength of the recommendation and the quality of the evidence supporting the recommendation.Adhering to these guidelines should reduce the number and severity of OIs among HSCT recipients.*For this report, HSCT is defined as any transplantation of blood-or marrow-derived hematopoietic stem cells, regardless of transplant type (e.g., allogeneic or autologous) or cell source (e.g., bone marrow, peripheral blood, or placental/umbilical cord blood).In addition, HSCT recipients are presumed immunocompetent at ≈24 months after HSCT if they are not on immunosuppressive therapy and do not have graft-versus-host disease (GVHD), a condition that occurs when the transplanted cells recognize that the recipient's cells are not the same cells and attack them. Using These GuidelinesFor all recommendations, prevention strategies are rated by the strength of the recommendation (Table 1) and the quality of the evidence (Table 2) supporting the recommendation.The principles of this rating system were developed by the Infectious Disease Society of America and the U.S. Public Health Service for use in the guidelines for preventing OIs among HIVinfected persons (3-6 ).This rating system allows assessments of recommendations to which adherence is critical.

Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients