Weill Cornell Bone Marrow Transplant Program

Preventing Infections

How to Prevent Infections Post-Transplant

After your transplant, your immune system is weaker and you are at risk for infection. Although your white blood cell count might be considered normal, it’s important to remember your immune system is still in recovery mode. Some medications that you are taking make that risk increase even more. Infections are more common in patients who have received an allogeneic transplant, particularly those with graft-versus-host-disease, versus an autologous transplant. The causes of these infections include, bacteria, fungi, and viruses. You should take steps to check if you have an infection. One of the easiest ways to do this is by taking your temperature twice a day and recording your numbers.

There are a number of ways you can try and prevent infection. The first way is to make sure you don’t submerge your central venous catheter under water while you’re taking a shower or bathing. To avoid getting bacteria on your skin, be sure to cleanse with soap and water every day.

Personal hygiene such as frequent hand washing is crucial after your transplant, especially if you are taking immunosuppressive medicines. If you are traveling or outside of your home, it is recommended you use hand sanitizer. Handwashing is recommended throughout the day and especially during the following activities: before and after making food, before eating, after touching pets, after being outside, after coughing, sneezing or blowing your nose, before and after adjusting your central venous catheter, and before taking oral medications.

Oral hygiene is another important factor to consider after your transplant. Daily oral care is necessary to decrease chance of infection and gum bleeding. It is recommended that you use a soft toothbrush or sponge to care for your teeth and gums. Speak with your doctor about the appropriate type of mouth wash, rinse and toothpaste you should use.

While being outdoors is recommended, there are certain outdoor activities that you should avoid when recovering after transplant. Gardening, raking, mulching, farming, and any activities involving direct contact with soil and plants may increase exposure to potential pathogens, which are substances that can cause disease. These activities should be put on hold until your immune system is back to its strength. In addition, swimming is another activity that is not recommended since you are more likely to get infections in pools and hot tubs. Cleaning in areas that have dust and mold should be avoided after your transplant. You will want to avoid all areas that are prone to mold.

Preventing respiratory infections is important since your immune system will be weak. It will be more difficult to fight off illnesses, so it is recommended you take steps to avoid contact with people, especially children, who have a cough or a cold. Any public area where you are required to be in close contact with others, such as a movie theater, a concert should be avoided in the early days after transplant. You may wear a face mask when you are in public if you feel more comfortable, but it is not required. We do recommend that you wear a face-mask while in hospital or clinic waiting rooms.

Most importantly, report to your doctor any change that you notice or any fever promptly so that early evaluation can be done. Many infections that we test for at the transplant clinic cannot be easily tested or detected in regular offices and specialized transplant clinics have access to tests that your local physician’s office may not.