Infection Control & Hospital Epidemiology

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

Lisa Saimana1a22 c1, Jane D. Siegela2a22, John J. LiPumaa3a22, Rebekah F. Browna4, Elizabeth A. Brysona5, Mary Jo Chambersa6, Veronica S. Downera7, Jill Fliegea8, Leslie A. Hazlea11, Manu Jaina10, Bruce C. Marshalla11, Catherine O’Malleya12, Suzanne R. Patteea13, Gail Potter-Bynoea14, Siobhan Reida15, Karen A. Robinsona16, Kathryn A. Sabadosaa17, H. Joel Schmidta18, Elizabeth Tullisa19, Jennifer Webbera20 and David J. Webera21a23

a1 Department of Pediatrics, Columbia University Medical Center, New York, New York; and Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, New York

a2 Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; and Children’s Medical Center, Dallas, Texas

a3 Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan

a4 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee

a5 Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio

a6 Department of Social Work, Arkansas Children’s Hospital, Little Rock, Arkansas

a7 University of Michigan Hospital, Ann Arbor, Michigan

a8 Pulmonary Division, Nebraska Medical Center, Omaha, Nebraska

a9 Current affiliation: Director, Clinical Operations and Performance Improvement, Spectrum Health Medical Group, Grand Rapids, Michigan

a10 Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

a11 Medical Department, Cystic Fibrosis Foundation, Bethesda, Maryland

a12 Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois

a13 Adult with cystic fibrosis, Silver Spring, Maryland

a14 Department of Infection Prevention and Control, Boston Children’s Hospital, Boston, Massachusetts

a15 Parent

a16 Johns Hopkins University, Baltimore, Maryland

a17 Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire

a18 Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia

a19 Department of Medicine, University of Toronto, and Keenan Research Centre of Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada

a20 Parent

a21 Departments of Medicine and Pediatrics, University of North Carolina at Chapel Hill Medical School, Chapel Hill, North Carolina

a22 Co-chairs of the Infection Prevention and Control Guideline for Cystic Fibrosis Committee

a23 The list of authors represents the entire Infection Prevention and Control Guideline for Cystic Fibrosis Committee

The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:

1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF . These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.

2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF . These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

(Received March 03 2014)

(Accepted March 05 2014)


c1 Columbia University, 622 West 168th Street, PH4 West Room 470, New York, NY 10032 (