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Safe Injection, Infusion, Medication Vial, and Point-of-Care Testing Practices in Healthcare (2025)

American journal of infection control 2025年

作者： Jennifer Ormsby Tonya Wagner Ria Gupta Tara Millson Bethany Phillips Boston Children's Hospital Infection Prevention & Control 300 Longwood Ave Boston MA 02115. Electronic address: jennifer.ormsby@childrens.harvard.edu. Regent Surgical Health Infection Prevention 672 Lakeside Drive Moncks Corner South Carolina 29461. Electronic address: tonyakayewagner@***. APIC Program Manager Center for Research Practice and Innovation1400 Crystal Drive Suite 900 Arlington VA 22202. Electronic address: rgupta@***. Medstar Georgetown University Hospital Infection Prevention 3800 Reservoir Rd NW Washington D.C. 20007. Electronic address: Tara.K.Millson@***. Advocate Health Infection Prevention 2025 Windsor Drive Oak Brook IL 60523. Electronic address: Bethany.phillips@***.

This position paper provides healthcare professionals (HCP) updated guidance with corresponding evidence and rationale to support safe injection, infusion, medication vial, and point-of-care testing practices in healthcare settings. It addresses the infection risks associated with these practices but does not address other safety issues such as right dose, right site, right medication, phlebotomy, or intravenous catheter care. This document updates the Association for Professionals in Infection control and Epidemiology (APIC) 2016 position paper.

关键词： Healthcare Infection Infusion Injection Medication Vial Point-of-care

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Multimodal Mobile Application to Address Sexual Dysfunction in Hematopoietic Stem Cell Transplant (HCT) Survivors

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Transplantation and Cellular Therapy 2024年第2期30卷 S45-S45页

作者： El-Jawahri, Areej R., MD Reese, Jennifer Barsky, PhD Traeger, Lara, PhD Dizon, Don, MD Bober, Sharon, PhD Vanderklish, Julie, CNP Newcomb, Richard Andrew, MD DeFilipp, Zachariah, MD Chen, Dr. Yi-Bin, MD Temel, Jennifer, MD Massachusetts General Hospital Boston MA Cancer Prevention and Control Program Fox Chase Cancer Center Philadelphia PA Psychology Massachusetts General Hospital Boston MA Rhode Island Hospital Rhode Island RI Dana Farber Cancer Institute Boston MA Hematopoietic Cell Transplant and Cellular Therapy Program Massachusetts General Hospital Boston MA Medicine Division of Hematology & Oncology Massachusetts General Hospital Boston MA Medicine Massachusetts General Hospital Boston MA

BackgroundSexual dysfunction is the most common complication affecting HCT survivors and is associated with worse patient-reported quality of life (QOL) and psychological distress. Yet, interventions to address sexual dysfunction in HCT survivors are lacking. MethodsWe conducted a pilot randomized trial of a multimodal mobile application (SHIFT) to address sexual dysfunction for patients with hematologic malignancies who were at least 3 months post autologous or allogeneic HCT and endorsed sexual dysfunction causing distress. Patients were randomly assigned to SHIFT or enhanced usual care. Intervention participants met with a trained HCT clinician for a brief clinical exam to address biological causes of sexual dysfunction and were then provided access to SHIFT for 8 weeks. SHIFT consists of five modules focused on educating and empowering patients to address their sexual health concerns and addressing the biologic, interpersonal, social, and psychological causes of sexual dysfunction. Patients assigned to enhanced usual care met with the trained HCT clinician for a brief clinical exam and they were not given access to SHIFT. The primary endpoint was feasibility, defined a priori as at least 60% of eligible patients enrolling and 60% of those enrolled completing at least 70% of the SHIFT modules. We assessed patient global satisfaction with sex, interest in sex, orgasm pleasure (PROMIS), QOL (Functional Assessment of Cancer Therapy-Bone Marrow Transplant [FACT-BMT]), and psychological distress (Hospital Anxiety and Depression-Scale [HADS]) at baseline and 8 weeks. To assess the usability of SHIFT, we used the System Usability Scale (>80 indicates excellent usability). We a priori identified a p-value <0.25 as promising for preliminary efficacy in this pilot study. ResultsWe enrolled 64.2% (61/95) of eligible patients (mean age = 57.2 (SD=14.2), 60% male). In the intervention group, 70.0% completed ≥ 80% of the SHIFT modules, and 66.7% completed all SHIFT modules. Pa

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Reduction patterns of Japanese encephalitis incidence following vaccine introduction into long-term expanded program on immunization in Yunnan Province,China

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Infectious Diseases of Poverty 2019年第6期8卷 84-91页

作者： Xiao-Ting Hu Qiong-Fen Li Chao Ma Zhi-Xian Zhao Li-Fang He Ting-Ting Tang Wen Yu Philip Owiti Expand ed Program on Immunization Yunnan Center for Disease Control and PreventionNO.158 DongSi StreetXiShan DistrictKunming CityYunnan ProvinceChina National Immunization Program Chinese Center for Disease Control and Prevention27 Nanwei RoadXicheng DistrictBeijingChina The International Union Against Tuberculosis and Lung Disease ParisFrance The National Tuberculosis Leprosy and Lung Disease ProgramNairobiKenya

Background:Japanese encephalitis(JE)is a leading cause of childhood viral encephalitis both at global level and in *** is recommended as a key strategy to control *** China most JE cases have been reported in southwest provinces,which include *** this study,we quantify the epidemiological shift of JE in Yunnan Province from 2005 to 2017,covering before and after the introduction of JE vaccination into routine Expanded program on Immunization(EPI)in ***:We used routinely collected data in the case-based JE surveillance system from 2005 through 2017 in *** were reported from hospital and county-level Centers for Disease control in line with the National JE Surveillance *** data were extracted,analysed and presented in appropriate *** coverage was estimated from actual JE doses administered and new births for each ***:A total 4780 JE cases(3077 laboratory-confirmed,1266 clinical and 437 suspected)were reported in the study *** of JE(per 100000 population)increased from 0.95 in 2005 to 1.69 in *** increase in vaccination coverage,incidence rates decreased steadily from 1.16 in 2009 to 0.17 in ***,seasonality remained similar across the years,peaking in ***(bordering Myanmar and Laos),Dehong(bordering Myanmar),and Zhaotong(an inland prefecture)had the highest incidence rates of 2.3,1.9,and 1.6,respectively.97%of all cases were among local *** vaccination coverage increased(and incidence decreased),proportion of JE cases among children<10 years old decreased from 70%in 2005 to 32%in 2017,while that among adults>20 years old increased from 12 to 48%.There were a large number of JE cases with unknown treatment outcomes,especially in the earlier years of the surveillance ***:The 13-year JE surveillance data in Yunnan Province showed dramatic decrease of total incidence and a shift from children to *** vaccinati

关键词： Vaccination program Incidence Surveillance system Epidemiology Operational research

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Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis

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The Lancet Infectious Diseases 2025年第4期25卷 445-456页

作者： Garcia Quesada, Maria Peterson, Meagan E Bennett, Julia C Hayford, Kyla Zeger, Scott L Yang, Yangyupei Hetrich, Marissa K Feikin, Daniel R Cohen, Adam L von Gottberg, Anne van der Linden, Mark van Sorge, Nina M de Oliveira, Lucia H de Miguel, Sara Yildirim, Inci Vestrheim, Didrik F Verani, Jennifer R Varon, Emmanuelle Valentiner-Branth, Palle Tzanakaki, Georgina Sinkovec Zorko, Nadja Setchanova, Lena P Serhan, Fatima Scott, Kevin J Scott, J Anthony Savulescu, Camelia Savrasova, Larisa Reyburn, Rita Oishi, Kazunori Nuorti, J Pekka Napoli, Daniela Mwenda, Jason M Muñoz-Almagro, Carmen Morfeldt, Eva McMahon, Kimberley McGeer, Allison Mackenzie, Grant A Eugenia León, Maria Ladhani, Shamez N Kristinsson, Karl G Kozakova, Jana Kleynhans, Jackie Klein, Nicola P Kellner, James D Jayasinghe, Sanjay Ho, Pak-Leung Hilty, Markus Harker-Jones, Marcella A Hammitt, Laura L Grgic-Vitek, Marta Gilkison, Charlotte Gierke, Ryan French, Neil Diawara, Idrissa Desmet, Stefanie De Wals, Philippe Dalby, Tine Dagan, Ron Corcoran, Mary Colzani, Edoardo Chanto Chacón, Grettel Castilla, Jesús Camilli, Romina Ang, Michelle Ampofo, Krow Almeida, Samanta C G Alarcon, Pedro Deloria Knoll, Maria Pennington, Kate Krause, Vicki Brandileone, Maria-Cristina Ricketson, Leah Deceuninck, Geneviève Lefebvre, Brigitte Díaz, Janepsy Puentes, Rodrigo Krizova, Pavla Rafai, Eric Toropainen, Maija Viriot, Delphine Ploy, Marie-Cecile Hossain, Ilias Georgakopoulou, Theano Magaziotou, Ioanna Chow, Kin-Hung Erlendsdottir, Helga Mereckiene, Jolita Del Manso, Martina Suga, Shigeru Bigogo, Godfrey Dimina, Elina Swarthout, Todd Nzoyikorera, Néhémie Steens, Anneke Galloway, Yvonne Winje, Brita Chan, Guanhao Thoon, Koh Cheng Avdičová, Mária de Gouveia, Linda du Plessis, Mignon Ciruela, Pilar Sanz, Juan Carlos Guevara, Marcela Lepp, Tiia Amin-Chowdhury, Zahin Macdonald, Laura Pilishvili, Tamara Kobayashi, Miwako Bruden, Dana Pelton, Stephen Sutcliffe, Catherine Aukes, Laurie Byington, Carrie Zintgraff, Jonathan Chamorro, Gustavo Kawabata, Aníbal Celentano, Lucia Rey-Ben Johns Hopkins Bloomberg School of Public Health Baltimore MD United States WHO Geneva Switzerland Centre for Respiratory Diseases and Meningitis National Institute for Communicable Diseases of the National Health Laboratory Service Johannesburg South Africa School of Pathology Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa Reference Laboratory for Streptococci Department of Medical Microbiology University Hospital RWTH Aachen Aachen Germany Medical Microbiology and Infection Prevention Netherlands Reference Laboratory for Bacterial Meningitis Amsterdam UMC University of Amsterdam Amsterdam Netherlands Pan American Health Organization WHO Washington DC United States CIBER de Enfermedades Respiratorias Madrid Spain Epidemiology Department Dirección General de Salud Pública Madrid Spain Department of Pediatrics Yale New Haven Children's Hospital New Haven CT United States Department of Public Health Ministry of Health and Care Services Oslo Norway Division of Global Health Protection Center for Global Health Centers for Disease Control and Prevention Nairobi Kenya Division of Bacterial Diseases National Center for Immunizations and Respiratory Diseases US Centers for Disease Control and Prevention Atlanta GA United States National Reference Centre for Pneumococci Data Research Department Intercommunal Hospital of Créteil Créteil France Infectious Disease Epidemiology and Prevention Statens Serum Institut Copenhagen Denmark National Meningitis Reference Laboratory Department of Public Health Policy School of Public Health University of West Attica Athens Greece Communicable Diseases Centre National Institute of Public Health Ljubljana Slovenia University Multiprofile Hospital for Active Treatment Saint Ivan Rilski Clinical Microbiology Laboratory Sofia Bulgaria Bacterial Respiratory Infection Service Scot

Background: Widespread use of pneumococcal conjugate vaccines (PCVs) has reduced vaccine-type invasive pneumococcal disease (IPD). We describe the serotype distribution of IPD after extensive use of ten-valent PCV (PCV10;Synflorix, GSK) and 13-valent PCV (PCV13;Prevenar 13, Pfizer) globally. Methods: IPD data were obtained from surveillance sites participating in the WHO-commissioned Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project that exclusively used PCV10 or PCV13 (hereafter PCV10 and PCV13 sites, respectively) in their national immunisation programmes and had primary series uptake of at least 70%. Serotype distribution was estimated for IPD cases occurring 5 years or more after PCV10 or PCV13 introduction (ie, the mature period when the serotype distribution had stabilised) using multinomial Dirichlet regression, stratified by PCV product and age group (<5 years, 5–17 years, 18–49 years, and ≥50 years). Findings: The analysis included cases occurring primarily between 2015 and 2018 from 42 PCV13 sites (63 362 cases) and 12 PCV10 sites (6806 cases) in 41 countries. Sites were mostly high income (36 [67%] of 54) and used three-dose or four-dose booster schedules (44 [81%]). At PCV10 sites, PCV10 serotypes caused 10·0% (95% CI 6·3–12·9) of IPD cases in children younger than 5 years and 15·5% (13·4–19·3) of cases in adults aged 50 years or older, while PCV13 serotypes caused 52·1% (49·2–65·4) and 45·6% (40·0–50·0), respectively. At PCV13 sites, PCV13 serotypes caused 26·4% (21·3–30·0) of IPD cases in children younger than 5 years and 29·5% (27·5–33·0) of cases in adults aged 50 years or older. The leading serotype at PCV10 sites was 19A in children younger than 5 years (30·6% [95% CI 18·2–43·1]) and adults aged 50 years or older (14·8% [11·9–17·8]). Serotype 3 was a top-ranked serotype, causing about 9% of cases in children younger than 5 years and 14% in adults aged 50 years or older at both PCV10 and PCV13 sites. Across all age an

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740. Healthcare-associated invasive Staphylococcus aureus among adults with prior COVID-19-associated hospitalization, 2020

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Open Forum Infectious Diseases 2023年第SUPPLEMENT_2期10卷

作者： Kelly A Jackson Sydney Resler Joelle Nadle Susan Petit Kimberly Yousey-Hindes Susan M Ray Ruth Lynfield Kathryn Como-Sabetti Carmen Bernu Ghinwa Dumyati Marissa Tracy William Schaffner Kadam Patel Fiona P Havers Holly M Biggs Isaac See U.S. Centers for Disease Control and Prevention Atlanta Georgia Rollins School of Public Health at Emory University Atlanta Georgia California Emerging Infections Program Oakland California Connecticut Department of Public Health Hartford Connecticut Yale School of Public Health New Haven Connecticut Emory University School of Medicine Atlanta Georgia Minnesota Department of Health St. Paul MN New York Emerging Infections Program and University of Rochester Medical Center Rochester New York University of Rochester Medical Center Rochester New York Vanderbilt University Medical Center Nashville Tennessee Centers for Disease Control and Prevention Atlanta Georgia CDC Atlanta Georgia

BackgroundCOVID-19 caused a large proportion of hospitalizations in 2020. We describe how COVID-19-associated hospitalizations affected the epidemiology of healthcare-associated (HA) invasiveStaphylococcus aureus(iSA)...

Background COVID-19 caused a large proportion of hospitalizations in 2020. We describe how COVID-19-associated hospitalizations affected the epidemiology of healthcare-associated (HA) invasive Staphylococcus aureus (iSA) infections.

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1443. Characteristics of nursing homes with higher rates of invasive methicillin-resistant Staphylococcus aureus infections

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Open Forum Infectious Diseases 2023年第SUPPLEMENT_2期10卷

作者： Isaac See Kelly A Jackson Rongxia Li Prabasaj Paul Kelly M Hatfield Joelle Nadle Susan Petit Daniel Wurm Allison Pall Susan M Ray Lee Harrison Laura Jeffrey Carmen Bernu Ruth Lynfield Ghinwa Dumyati Anita Gellert Tiffanie M Markus William Schaffner Kara M Jacobs Slifka Nimalie D Stone CDC Atlanta Georgia U.S. Centers for Disease Control and Prevention Atlanta Georgia Centers for Disease Control and Prevention Atlanta Georgia California Emerging Infections Program Oakland California Connecticut Department of Public Health Hartford Connecticut Emory School of Medicine Atlanta Georgia Emory University School of Medicine Atlanta Georgia University of Pittsburgh Pittsburgh Pennsylvania Johns Hopkins University Baltimore Maryland Minnesota Department of Health St. Paul Minnesota New York Emerging Infections Program and University of Rochester Medical Center Rochester New York University of Rochester Medical Center Rochester New York Vanderbilt University Medical Center Nashville Tennessee

Background Invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in nursing home residents now outnumber hospital-onset invasive MRSA infections. Elucidating characteristics of nursing homes with higher invasive MRSA rates could inform strategies to reduce rates of infections and prioritize facilities for prevention efforts.

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High-risk spatiotemporal patterns of cutaneous leishmaniasis:a nationwide study in Iran from 2011 to 2020

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Infectious Diseases of Poverty 2023年第3期12卷 93-93页

作者： Neda Firouraghi Robert Bergquist Munazza Fatima Alireza Mohammadi Davidson H.Hamer Mohammad Reza Shirzadi Behzad Kiani Department of Medical Informatics School of MedicineMashhad University of Medical SciencesMashhadIran Ingerod BrastadSweden Formerly with the UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases World Health OrganizationGenevaSwitzerland Department of Geography The Islamia University of BahawalpurBahawalpurPunjabPakistan Department of Geography and Urban Planning Faculty of Social SciencesUniversity of Mohaghegh ArdabiliArdabilIran Department of Global Health Boston University School of Public HealthBostonMAUSA Section of Infectious Diseases Department of MedicineBoston University School of MedicineBostonMAUSA Center for Disease Control and Prevention(CDC) Iran Ministry of Health&Medical EducationTehranIran Centre de Recherche en SantéPublique Universitéde Montréal7101Avenue du ParcMontréalCanada

Background Cutaneous leishmaniasis(CL)is a wide-reaching infection of major public health *** is one of the six most endemic countries in the *** study aims to provide a spatiotemporal visualization of CL cases in Iran at the county level from 2011 to 2020,detecting high-risk zones,while also noting the movement of high-risk *** On the basis of clinical observations and parasitological tests,data of 154,378 diagnosed patients were obtained from the Iran Ministry of Health and Medical *** spatial scan statistics,we investigated the disease’s purely temporal,purely spatial,spatial variation in temporal trends and spatiotemporal *** P=0.05 level,the null hypothesis was rejected in every *** In general,the number of new CL cases decreased over the course of the 9-year research *** 2011 to 2020,a regular seasonal pattern,with peaks in the fall and troughs in the spring,was *** period of September–February of 2014–2015 was found to hold the highest risk in terms of CL incidence rate in the whole country[relative risk(RR)=2.24,P<0.001)].In terms of location,six signifcant high-risk CL clusters covering 40.6%of the total area of the country were observed,with the RR ranging from 1.87 to *** addition,spatial variation in the temporal trend analysis found 11 clusters as potential high-risk areas that highlighted certain regions with an increasing ***,fve space-time clusters were *** geographical displacement and spread of the disease followed a moving pattern over the 9-year study period afecting many regions of the *** Our study has revealed signifcant regional,temporal,and spatiotemporal patterns of CL distribution in *** the years,there have been multiple shifts in spatiotemporal clusters,encompassing many diferent parts of the country from 2011 to *** results reveal the formation of clusters across counties that cover certain parts of provinces

关键词： Cutaneous leishmaniasis Spatial epidemiology Geographical Information Systems Spatiotemporal analysis SaTScan Spatial scan statistics Neglected tropical diseases Spatiotemporal clustering Iran

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177. Distinctive Features of Ertapenem Mono-Resistant Carbapenem-Resistant Enterobacterales in the United States: A Cohort Study

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Open Forum Infectious Diseases 2021年第SUPPLEMENT_1期8卷 S108–S109页

作者： Max W Adelman Chris W Bower Julian E Grass Uzma Ansari Isaac See Joseph D Lutgring Jesse T Jacob Emory University School of Medicine Atlanta Georgia Georgia Emerging Infections Program Decatur GA Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta GA Centers for Disease Control and Prevention Atlanta Georgia Emory University Atlanta GA

BackgroundCarbapenem-resistant Enterobacterales (CRE) are highly antibiotic-resistant bacteria. Whether CRE resistant only to ertapenem among carbapenems (ertapenem mono-resistant) represent a unique CRE subset with r...

Background Carbapenem-resistant Enterobacterales (CRE) are highly antibiotic-resistant bacteria. Whether CRE resistant only to ertapenem among carbapenems (ertapenem mono-resistant) represent a unique CRE subset with regards to risk factors, carbapenemase genes, and outcomes is unknown.

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The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance

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The Lancet Infectious Diseases 2025年

作者： Sati, Hatim Carrara, Elena Savoldi, Alessia Hansen, Paul Garlasco, Jacopo Campagnaro, Enrica Boccia, Simone Castillo-Polo, Juan Antonio Magrini, Eugenia Garcia-Vello, Pilar Wool, Eve Gigante, Valeria Duffy, Erin Cassini, Alessandro Huttner, Benedikt Pardo, Pilar Ramon Naghavi, Mohsen Mirzayev, Fuad Zignol, Matteo Cameron, Alexandra Tacconelli, Evelina Aboderin, Aaron Al Ghoribi, Majed Al-Salman, Jameela Amir, Afreenish Apisarnthanarak, Anucha Blaser, Martin El-Sharif, Amany Essack, Sabiha Harbarth, Stephan Huang, Xun Kapoor, Geetanjali Knight, Gwenan Muhwa, Jeremiah Chakaya Monnet, Dominique L. Ousassa, Timothée Sacsaquispe, Rosa Severin, Juliëtte Sugai, Motoyuki Taneja, Neelam Umubyeyi Nyaruhirira, Alaine Impact Initiatives and Research Coordination Unit Division of Antimicrobial Resistance World Health Organization Geneva Switzerland Division of Infectious Diseases Department of Diagnostic and Public Health University of Verona Verona Italy Department of Economics University of Otago Dunedin New Zealand Institute for Health Metrics and Evaluation University of Washington Seattle WA United States Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator Boston MA United States Infectious Diseases Service Lausanne Université Hospital Lausanne Switzerland Department of Surveillance Prevention and Control Division of Antimicrobial Resistance World Health Organization Geneva Switzerland Antimicrobial Resistance Special Program Regional Office for the Americas of the World Health Organization Washington DC United States World Health Organization Global Tuberculosis Programme Geneva Switzerland

Background: The 2017 WHO Bacterial Priority Pathogens List (BPPL) has been instrumental in guiding global policy, research and development, and investments to address the most urgent threats from antibiotic-resistant pathogens, and it is a key public health tool for the prevention and control of antimicrobial resistance (AMR). Since its release, at least 13 new antibiotics targeting bacterial priority pathogens have been approved. The 2024 WHO BPPL aims to refine and build on the previous list by incorporating new data and evidence, addressing previous limitations, and improving pathogen prioritisation to better guide global efforts in combating AMR. Methods: The 2024 WHO BPPL followed a similar approach to the first prioritisation exercise, using a multicriteria decision analysis framework. 24 antibiotic-resistant bacterial pathogens were scored based on eight criteria, including mortality, non-fatal burden, incidence, 10-year resistance trends, preventability, transmissibility, treatability, and antibacterial pipeline status. Pathogens were assessed on each of the criteria on the basis of available evidence and expert judgement. A preferences survey using a pairwise comparison was administered to 100 international experts (among whom 79 responded and 78 completed the survey) to determine the relative weights of the criteria. Applying these weights, the final ranking of pathogens was determined by calculating a total score in the range of 0–100% for each pathogen. Subgroup and sensitivity analyses were conducted to assess the impact of experts’ consistency, background, and geographical origin on the stability of the rankings. An independent advisory group reviewed the final list, and pathogens were subsequently streamlined and grouped into three priority tiers based on a quartile scoring system: critical (highest quartile), high (middle quartiles), and medium (lowest quartile). Findings: The pathogens’ total scores ranged from 84% for the top-ranked bacterium (carb

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Mediators of a Multimodal Sexual Dysfunction Intervention Among Hematopoietic Stem Cell Transplant Recipients

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Transplantation and Cellular Therapy 2025年第2期31卷 S367-S367页

作者： Nelson, Ashley M., PhD Reese, Jennifer Barsky, PhD Traeger, Lara, PhD Greer, Joseph A., PhD Temel, Jennifer, MD Bober, Sharon, PhD Pepper, Julia Newcomb, Richard Andrew, MD El-Jawahri, Areej R., MD Psychiatry Massachusetts General Hospital Boston MA Cancer Prevention and Control Program Fox Chase Cancer Center Philadelphia PA Psychology Massachusetts General Hospital Boston MA Medicine Massachusetts General Hospital Boston MA Dana Farber Cancer Institute Boston MA Massachusetts General Hospital Boston MA Medicine Division of Hematology & Oncology Massachusetts General Hospital Boston MA

IntroductionSexual dysfunction is a common and persistent complication following hematopoietic stem cell transplant (HSCT). We developed and tested a multimodal sexual dysfunction intervention consisting of three monthly visits with trained transplant clinicians focused on addressing biopsychosocial causes of sexual dysfunction. We previously demonstrated that this intervention led to improvements in sexual function and quality of life (QOL) and reductions in anxiety and depression symptoms. ObjectivesOur aim for the present study was to examine the degree to which the effects of the sexual dysfunction intervention on patient-reported QOL and mood symptoms were accounted for by changes in sexual function and satisfaction. MethodsWe conducted a secondary analysis of a randomized clinical trial investigating a multimodal sexual dysfunction intervention versus enhanced standard care for HSCT survivors between 2/2019 and 2/2023. Participants completed self-report measures of sexual function (i.e., PROMIS SexFS domains of sexual satisfaction, interest, and orgasm), QOL (FACT-BMT), and anxiety and depression symptoms (HADS) at baseline and 3 months post-enrollment. We used causal mediation with bootstrapping to assess whether changes in sexual function domains mediated intervention effects on patient-reported QOL and mood symptoms at 3 months controlling for baseline values. ResultsIn total, 125 HSCT recipients ( M age=55 years, 33% female, 73% allogeneic HSCT) participated. Changes in sexual satisfaction, interest, and orgasm mediated the intervention effects on 3-month QOL (indirect effect = 7.20, 95%CI 2.74, 11.65; indirect effect = 4.21, 95%CI 0.67, 7.74, indirect effect = 5.92, 95%CI 2.20, 9.65, respectively) and depression symptoms (indirect effect = -1.03, 95%CI -1.79, -0.28; indirect effect = -0.65, 95%CI -1.23, -0.06; indirect effect = -0.72, 95%CI -1.38, -0.05, respectively). Changes in sexual satisfaction, but not interest or orgasm, mediated effects on 3-month

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