当前位置： SCI文献检索 > Mediterranean Journal of Hematology and Infectious Diseases期刊下所有文献 > Bacterial Infections in Hematopoietic Stem Cell Transplant Recipients.

Bacterial Infections in Hematopoietic Stem Cell Transplant Recipients.

Abstract：

:Bacterial infections are major complications after Hematopoietic Stem Cell Transplant (HSCT). They consist mainly of bloodstream infections (BSI), followed by pneumonia and gastrointestinal infections, including typhlitis and Clostridium difficile infection. Microbiological data come mostly from BSI. Coagulase negative staphylococci and Enterobacteriaceae are the most frequent pathogens causing approximately 25% of BSI each, followed by enterococci, P. aeruginosa and viridans streptococci. Bacterial pneumonia is frequent after HSCT, and Gram-negatives are predominant. Clostridium difficile infection affects approximately 15% of HSCT recipients, being more frequent in case of allogeneic than autologous HSCT. The epidemiology and the prevalence of resistant strains vary significantly between transplant centres. In some regions, multi-drug resistant (MDR) Gram-negative rods are increasingly frequent. In others, vancomycin-resistant enterococci are predominant. In the era of increasing resistance to antibiotics, the efficacy of fluoroquinolone prophylaxis and standard treatment of febrile neutropenia have been questioned. Therefore, a thorough evaluation of local epidemiology is mandatory to decide the need for prophylaxis and the choice of the best regimen for empirical treatment of febrile neutropenia. For the latter, individualised approach has been proposed, consisting of either escalation or de-escalation strategy. De-escalation strategy is recommended since resistant bacteria should be covered upfront, mainly in patients with severe clinical presentation and previous infection or colonisation with a resistant pathogen. Non-pharmacological interventions, such as screening for resistant bacteria, applying isolation and contact precautions should be put in place to limit the spread of MDR bacteria. Antimicrobial stewardship program should be implemented in transplant centres.

journal_name

Mediterr J Hematol Infect Dis

journal_title

Mediterranean journal of hematology and infectious diseases

authors

Balletto E,Mikulska M

doi

10.4084/MJHID.2015.045

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

e2015045

issue

issn

2035-3006

pii

mjhid-7-1-e2015045

journal_volume

pub_type

杂志文章,评审

在线工具

Bacterial Infections in Hematopoietic Stem Cell Transplant Recipients.