title: [Nosocomial infection in patients receiving a solid organ transplant or haematopoietic stem cell transplant].
abstract: Bacterial infections are the most common infections in solid organ transplant recipients. These infections occur mainly in the first month after transplantation and are hospital-acquired. Nosocomial infections cause significant morbidity and are the most common cause of mortality in this early period of transplantation. These infections are caused by multi-drug resistant (MDR) microorganisms, mainly Gram-negative enterobacteria, non-fermentative Gram-negative bacilli, enterococci, and staphylococci. The patients at risk of developing nosocomial bacterial infections are those previously colonized with MDR bacteria while on the transplant waiting list. Intravascular catheters, the urinary tract, the lungs, and surgical wounds are the most frequent sources of infection. Preventive measures are the same as those applied in non-immunocompromised, hospitalized patients except in patients at high risk for developing fungal infection. These patients need antifungal therapy during their hospitalization, and for preventing some bacterial infections in the early transplant period, patients need vaccinations on the waiting list according to the current recommendations. Although morbidity and mortality related to infectious diseases have decreased during the last few years in haematopoietic stem cell transplant recipients, they are still one of the most important complications in this population. Furthermore, as occurs in the general population, the incidence of nosocomial infections has increased during the different phases of transplantation. It is difficult to establish general preventive measures in these patients, as there are many risk factors conditioning these infections. Firstly, they undergo multiple antibiotic treatments and interventions; secondly, there is a wide variability in the degree of neutropenia and immunosuppression among patients, and finally they combine hospital and home stay during the transplant process. However, some simple measures could be implemented to improve the current situation.
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, España. Electronic address: AMORENO@clinic.ub.es.
authors.forename: Asunción
authors.initials: A
authors.lastname: Moreno Camacho
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitari Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Ruiz Camps
mesh_terms: D003428:Cross Infection / Q000382:microbiology* / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016377:Organ Transplantation; D011183:Postoperative Complications / Q000382:microbiology* / Q000517:prevention & control
keywords: Bacterias multirresistentes; Haematopoietic stem cell transplant; Infección nosocomial; Medidas preventivas; Multi-drug resistant bacteria; Nosocomial infection; Preventive measures; Solid organ transplantation; Trasplante de progenitores hematopoyéticos; Trasplante de órgano sólido