title: Bacterial infections in hematopoietic stem cell transplantation recipients.
abstract: OBJECTIVE
  Bacterial infections are among the most frequent complications of hematopoietic stem cell transplant (HSCT). This review describes current epidemiology and management of bacterial infections.
  
  
  RESULTS
  Multidrug resistant (MDR) bacteria are increasingly frequent in HSCT recipients, but significant differences in etiology of bacterial infections and prevalence of resistant strains exist between different transplant centers. Methicillin-resistant coagulase-negative staphylococci, extended-spectrum beta-lactamase-producing Enterobacteriaceae, vancomycin-resistant enterococci and MDR Pseudomonas aeruginosa are the most relevant examples. Infection control measures are mandatory to limit the spread of resistant strains. Selective digestive decontamination is controversial and potentially associated with inducing resistance to antibiotics that might be the last treatment option, such as colistin or aminoglycosides. Empirical therapy should be individualized, and an escalation or de-escalation approach should be chosen depending on local epidemiology, colonization and clinical presentation. Antimicrobial stewardship, with the aim of improving management of bacterial infections, should be put in place in transplant units.
  
  
  CONCLUSIONS
  Bacterial infections in the transplant population warrant currently particular attention to limit the negative impact of infections caused by resistant strains.
authors.affiliation: aDivision of Infectious Diseases, IRCCS San Martino University Hospital - IST bDepartment of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Mikulska
authors.forename: Valerio
authors.initials: V
authors.lastname: Del Bono
authors.forename: Claudio
authors.initials: C
authors.lastname: Viscoli
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents