Alp Sehnaz, Akova Murat
Associate Professor, Hacettepe University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
Professor, Hacettepe University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
Mediterr J Hematol Infect Dis. 2017 Jan 1;9(1):e2017002. doi: 10.4084/MJHID.2017.002. eCollection 2017.
Recipients of hematopoietic stem cell transplantation (HSCT) are at substantial risk of bacterial, fungal, viral, and parasitic infections depending on the time elapsed since transplantation, presence of graft-versus-host disease (GVHD), and the degree of immunosuppression. Infectious complications in HSCT recipients are associated with high morbidity and mortality. Bacterial infections constitute the major cause of infectious complications, especially in the early post-transplant period. The emergence of antibacterial resistance complicates the management of bacterial infections in this patient group. Multidrug-resistant bacterial infections in this group of patients have attracted considerable interest and may lead to significant morbidity and mortality. Empirical antibacterial therapy in patients with HSCT and febrile neutropenia has a critical role for survival and should be based on local epidemiology. This review attempts to provide an overview of risk factors and epidemiology of emerging resistant bacterial infections and their management in HSCT recipients.
造血干细胞移植(HSCT)受者有发生细菌、真菌、病毒和寄生虫感染的重大风险,这取决于移植后经过的时间、移植物抗宿主病(GVHD)的存在情况以及免疫抑制的程度。HSCT受者的感染并发症与高发病率和死亡率相关。细菌感染是感染并发症的主要原因,尤其是在移植后的早期。抗菌药物耐药性的出现使该患者群体细菌感染的管理变得复杂。该患者群体中的多重耐药细菌感染已引起了相当大的关注,并可能导致显著的发病率和死亡率。HSCT合并发热性中性粒细胞减少症患者的经验性抗菌治疗对生存起着关键作用,且应基于当地的流行病学情况。本综述试图概述HSCT受者中新出现的耐药细菌感染的危险因素、流行病学及其管理。