Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli- IRCCS , Rome, Italy.
Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona, Spain.
Expert Rev Hematol. 2020 Nov;13(11):1235-1251. doi: 10.1080/17474086.2020.1831382. Epub 2020 Nov 3.
Infections remain a significant problem, in patients undergoing an allogeneic hematopoietic stem-cell transplant (HSCT) and efforts have been made over the years, to reduce the incidence, morbidity and mortality of infectious complications.
This manuscript is focused on the epidemiology, risk factors and prevention of infections after allogeneic HSCT. A systematic literature review was performed using the PubMed database, between November 2019 and January 2020, with the following MeSH terms: stem-cell transplantation, infection, fungal, bacterial, viral, prophylaxis, vaccines, prevention. The authors reviewed all the publications, and following a common revision, a summary report was made and results were divided in three sections: bacterial, fungal and viral infections.
Different infections occur in the early, intermediate and late post-transplant period, due to distinct risk factors. Improved diagnostic techniques, pre-emtive therapy and better prophylaxis of immunologic complications, have reduced the morbidity and mortality of infections. The role of the gut microbiota is under careful scrutiny and may further help us to identify high-risk patients.
感染仍然是一个重大问题，尤其是在接受异基因造血干细胞移植（HSCT）的患者中。多年来，人们一直致力于降低感染性并发症的发生率、发病率和死亡率。
本文主要关注异基因 HSCT 后感染的流行病学、危险因素和预防。使用 PubMed 数据库，在 2019 年 11 月至 2020 年 1 月期间进行了系统的文献回顾，使用了以下 MeSH 术语：干细胞移植、感染、真菌、细菌、病毒、预防、疫苗、预防。作者审查了所有出版物，并在共同修订后，编写了一份总结报告，结果分为三个部分：细菌、真菌和病毒感染。
由于不同的危险因素，不同的感染发生在移植后早期、中期和晚期。改进的诊断技术、先发制人的治疗和更好的免疫并发症预防，降低了感染的发病率和死亡率。肠道微生物组的作用正在受到仔细审查，这可能有助于我们进一步确定高风险患者。
