Patient selection: allogeneic or autologous hematopoietic stem cell transplant (HSCT)
Pre-engraftment period: 0 to 30 days after the HSCT
Risk factors for pre-engraftment Gram-negative bacteremia in allo-HSCT:
(1) acute leukemia
(2) transplant from HLA-mismatched donor or from cord blood
(3) older age
(4) prolonged severe neutropenia
Risk factors for pre-engraftment Gram-negative bacteremia in auto-HSCT:
(1) diagnosis other than multiple myeloma (Table 4)
(2) no antibacterial prophylaxis
(3) older age
Risk factors for post-transplant infection by a resistant Gram-negative bacteria:
(1) pre-transplant infection by the same organism
(2) colonization by the organism prior to transplant
The key pathogens are Pseudomonas aeruginosa and carba-NS Enterobacteria (not susceptible to carbapenems).
