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Enterobacteriaceae in Transplantation

  • Kathryn Whitaker
  • Valerie Cluzet
  • Emily A. BlumbergEmail author
Chapter

Abstract

Enterobacteriaceae comprise important pathogens for recipients of solid organ and hematopoietic stem cell transplants. Especially common in the early posttransplant period when transplant recipients are still hospitalized, they can occur at any time following the procedure. Increasing frequency of colonization and invasive disease due to antimicrobial-resistant pathogens has been described in recipients of solid organ and hematopoietic stem cell transplants. In solid organ transplant recipients, surgical considerations may affect the development of these infections, and transplant organ-specific infections are frequently seen. In stem cell recipients, blood stream infections are among the most common manifestations. In cases of respiratory tract, superficial wound, and urinary tract isolation of Enterobacteriaceae, it is important to differentiate colonization from true infection. The choice of appropriate antimicrobials should include consideration of the risk for antimicrobial resistance. Source control may be critical to cure infection, especially when the patient has either line-related bloodstream infection or surgical site/wound involvement. Transplant recipients may also be at risk for infection with Enterobacteriaceae that are not typically considered pathogenic in the normal host; consequently, all cultures should be carefully interpreted with respect to clinical presentation and the source of the culture.

Keywords

Solid organ transplantation Hematopoietic stem cell transplantation Escherichia coli Klebsiella spp. Enterobacter spp. Serratia spp. Citrobacter spp. Proteus spp. Salmonella spp. Shigella spp. Yersinia spp. 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kathryn Whitaker
    • 1
  • Valerie Cluzet
    • 2
  • Emily A. Blumberg
    • 1
    Email author
  1. 1.Division of Infectious DiseasesHospital of the University of Pennsylvania, Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Health Quest Medical Practice, Department of Infectious DiseasesPoughkeepsieUSA

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