Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea

Cho, Sung-Yeon; Lee, Hyeon-Jeong; Lee, Dong-Gun

The distribution of causative organisms in febrile neutropenic patients varies geographically. In the United States and Europe, GPC accounted for 60% to 70% of MDI until the early 1990s, while the proportion of The Korean Journal of Internal Medicine Vol. 33, No. 2, March 2018 GNB increased after the mid-2000s. In a multicenter epidemiological survey, the proportions of Gram-positive and -negative cases were 55% (range, 30% to 85%) and 45% (range, 15% to 70%), respectively [16] [17] [18] . Enterobacteriaceae was the most common causative organism, accounting for 30% (range, 8% to 56%). The second most common organism was coagulase-negative staphylococci (24% [range, 7% to 51%]). In Korean studies, GNB were also more common until the mid-2000s, which is consistent with other reports from the Asia-Pacific region [19] . Intestinal bacteria such as Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are frequently reported GNB, and Enterococcus, Streptococcus, and Staphylococcus species are common among GPC [6] [7] [8] [20] [21] [22] . Because the epidemiology of bacterial pathogens and the resistance profiles varies, early empirical antimicrobial agents must be selected according to the distributions and susceptibilities of the frequently detected bacterial taxa in that center [13, 15, 19] .