{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:00:44Z","timestamp":1787029244135,"version":"build-2736575974"},"reference-count":56,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merit Review Award","award":["BX001786"],"award-info":[{"award-number":["BX001786"]}]},{"name":"Merit Review Award","award":["HL144478"],"award-info":[{"award-number":["HL144478"]}]},{"name":"RO1 funding","award":["BX001786"],"award-info":[{"award-number":["BX001786"]}]},{"name":"RO1 funding","award":["HL144478"],"award-info":[{"award-number":["HL144478"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Allogeneic stem cell transplantation is a lifesaving treatment for many malignancies. Post-transplant patients may suffer from graft versus host disease in the acute and\/or the chronic form(s). Post-transplantation immune deficiency due to a variety of factors is a major cause of morbidity and mortality. Furthermore, immunosuppression can lead to alterations in host factors that predisposes these patients to infections. Although patients who receive stem cell transplant are at an increased risk of opportunistic pathogens, which include fungi and viruses, bacterial infections remain the most common cause of morbidity. Here, we review bacterial pathogens that lead to pneumonias specifically in the chronic GVHD population.<\/jats:p>","DOI":"10.3390\/pathogens12050726","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T07:35:50Z","timestamp":1684395350000},"page":"726","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Bacterial Pathogens Causing Pneumonia Post Hematopoietic Stem Cell Transplant: The Chronic GVHD Population"],"prefix":"10.3390","volume":"12","author":[{"given":"Said","family":"Chaaban","sequence":"first","affiliation":[{"name":"VA Nebraska Western Iowa Health Care System, Omaha, NE 68105, USA"},{"name":"Division of Pulmonary, Critical Care & Sleep, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Zimmer","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya Raj","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Schmidt","sequence":"additional","affiliation":[{"name":"McGoogan Health Sciences Library, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxana T.","family":"Sadikot","sequence":"additional","affiliation":[{"name":"VA Nebraska Western Iowa Health Care System, Omaha, NE 68105, USA"},{"name":"Division of Pulmonary, Critical Care & Sleep, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"ref_1","first-page":"259","article-title":"Major pulmonary complications after hematopoietic stem cell transplant","volume":"14","author":"Diab","year":"2016","journal-title":"Exp. Clin. Transplant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1038\/s41409-019-0476-6","article-title":"Worldwide Network for Blood & Marrow Transplantation (WBMT) special article, challenges facing emerging alternate donor registries","volume":"54","author":"Aljurf","year":"2019","journal-title":"Bone Marrow Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.ccm.2016.12.005","article-title":"Bacterial Pneumonia in Patients with Cancer: Novel Risk Factors and Management","volume":"38","author":"Wong","year":"2017","journal-title":"Clin. Chest Med."},{"key":"ref_4","unstructured":"Schuster, M.G., Cleveland, A.A., Dubberke, E.R., Kauffman, C.A., Avery, R.K., Husain, S., Paterson, D.L., Silveira, F.P., Chiller, T.M., and Benedict, K. (2017). Open Forum Infectious Diseases, Oxford University Press."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E629","DOI":"10.1111\/j.1399-0012.2011.01495.x","article-title":"Pneumonia in allogeneic stem cell transplantation recipients: A multicenter prospective study","volume":"25","author":"Espigado","year":"2011","journal-title":"Clin. Transplant."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1200\/JOP.18.00269","article-title":"Optimal management of neutropenic fever in patients with cancer","volume":"15","author":"Zimmer","year":"2019","journal-title":"J. Oncol. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/bmt.2009.254","article-title":"Guidelines for preventing infectious complications among hematopoietic cell transplant recipients: A global perspective","volume":"44","author":"Tomblyn","year":"2009","journal-title":"Bone Marrow Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1056\/NEJMra1609337","article-title":"Acute graft-versus-host disease\u2014Biologic process, prevention, and therapy","volume":"377","author":"Zeiser","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1016\/j.bbmt.2007.07.007","article-title":"Risk factors for late infections after allogeneic hematopoietic stem cell transplantation from a matched related donor","volume":"13","author":"Robin","year":"2007","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jtct.2021.10.002","article-title":"Chronic graft-versus-host disease, nonrelapse mortality, and disease relapse in older versus younger adults undergoing matched allogeneic peripheral blood hematopoietic cell transplantation: A Center for International Blood and Marrow Transplant Research Analysis","volume":"28","author":"Bhatt","year":"2022","journal-title":"Transplant. Cell. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1182\/bloodadvances.2019000050","article-title":"Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission","volume":"3","author":"Rashidi","year":"2019","journal-title":"Blood Adv."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"A126","DOI":"10.24292\/01.OR.090817","article-title":"Pneumonia in patients after hematopoietic stem cell transplantation","volume":"7","year":"2017","journal-title":"OnCOReview"},{"key":"ref_13","first-page":"6963","article-title":"Impact of immune modulation with anti\u2013T-cell antibodies on the outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for hematologic malignancies","volume":"117","author":"Soiffer","year":"2011","journal-title":"Blood J. Am. Soc. Hematol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1378\/chest.109.4.1066","article-title":"Pulmonary complications of bone marrow transplantation","volume":"109","author":"Soubani","year":"1996","journal-title":"Chest"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1182\/hematology.2021000301","article-title":"Updates in chronic graft-versus-host disease","volume":"2021","author":"Hamilton","year":"2021","journal-title":"Hematology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1055\/s-2001-18919","article-title":"Functional hyposplenia after allogenic bone marrow transplantation: A case report","volume":"22","author":"Wollenberg","year":"2001","journal-title":"Ultraschall Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/md.0b013e31803eb176","article-title":"Streptococcus pneumoniae infections in 47 hematopoietic stem cell transplantation recipients: Clinical characteristics of infections and vaccine-breakthrough infections, 1989\u20132005","volume":"86","author":"Youssef","year":"2007","journal-title":"Medicine"},{"key":"ref_18","first-page":"903","article-title":"Fatal pneumococcal infections following allogeneic bone marrow transplant","volume":"14","author":"Rege","year":"1994","journal-title":"Bone Marrow Transplant."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Saj, F., Reddy, V.N., Kayal, S., Dubashi, B., Singh, R., Joseph, N.M., and Ganesan, P. (2022). Double Infection in a Patient with Chronic GVHD Post Allogeneic Transplant: Hickam\u2019s Dictum Trumps Occam\u2019s Razor!\u2014A Case Report with Review of Literature. Indian J. Med. Paediatr. Oncol.","DOI":"10.1055\/s-0042-1748166"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e359","DOI":"10.1016\/S1473-3099(22)00227-4","article-title":"Mycobacterial infections in adults with haematological malignancies and haematopoietic stem cell transplants: Guidelines from the 8th European Conference on Infections in Leukaemia","volume":"22","author":"Bergeron","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1399-3062.2004.00068.x","article-title":"Tuberculosis in allogeneic stem cell transplant recipients: Still a problem in the 21st century","volume":"6","author":"Erdstein","year":"2004","journal-title":"Transpl. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/sj.bmt.1702163","article-title":"Central nervous system (CNS) tuberculosis following allogeneic stem cell transplantation","volume":"25","author":"Campos","year":"2000","journal-title":"Bone Marrow Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1038\/sj.bmt.1703092","article-title":"Pulmonary tuberculosis in allogeneic hematopoietic stem cell transplantation","volume":"27","author":"Ku","year":"2001","journal-title":"Bone Marrow Transplant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jmii.2018.07.001","article-title":"Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area","volume":"53","author":"Liu","year":"2020","journal-title":"J. Microbiol. Immunol. Infect. = Wei Mian Yu Gan Ran Za Zhi"},{"key":"ref_25","first-page":"59","article-title":"Incidence of tuberculosis after bone marrow transplantation in a single center from Turkey","volume":"29","author":"Arslan","year":"1998","journal-title":"Haematologia"},{"key":"ref_26","first-page":"809","article-title":"Tuberculosis in bone marrow transplant recipients: Report of two eases and review of the literature","volume":"18","author":"Martino","year":"1996","journal-title":"Bone Marrow Transplant."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1164\/ajrccm.158.4.9712072","article-title":"Risk factors for pulmonary tuberculosis in bone marrow transplant recipients","volume":"158","author":"Ip","year":"1998","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/sj.bmt.1702506","article-title":"Tuberculosis after hematopoietic stem cell transplantation: Incidence, clinical characteristics and outcome","volume":"26","author":"Martino","year":"2000","journal-title":"Bone Marrow Transplant."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jiac.2017.08.011","article-title":"Mycobacterium abscessus and massiliense lung infection during macrolide treatment for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation","volume":"24","author":"Miyake","year":"2018","journal-title":"J. Infect. Chemother."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1399-3062.2008.00351.x","article-title":"Mycobacterium chelonae necrotizing pneumonia after allogeneic hematopoietic stem cell transplant: Report of clinical response to treatment with tigecycline","volume":"11","author":"Peres","year":"2009","journal-title":"Transpl. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1001\/jama.2017.9938","article-title":"Effect of azithromycin on airflow decline\u2013free survival after allogeneic hematopoietic stem cell transplant: The allozithro randomized clinical trial","volume":"318","author":"Bergeron","year":"2017","journal-title":"JAMA"},{"key":"ref_32","first-page":"2500","article-title":"Azithromycin promotes relapse by disrupting immune and metabolic networks after allogeneic stem cell transplantation","volume":"140","author":"Vallet","year":"2022","journal-title":"Blood J. Am. Soc. Hematol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s12185-015-1745-9","article-title":"Clinical significance of nontuberculous mycobacteria from respiratory specimens in stem cell transplantation recipients","volume":"101","author":"Kang","year":"2015","journal-title":"Int. J. Hematol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.healun.2007.05.015","article-title":"Successful Lung Transplantation for Post-BMT Bronchiolitis Obliterans and Lipoid Pneumonia Associated with Atypical Mycobacterium and Aspergillosis Infection","volume":"26","author":"Au","year":"2007","journal-title":"J. Heart Lung Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"675","DOI":"10.3109\/10428190109097667","article-title":"Mycobacterial pulmonary infection post allogeneic bone marrow transplantation","volume":"40","author":"Mohite","year":"2001","journal-title":"Leuk. Lymphoma"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/01.idc.0000144899.20580.4d","article-title":"Recognition of misdiagnosed tuberculosis in a bone marrow transplant recipient leads to identification of \u201cpseudotuberculosis\u201d due to laboratory contamination","volume":"12","author":"Alangaden","year":"2004","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1701960","DOI":"10.1183\/13993003.01960-2017","article-title":"Pulmonary alveolar proteinosis and Mycobacterium abscessus lung infection related to ruxolitinib after allogeneic stem cell transplantation","volume":"51","author":"Salvator","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e12745","DOI":"10.1111\/tid.12745","article-title":"Legionnaires\u2019 disease in transplant recipients: A 15-year retrospective study in a tertiary referral center","volume":"19","author":"Sivagnanam","year":"2017","journal-title":"Transpl. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1093\/cid\/ciz538","article-title":"Slowly or nonresolving legionnaires\u2019 disease: Case series and literature review","volume":"70","author":"Pouderoux","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/tid.12201","article-title":"Cutaneous legionellosis: Case report and review of the medical literature","volume":"16","author":"Padrnos","year":"2014","journal-title":"Transpl. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s11908-016-0517-x","article-title":"Legionellosis in transplantation","volume":"18","author":"Sivagnanam","year":"2016","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4294","DOI":"10.1128\/JCM.38.11.4294-4295.2000","article-title":"Persistent Legionella infection in a patient after bone marrow transplantation","volume":"38","author":"Schindel","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1016\/j.bbmt.2018.03.010","article-title":"Increased Incidence of Nocardial Infections in an Era of Atovaquone Prophylaxis in Allogeneic Hematopoietic Stem Cell Transplant Recipients","volume":"24","author":"Molina","year":"2018","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.2169\/internalmedicine.53.1860","article-title":"Pulmonary Nocardia nova Infection after allogeneic hematopoietic stem cell transplantation","volume":"53","author":"Yamakawa","year":"2014","journal-title":"Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/j.1399-3062.2007.00268.x","article-title":"Pulmonary Nocardia and Aspergillus co-infection in a patient with chronic graft-versus-host disease: Images in transplant infectious disease","volume":"10","author":"Hamadani","year":"2008","journal-title":"Transpl. Infect. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/j.1445-5994.2006.01088.x","article-title":"Nocardia infection following bone marrow transplantation","volume":"36","author":"Kennedy","year":"2006","journal-title":"Intern. Med. J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.2169\/internalmedicine.49.3658","article-title":"Pulmonary nocardiosis developed in a hematopoietic stem cell transplant recipient with bronchiolitis obliterans","volume":"49","author":"Nishida","year":"2010","journal-title":"Intern. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1007\/s00277-003-0813-z","article-title":"Pulmonary nocardiosis in a patient with CML relapse undergoing imatinib therapy after bone marrow transplantation","volume":"83","author":"Lin","year":"2004","journal-title":"Ann. Hematol."},{"key":"ref_49","first-page":"479","article-title":"Pulmonary nocardiosis in a patient with a bone marrow transplant","volume":"15","author":"Shearer","year":"1995","journal-title":"Bone Marrow Transplant."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/BF02984005","article-title":"Frequent exacerbation of pulmonary nocardiosis during maintenance antibiotic therapies in a hematopoietic stem cell transplant recipient","volume":"86","author":"Kakihana","year":"2007","journal-title":"Int. J. Hematol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Tuon, F.F., Dantas, L.R., Suss, P.H., and Tasca Ribeiro, V.S. (2022). Pathogenesis of the Pseudomonas aeruginosa biofilm: A review. Pathogens, 11.","DOI":"10.3390\/pathogens11030300"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1164\/rccm.200408-1044SO","article-title":"Pathogen\u2013host interactions in Pseudomonas aeruginosa pneumonia","volume":"171","author":"Sadikot","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.medcli.2022.03.014","article-title":"Long-term treatment with nebulized colistin in oncological patients with recurrent respiratory infections","volume":"159","author":"Suanzes","year":"2022","journal-title":"Med. Clin."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/00007890-198402000-00008","article-title":"Obstructive lung disease after allogeneic bone marrow transplantation","volume":"37","author":"Kurzrock","year":"1984","journal-title":"Transplantation"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/BF01735262","article-title":"Lung diseases after bone marrow transplantation","volume":"64","author":"Link","year":"1986","journal-title":"Klin. Wochenschr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.6004\/jnccn.2012.0147","article-title":"Current issues in vaccines for adult patients with hematologic malignancies","volume":"10","author":"Issa","year":"2012","journal-title":"J. Natl. Compr. Cancer Netw. JNCCN"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/5\/726\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:36:50Z","timestamp":1760125010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/5\/726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,17]]},"references-count":56,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["pathogens12050726"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12050726","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,17]]}}}