The main bacterial infection complicating heart transplantation is nosocomially-acquired ventilator-associated pneumonia caused by gram-negative bacteria, including P. aeruginosa, Klebsiella pneumoniae, and the other Enterobacteriaceae. Of special interest are wound infections, especially mid-line sternotomy infections caused by Staphylococcus aureus and coagulase-negative staphylococci. Medias-tinitis and line-related bacteremias also occur after heart transplantation. Endocarditis, related to valvular lesions caused by repeated endomyocardial biopsies and colonization by circulating bacteria, is occasionally reported after transplantation.

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