Background:Multidrug resistant (MDR) bacteria are increasingly frequent in HSCT recipients, but significant differences in etiology of bacterial infections and prevalence of resistant strains exist between different transplant centers Extended‐spectrum beta‐lactamase producing Escherichia coli, Vancomicyn resistant enterococci, Penicillin‐resistant Pneumococci Methicillin‐resistant Staphylococcus aureus and are major problem to manage.Aims:Aim: to evaluate the frequency of multidrug resistant bacteria in our center.Methods:During a 19 years period we have transplanted 500 patients with different hematological malignant and nonmalignant diseases. All patients were treated in sterile room conditioned with HEPA filters and low bacterial diet. Antibacterial prophylaxis consisted Ciprofloxacine 1,0gr/day. As empirical antibiotics regimen we administered combination of third‐generation cephalosporin + amynoglicoside, while as second line therapy Imipenem + VancomycinResults:in every patient 3 times a week we monitor: blood culture, central venous catheter culture, sputum, urine culture. From all 288 bacterial isolates the distribution of MDR bacteria were: ESBL positive Escherichia coli 3 (0,10%) VR Enterococcus 2(0,06%) MDR Pseudomonas aer. 1 (0,03%) Klebsiella aerogenes 2 (0,06%) MRSA 17(0,06%) Acinetobacter baumanii 2(0,06%) Stenotrophomonas Maltophilia 2(0,06%). There were fatal outcome due to sepsis in 3 patients (VRE 1, MDR Pseudomonas 1, Stenotrophomonas maltophilia 1).Summary/Conclusion:The monitoring of local microflora is crucial for every transplant center. Empirical first‐line therapy must be individualized and according to ECIL 4 escalation and de‐escalation strategy is necessery for better outcome in this group of immunocompromised patients.