{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:53:26Z","timestamp":1791384806548,"version":"4.3.3"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T00:00:00Z","timestamp":1469750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:p>\n                    The aim of this study was to identify risk factors for mortality in patients suffering from hematological malignancies (HMs) with bloodstream infections (BSIs) caused by Klebsiella pneumoniae (KP). We conducted a prospective cohort study on KP BSI in 13 Italian hematological units participating in the HEMABIS registry\u2013SEIFEM group. The outcome measured was death within 21 days of BSI onset. Survivor and non\u2010survivor subgroups were compared and Cox regression analysis was conducted to identify independent predictors of mortality. A total of 278 episodes of KP BSI were included in the study between January 2010 and June 2014. We found that 161 (57.9%) KP isolates were carbapenem resistant (CRKP). The overall 21\u2010day mortality rate was 36.3%. It was significantly higher for patients with CRKP BSI (84\/161, 52.2%) than for those with BSI caused by carbapenem susceptible KP (CSKP) (17\/117, 14.5%;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Septic shock (HR 3.86), acute respiratory failure (HR 2.32), inadequate initial antimicrobial therapy (HR 1.87) and carbapenem resistance by KP isolates (HR 1.85) were independently associated with mortality. A subanalysis was conducted in only 149 patients with CRKP BSI who had received \u226548 hr of adequate antibiotic therapy, and combination therapy was independently associated with survival (HR 0.32). Our study shows that in recent years carbapenem resistance has dramatically increased in HM patients with KP BSI in Italy and is associated with a worse outcome. The optimal management of such infections and the definition of new empirical\/targeted antimicrobial strategies in HM patients can still be considered unmet clinical needs. Am. J. Hematol. 91:1076\u20131081, 2016. \u00a9 2016 Wiley Periodicals, Inc.\n                  <\/jats:p>","DOI":"10.1002\/ajh.24489","type":"journal-article","created":{"date-parts":[[2016,7,18]],"date-time":"2016-07-18T18:56:44Z","timestamp":1468868204000},"page":"1076-1081","source":"Crossref","is-referenced-by-count":141,"title":["Bloodstream infections caused by\n                    <i>Klebsiella pneumoniae<\/i>\n                    in onco\u2010hematological patients: clinical impact of carbapenem resistance in a multicentre prospective survey"],"prefix":"10.1002","volume":"91","author":[{"given":"Enrico Maria","family":"Trecarichi","sequence":"first","affiliation":[{"name":"Institute of Infectious Diseases, Policlinico Universitario Agostino Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livio","family":"Pagano","sequence":"additional","affiliation":[{"name":"Institute of Hematology, Policlinico Universitario Agostino Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Martino","sequence":"additional","affiliation":[{"name":"Haematology, Bianchi Melacrino Morelli Hospital Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Candoni","sequence":"additional","affiliation":[{"name":"Division of Hematology and Stem Cell Transplantation University Hospital of Udine Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Di Blasi","sequence":"additional","affiliation":[{"name":"Institute of Hematology, Policlinico Universitario Agostino Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaolo","family":"Nadali","sequence":"additional","affiliation":[{"name":"Section of Hematology Department of Clinical and Experimental Medicine University of Verona  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Fianchi","sequence":"additional","affiliation":[{"name":"Institute of Hematology, Policlinico Universitario Agostino Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Delia","sequence":"additional","affiliation":[{"name":"Hematology Section Department of Emergency and Organ Transplant University of Bari Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Institute of Hematology, Policlinico Universitario Agostino Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Perriello","sequence":"additional","affiliation":[{"name":"Institute of Hematology, S. Maria della Misericordia Hospital, University of Perugia Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Busca","sequence":"additional","affiliation":[{"name":"Department of Hematology and Stem Cell Transplant Unit AOU Citta' della Salute e della Scienza Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Aversa","sequence":"additional","affiliation":[{"name":"Hematology and BMT Unit, Azienda Ospedaliero\u2010Universitaria di Parma, Parma, Italy; Department of Clinical and Experimental Medicine, Hematology and BMT Unit, University of Parma Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Fanci","sequence":"additional","affiliation":[{"name":"Haematology Unit, Careggi Hospital and University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorella","family":"Melillo","sequence":"additional","affiliation":[{"name":"Department of Hematology and Stem Cell Transplant Unit IRCCS \u201cCasa Sollievo della Sofferenza\u201d Hospital San Giovanni Rotondo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Lessi","sequence":"additional","affiliation":[{"name":"Department of Medicine Haematology Unit, University of Padova  Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ilaria","family":"Del Principe","sequence":"additional","affiliation":[{"name":"Cattedra di Ematologia, Dipartimento di Biomedicina e Prevenzione, Universit\u00e0 Tor Vergata Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Hematology, Spedali Civili  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Tumbarello","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases, Policlinico Universitario Agostino Gemelli Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the HaematologicMalignancies Associated Bloodstream Infections Surveillance (HEMABIS) registry \u2013 Sorveglianza Epidemiologica Infezioni Funginein Emopatie Maligne(SEIFEM) group, Italy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000038"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2014.11.022"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-013-1819-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2015.044"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1586\/14787210.2013.836057"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70190-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2007.130094"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.231"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044097"},{"key":"e_1_2_6_11_1","unstructured":"European Centre for Disease Prevention and Control. 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