{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:11:13Z","timestamp":1792782673198,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Tel Aviv University","id":[{"id":"https:\/\/ror.org\/04mhzgx49","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"\n Abstract<\/jats:title>\n \n The purpose of this study was to analyze bacterial bloodstream infections (BSIs) occurring in hospitalized pediatric hemato-oncology patients during 2012 to 2023. Data on 775 bacterial BSI episodes occurring in 456 patients (292, 63.04%, hematological malignancies and 164, 35.96%, solid tumors) were retrospectively collected and analyzed. In total,\u00a0362 (46.71%) bacterial-BSIs had profound neutropenia; 849 pathogens were isolated; gram-negative (GN) (68.78%, 584\/849) were more common than gram-positive (GP) pathogens (30.86%, 262\/849),\n P<\/jats:italic>\n \u2009<\u20090.001. The most frequent GN isolates were\n Klebsiella<\/jats:italic>\n spp. (20.38% of all isolates),\n Escherichia coli<\/jats:italic>\n (19.20%), and\n Pseudomonas aeruginosa<\/jats:italic>\n (12.01%); the most common GP isolates were\n Streptococcus viridans<\/jats:italic>\n (9.19%)\n Enterococcus<\/jats:italic>\n spp. (6.36%), and\n Staphylococcus aureus<\/jats:italic>\n (6.12%, 21.15% MRSA). An increase in GN rates was observed in 2018\u20132023 versus 2012\u20132017 (74.16% vs. 63.22%,\n P<\/jats:italic>\n \u2009=\u20090.001). Overall nonsusceptibility rates of\n Klebsiella<\/jats:italic>\n spp. and\n E. coli<\/jats:italic>\n were 80.13% and 90.07% for piperacillin, 16.76% and 9.82% for amikacin, 69.19% and 50.31% for ceftriaxone, 34.68% and 23.92% for piperacillin\/tazobactam, and 8.72% and 1.85% for meropenem. Nonsusceptibility rates of\n Acinetobacter baumannii<\/jats:italic>\n were 57.14% for both piperacillin\/tazobactam and meropenem. The appropriateness of empiric antibiotic therapy (EAT) with piperacillin\/tazobactam was lower than piperacillin\/tazobactam\u2009+\u2009amikacin (62.61% vs. 90.45%,\n P<\/jats:italic>\n \u2009<\u20090.0001). PICU admission was required in 230 (29.68%); 7-day and 30-day mortality rates were 6.36% and 14.69%, respectively.\n <\/jats:p>\n \n Conclusions<\/jats:italic>\n :\n <\/jats:p>\n \n We report an increase in GN-BSIs and in nonsusceptibility rates of\n Klebsiella<\/jats:italic>\n spp. and\n E. coli<\/jats:italic>\n to several first\/second-line antibiotics used in empiric antibiotic therapy. In our setting, an EAT protocol including piperacillin\/tazobactam and amikacin covered most pathogens and should be considered in stable children with suspicion of BSI.\n \n \n \n \n \n What is Known:<\/jats:bold>\n \u2022\n Bloodstream infections and antibiotic resistance rates are increasing in pediatric hemato-oncology patients.<\/jats:italic>\n <\/jats:td>\n <\/jats:tr>\n \n \n What is New:<\/jats:bold>\n \u2022\n We found a dominance of gram-negative pathogens and moderate to high resistance rates of Klebsiella spp. and Escherichia coli for piperacillin\/tazobactam, ciprofloxacin, and ceftriaxone.<\/jats:italic>\n \u2022\n Empiric antibiotic therapy was appropriate for 77.07% of evaluable pathogens.<\/jats:italic>\n \u2022\n The appropriateness of empiric antibiotic therapy with piperacillin\/tazobactam alone was lower than that of piperacillin\/tazobactam plus amikacin.<\/jats:italic>\n <\/jats:td>\n <\/jats:tr>\n <\/jats:tbody>\n <\/jats:table>\n <\/jats:table-wrap>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00431-026-07305-7","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T20:00:27Z","timestamp":1786564827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bacterial bloodstream infections in pediatric oncology patients in a tertiary medical center: pathogen distribution, antimicrobial nonsusceptibility, and outcomes"],"prefix":"10.1007","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7167-384X","authenticated-orcid":false,"given":"Menucha","family":"Jurkowicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Leibovitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hila","family":"Rosental","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Keller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilad","family":"Sherman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrat","family":"Dresner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Katzenellenbogen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Gelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Paret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reut","family":"Myaskovetzky-Yitshack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Golan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assaf","family":"Barg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Toren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"9","key":"7305_CR1","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1097\/MPH.0b013e3181b1edc6","volume":"31","author":"H Hakim","year":"2009","unstructured":"Hakim H, Flynn PM, Knapp KM, Srivastava DK, Gaur AH (2009) Etiology and clinical course of febrile neutropenia in children with cancer. 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SMC-D-0915\u201323) and was performed in accordance with the Declaration of Helsinki. All data were fully anonymized prior to analysis, with no identifiable patient information retained. The institutional review board granted a waiver of informed consent, as the study involved analysis of deidentified data and posed minimal risk to participants.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"661"}}