{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:32:31Z","timestamp":1792791151049,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,7]],"date-time":"2024-07-07T00:00:00Z","timestamp":1720310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,7]],"date-time":"2024-07-07T00:00:00Z","timestamp":1720310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea","award":["HI23C0299"],"award-info":[{"award-number":["HI23C0299"]}],"id":[{"id":"https:\/\/ror.org\/00fdzyk40","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Research Foundation of Korea grant funded by the Korean government","award":["RS-2023-00246999"],"award-info":[{"award-number":["RS-2023-00246999"]}],"id":[{"id":"https:\/\/ror.org\/013aysd81","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Despite the improved outcomes in patients with hematological malignancies, infections caused by multidrug-resistant organisms (MDROs) pose a new threat to these patients. We retrospectively reviewed the patients with hematological cancer and bacterial bloodstream infections (BSIs) at a tertiary hospital between 2003 and 2022 to assess the impact of MDROs on outcomes. Among 328 BSIs, 81 (24.7%) were caused by MDROs. MDRO rates increased from 10.3% (2003\u20132007) to 39.7% (2018\u20132022) (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). The 30-day mortality rate was 25.0%, which was significantly higher in MDRO-infected patients than in non-MDRO-infected patients (48.1 vs. 17.4%;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). The observed trend was more pronounced in patients with newly diagnosed diseases and relapsed\/refractory disease but less prominent in patients in complete remission. Among MDROs, carbapenem-resistant Gram-negative bacteria exhibited the highest mortality, followed by vancomycin-resistant enterococci, methicillin-resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    , and extended-spectrum \u03b2-lactamase-producing\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    . Multivariate analysis identified independent risk factors for 30-day mortality as age\u2009\u2265\u200965\u00a0years, newly diagnosed disease, relapsed\/refractory disease, MDROs, polymicrobial infection, CRP\u2009\u2265\u200920\u00a0mg\/L, and inappropriate initial antibiotic therapy. In conclusion, MDROs contribute to adverse outcomes in patients with hematological cancer and bacterial BSIs, with effects varying based on the underlying disease status and causative pathogens. Appropriate initial antibiotic therapy may improve patient outcomes.\n                  <\/jats:p>","DOI":"10.1038\/s41598-024-66524-w","type":"journal-article","created":{"date-parts":[[2024,7,7]],"date-time":"2024-07-07T05:01:32Z","timestamp":1720328492000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Impact of multidrug resistance on outcomes in hematologic cancer patients with bacterial bloodstream infections"],"prefix":"10.1038","volume":"14","author":[{"given":"Ki-Ho","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye Ji","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Jun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Hoon","family":"Maeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Kyung","family":"Baek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Joon","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woojae","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Youn","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Mi","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Suk","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,7]]},"reference":[{"issue":"7","key":"66524_CR1","doi-asserted-by":"publisher","first-page":"1850","DOI":"10.1038\/s41375-022-01596-z","volume":"36","author":"L Chen","year":"2022","unstructured":"Chen, L. et al. Changing causes of death in persons with haematological cancers 1975\u20132016. Leukemia 36(7), 1850\u20131860. https:\/\/doi.org\/10.1038\/s41375-022-01596-z (2022).","journal-title":"Leukemia"},{"issue":"13","key":"66524_CR2","doi-asserted-by":"publisher","first-page":"e606","DOI":"10.1016\/s1470-2045(14)70344-4","volume":"15","author":"M Ruhnke","year":"2014","unstructured":"Ruhnke, M., Arnold, R. & Gastmeier, P. Infection control issues in patients with haematological malignancies in the era of multidrug-resistant bacteria. Lancet Oncol. 15(13), e606\u2013e619. https:\/\/doi.org\/10.1016\/s1470-2045(14)70344-4 (2014).","journal-title":"Lancet Oncol."},{"issue":"1","key":"66524_CR3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3109\/00365549409008594","volume":"26","author":"E Rintala","year":"1994","unstructured":"Rintala, E. Incidence and clinical significance of positive blood cultures in febrile episodes of patients with hematological malignancies. Scand. J. Infect. Dis. 26(1), 77\u201384. https:\/\/doi.org\/10.3109\/00365549409008594 (1994).","journal-title":"Scand. J. Infect. Dis."},{"key":"66524_CR4","doi-asserted-by":"publisher","first-page":"743","DOI":"10.2147\/TCRM.S68450","volume":"10","author":"H Gedik","year":"2014","unstructured":"Gedik, H. et al. Bloodstream infections in patients with hematological malignancies: Which is more fatal - cancer or resistant pathogens?. Ther. Clin. Risk Manag. 10, 743\u2013752. https:\/\/doi.org\/10.2147\/TCRM.S68450 (2014).","journal-title":"Ther. Clin. Risk Manag."},{"issue":"3","key":"66524_CR5","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1111\/j.1469-0691.2005.01298.x","volume":"12","author":"M N\u00f8rgaard","year":"2006","unstructured":"N\u00f8rgaard, M., Larsson, H., Pedersen, G., Sch\u00f8nheyder, H. C. & S\u00f8rensen, H. T. Risk of bacteraemia and mortality in patients with haematological malignancies. Clin. Microbiol. Infect. 12(3), 217\u2013223. https:\/\/doi.org\/10.1111\/j.1469-0691.2005.01298.x (2006).","journal-title":"Clin. Microbiol. Infect."},{"issue":"Suppl 1","key":"66524_CR6","doi-asserted-by":"publisher","first-page":"S51","DOI":"10.1016\/j.ijantimicag.2007.06.012","volume":"30","author":"J Klastersky","year":"2007","unstructured":"Klastersky, J. et al. Bacteraemia in febrile neutropenic cancer patients. Int. J. Antimicrob. Agents. 30(Suppl 1), S51-59. https:\/\/doi.org\/10.1016\/j.ijantimicag.2007.06.012 (2007).","journal-title":"Int. J. Antimicrob. Agents."},{"issue":"6","key":"66524_CR7","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1007\/s00277-021-04541-9","volume":"100","author":"S Weber","year":"2021","unstructured":"Weber, S. et al. Profiling of bacterial bloodstream infections in hematological and oncological patients based on a comparative survival analysis. Ann. Hematol. 100(6), 1593\u20131602. https:\/\/doi.org\/10.1007\/s00277-021-04541-9 (2021).","journal-title":"Ann. Hematol."},{"issue":"3","key":"66524_CR8","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","volume":"18","author":"AP Magiorakos","year":"2012","unstructured":"Magiorakos, A. P. et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clin. Microbiol. Infect. 18(3), 268\u2013281. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03570.x (2012).","journal-title":"Clin. Microbiol. Infect."},{"key":"66524_CR9","unstructured":"Centers for Disease Control and Prevention. Multidrug-resistant organisms (MDRO) management. II. Background. MDRO definition., <https:\/\/www.cdc.gov\/infection-control\/hcp\/mdro-management\/background.html> (2024)."},{"issue":"8","key":"66524_CR10","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1007\/s00277-020-04144-w","volume":"99","author":"R Kara Ali","year":"2020","unstructured":"Kara Ali, R. et al. An eleven-year cohort of bloodstream infections in 552 febrile neutropenic patients: resistance profiles of Gram-negative bacteria as a predictor of mortality. Ann. Hematol. 99(8), 1925\u20131932. https:\/\/doi.org\/10.1007\/s00277-020-04144-w (2020).","journal-title":"Ann. Hematol."},{"issue":"11","key":"66524_CR11","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.1007\/s00277-018-3423-5","volume":"97","author":"S Scheich","year":"2018","unstructured":"Scheich, S. et al. Bloodstream infections with gram-negative organisms and the impact of multidrug resistance in patients with hematological malignancies. Ann. Hematol. 97(11), 2225\u20132234. https:\/\/doi.org\/10.1007\/s00277-018-3423-5 (2018).","journal-title":"Ann. Hematol."},{"issue":"1","key":"66524_CR12","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s00277-011-1247-7","volume":"91","author":"CI Kang","year":"2012","unstructured":"Kang, C. I., Chung, D. R., Ko, K. S., Peck, K. R. & Song, J. H. Risk factors for infection and treatment outcome of extended-spectrum \u03b2-lactamase-producing Escherichia coli and Klebsiella pneumoniae bacteremia in patients with hematologic malignancy. Ann. Hematol. 91(1), 115\u2013121. https:\/\/doi.org\/10.1007\/s00277-011-1247-7 (2012).","journal-title":"Ann. Hematol."},{"issue":"9","key":"66524_CR13","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1007\/s00277-018-3341-6","volume":"97","author":"C Cattaneo","year":"2018","unstructured":"Cattaneo, C. et al. Bloodstream infections in haematological cancer patients colonized by multidrug-resistant bacteria. Ann. Hematol. 97(9), 1717\u20131726. https:\/\/doi.org\/10.1007\/s00277-018-3341-6 (2018).","journal-title":"Ann. Hematol."},{"key":"66524_CR14","unstructured":"Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Approved Standard \u2013 33th Edition. 33th edn (CLSI, 2023)."},{"key":"66524_CR15","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00203-19","author":"RM Humphries","year":"2019","unstructured":"Humphries, R. M., Abbott, A. N. & Hindler, J. A. Understanding and addressing CLSI breakpoint revisions: A primer for clinical laboratories. J. Clin. Microbiol. https:\/\/doi.org\/10.1128\/jcm.00203-19 (2019).","journal-title":"J. Clin. Microbiol."},{"issue":"5","key":"66524_CR16","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","volume":"40","author":"ME Charlson","year":"1987","unstructured":"Charlson, M. E., Pompei, P., Ales, K. L. & MacKenzie, C. R. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic Dis. 40(5), 373\u2013383. https:\/\/doi.org\/10.1016\/0021-9681(87)90171-8 (1987).","journal-title":"J. Chronic Dis."},{"issue":"12","key":"66524_CR17","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1016\/j.jclinepi.2004.03.012","volume":"57","author":"V Sundararajan","year":"2004","unstructured":"Sundararajan, V. et al. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J. Clin. Epidemiol. 57(12), 1288\u20131294. https:\/\/doi.org\/10.1016\/j.jclinepi.2004.03.012 (2004).","journal-title":"J. Clin. Epidemiol."},{"issue":"1","key":"66524_CR18","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s15010-019-01370-x","volume":"48","author":"Y Tang","year":"2020","unstructured":"Tang, Y., Wu, X., Cheng, Q. & Li, X. Inappropriate initial antimicrobial therapy for hematological malignancies patients with Gram-negative bloodstream infections. Infection 48(1), 109\u2013116. https:\/\/doi.org\/10.1007\/s15010-019-01370-x (2020).","journal-title":"Infection"},{"key":"66524_CR19","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-6824-1","volume-title":"Recursive Partioning and Applications","author":"H Zhang","year":"2010","unstructured":"Zhang, H. & Burton, H. S. Recursive Partioning and Applications 2nd edn. (Springer, 2010).","edition":"2"},{"issue":"42","key":"66524_CR20","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000012782","volume":"97","author":"JP Burnham","year":"2018","unstructured":"Burnham, J. P., Rojek, R. P. & Kollef, M. H. Catheter removal and outcomes of multidrug-resistant central-line-associated bloodstream infection. Medicine (Baltimore) 97(42), e12782. https:\/\/doi.org\/10.1097\/md.0000000000012782 (2018).","journal-title":"Medicine (Baltimore)"},{"key":"66524_CR21","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/s12879-015-0801-7","volume":"15","author":"SY Cho","year":"2015","unstructured":"Cho, S. Y. et al. Stenotrophomonas maltophilia bloodstream infection in patients with hematologic malignancies: A retrospective study and in vitro activities of antimicrobial combinations. BMC Infect. Dis. 15, 69. https:\/\/doi.org\/10.1186\/s12879-015-0801-7 (2015).","journal-title":"BMC Infect. Dis."},{"issue":"4","key":"66524_CR22","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.cmi.2015.12.010","volume":"22","author":"MP Freire","year":"2016","unstructured":"Freire, M. P. et al. Bloodstream infection caused by extensively drug-resistant Acinetobacter baumannii in cancer patients: High mortality associated with delayed treatment rather than with the degree of neutropenia. Clin. Microbiol. Infect. 22(4), 352\u2013358. https:\/\/doi.org\/10.1016\/j.cmi.2015.12.010 (2016).","journal-title":"Clin. Microbiol. Infect."},{"issue":"4","key":"66524_CR23","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.diagmicrobio.2017.05.003","volume":"88","author":"P Tofas","year":"2017","unstructured":"Tofas, P. et al. Pseudomonas aeruginosa bacteraemia in patients with hematologic malignancies: Risk factors, treatment and outcome. Diagn. Microbiol. Infect. Dis. 88(4), 335\u2013341. https:\/\/doi.org\/10.1016\/j.diagmicrobio.2017.05.003 (2017).","journal-title":"Diagn. Microbiol. Infect. Dis."},{"issue":"10","key":"66524_CR24","doi-asserted-by":"publisher","first-page":"1771","DOI":"10.1093\/cid\/ciz031","volume":"69","author":"GA Papanicolaou","year":"2019","unstructured":"Papanicolaou, G. A. et al. Bloodstream infection due to vancomycin-resistant enterococcus is associated with increased mortality after hematopoietic cell transplantation for acute Leukemia and myelodysplastic syndrome: A multicentre: Retrospective Cohort Study. Clin. Infect. Dis. 69(10), 1771\u20131779. https:\/\/doi.org\/10.1093\/cid\/ciz031 (2019).","journal-title":"Clin. Infect. Dis."},{"issue":"1","key":"66524_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210991","volume":"14","author":"O Ballo","year":"2019","unstructured":"Ballo, O. et al. Colonization with multidrug resistant organisms determines the clinical course of patients with acute myeloid leukemia undergoing intensive induction chemotherapy. PLoS One 14(1), e0210991. https:\/\/doi.org\/10.1371\/journal.pone.0210991 (2019).","journal-title":"PLoS One"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-66524-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-66524-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-66524-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,7]],"date-time":"2024-07-07T05:03:15Z","timestamp":1720328595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-66524-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,7]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["66524"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-66524-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,7]]},"assertion":[{"value":"15 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15622"}}