{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:45:20Z","timestamp":1791488720574,"version":"4.3.4"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cumulative incidence of pre-engraftment GNB was 17.3% in allo-HSCT and 9% in auto-HSCT. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates. By multivariate analysis, variables associated with GNB were a diagnosis of acute leukemia, a transplant from a HLA-mismatched donor and from cord blood, older age, and duration of severe neutropenia in allo-HSCT, and a diagnosis of lymphoma, older age, and no antibacterial prophylaxis in auto-HSCT. A pretransplant infection by a resistant pathogen was significantly associated with an increased risk of posttransplant infection by the same microorganism in allo-HSCT. Colonization by resistant gram-negative bacteria was significantly associated with an increased rate of infection by the same pathogen in both transplant procedures. GNB was independently associated with increased mortality at 4 months both in allo-HSCT (hazard ratio, 2.13; 95% confidence interval, 1.45\u20133.13; P &lt;.001) and auto-HSCT (2.43; 1.22\u20134.84; P = .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-engraftment GNB is an independent factor associated with increased mortality rate at 4 months after auto-HSCT and allo-HSCT. Previous infectious history and colonization monitoring represent major indicators of GNB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials registration<\/jats:title>\n                    <jats:p>NCT02088840.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/cix690","type":"journal-article","created":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T15:12:57Z","timestamp":1501600377000},"page":"1884-1896","source":"Crossref","is-referenced-by-count":145,"title":["Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia After Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey"],"prefix":"10.1093","volume":"65","author":[{"given":"Corrado","family":"Girmenia","sequence":"first","affiliation":[{"name":"Dipartimento di Ematologia, Oncologia, e Dermatologia, Azienda Policlinico Umberto I, Sapienza University of Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bertaina","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Oncoematologia, Ospedale pediatrico Bambino Ges\u00f9"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Piciocchi","sequence":"additional","affiliation":[{"name":"Fondazione GIMEMA (Gruppo Italiano Malattie EMatologiche dell\u2019Adulto), Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Perruccio","sequence":"additional","affiliation":[{"name":"Struttura Complessa di Ematologia con Trapianto, Ospedale Santa Maria della Misericordia; Perugia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Algarotti","sequence":"additional","affiliation":[{"name":"Divisione di Ematologia, ASST Papa Giovanni XXIII, Bergamo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Busca","sequence":"additional","affiliation":[{"name":"Dipartimento di Oncologia ed Ematologia A.O. 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