{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:53:25Z","timestamp":1791384805086,"version":"4.3.3"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"ISCIII","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To describe current resistance to the \u03b2-lactams empirically recommended in the guidelines in bloodstream infection (BSI) episodes caused by Gram-negative bacilli (GNB).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective, multicentre cohort study of the last 50 BSI episodes in haematological patients across 14 university hospitals in Spain. Rates of inappropriate empirical antibiotic therapy (IEAT) and impact on mortality were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 700 BSI episodes, 308 (44%) were caused by GNB, mainly Escherichia coli (141; 20.1%), Klebsiella spp. (56; 8%) and Pseudomonas aeruginosa (48; 6.9%). Among GNB BSI episodes, 80 (26%) were caused by MDR isolates. In those caused by Enterobacterales, 25.8% were ESBL producers and 3.5% were carbapenemase producers. Among P. aeruginosa BSI episodes, 18.8% were caused by MDR isolates. Overall, 34.7% of the isolated GNB were resistant to at least one of the three \u03b2-lactams recommended in febrile neutropenia guidelines (cefepime, piperacillin\/tazobactam and meropenem). Despite extensive compliance with guideline recommendations (91.6%), 16.6% of BSI episodes caused by GNB received IEAT, which was more frequent among MDR GNB isolates (46.3% versus 6.1%; P\u200a&amp;lt;\u200a0.001). Thirty day mortality was 14.6%, reaching 21.6% in patients receiving IEAT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Current resistance to empirical \u03b2-lactams recommended in febrile neutropenia guidelines is exceedingly high and IEAT rates are greater than desired. There is an urgent need to adapt guidelines to current epidemiology and better identify patients with a high risk of developing MDR GNB infection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac135","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T11:13:13Z","timestamp":1649934793000},"page":"2017-2023","source":"Crossref","is-referenced-by-count":24,"title":["Resistance to empirical \u03b2-lactams recommended in febrile neutropenia guidelines in Gram-negative bacilli bloodstream infections in Spain: a multicentre study"],"prefix":"10.1093","volume":"77","author":[{"given":"Mariana","family":"Chumbita","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednic de Barcelona-IDIBAPS , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Puerta-Alcalde","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic de Barcelona-IDIBAPS , Barcelona , 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Abell\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital General Universitario de Alicante , Alicante , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlota","family":"Gudiol","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Bellvitge, Institut Catal\u00e0 d\u2019Oncologia, IDIBELL, l\u2019Hospitalet de Llobregat , Barcelona , Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER) de Enfermedades Infecciosas (CB21\/13\/00009), Instituto de Salud Carlos III , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Guerreiro","sequence":"additional","affiliation":[{"name":"Hospital Universitario y Polit\u00e9cnico La Fe , Valencia , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Gonz\u00e1lez-Sierra","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen de las Nieves , Granada , 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