{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:42:45Z","timestamp":1792215765378,"version":"4.4.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vancomycin-resistant Enterococcus faecium (VREfm) bloodstream infection (BSI) represents a growing challenge in hematology-oncology settings. This study aimed to characterize the epidemiology, risk factors, and prognostic impact of VREfm BSI within a mixed adult hematology-oncology and transplant unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective matched case-control study (2014\u20132024). Multivariable conditional logistic regression identified factors associated with VREfm BSI, and restricted cubic spline (RCS) models assessed nonlinear exposure-response relationships between antimicrobial classes and VREfm BSI. Survival was analyzed using Kaplan\u2013Meier curves and Cox proportional hazards regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>VREfm BSI incidence rose from 0.02 to 0.07 per 1000 person-days (2014\u20132018 vs 2019\u20132024). A high-risk composite comprising recipients of allogeneic stem cell transplant and\/or AML (adjusted OR [aOR], 3.90; 95% CI, 1.87\u20138.15; P &amp;lt; .001) and ICU admission (aOR, 5.63; 95% CI, 2.15\u201314.78; P &amp;lt; .001), were independently associated with VREfm BSI. Cumulative days of carbapenems (aOR, 1.09\/day; 95% CI, 1.02\u20131.17; P = .013), beta-lactam\/beta-lactamase inhibitors (aOR, 1.09\/day; 95% CI, 1.02\u20131.16; P = .006), and systemic antifungals (aOR, 1.12\/day; 95% CI, 1.03\u20131.22; P = .009) exhibited duration-dependent associations. RCS models demonstrated a nonlinear, duration-dependent association with cumulative antibiotic exposure, including antianaerobic agents (P &amp;lt; .001). VREfm BSI was associated with increased mortality (adjusted hazard ratio, 2.09; 95% CI, 1.63\u20132.66; P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VREfm BSI reflects the interplay between host susceptibility and nonlinear, duration- and spectrum-dependent antibiotic exposure pressure. This underscores the importance of antimicrobial stewardship strategies as a potential intervention to mitigate risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag627","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:39:22Z","timestamp":1791027562000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors and Outcomes of Vancomycin-Resistant\n                    <i>Enterococcus faecium<\/i>\n                    Bloodstream Infection in Hematologic Malignancies and Stem Cell Transplant Recipients: A Case-Control Study"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9304-2114","authenticated-orcid":false,"given":"Khuloud","family":"Aldhaheri","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, Abu Dhabi ,","place":["United Arab Emirates"]},{"name":"Division of Infectious Diseases, University of British Columbia Department of Medicine, , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4555-9372","authenticated-orcid":false,"given":"Jollee S T","family":"Fung","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of British Columbia Department of Medicine, , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0931-3770","authenticated-orcid":false,"given":"Cesilia","family":"Nishi","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Vancouver General Hospital , Vancouver, British Columbia ,","place":["Canada"]},{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica E","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Vancouver General Hospital , Vancouver, British Columbia ,","place":["Canada"]},{"name":"Faculty of Pharmaceutical Sciences, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Mah","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of British Columbia Department of Medicine, , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissa J","family":"Wright","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of British Columbia Department of Medicine, , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4718-5212","authenticated-orcid":false,"given":"Ryan J","family":"Stubbins","sequence":"additional","affiliation":[{"name":"Leukemia and Bone Marrow Transplant Program of British Columbia, BC Cancer , Vancouver, British Columbia ,","place":["Canada"]},{"name":"Department of Medicine, Division of Hematology, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3663-0974","authenticated-orcid":false,"given":"Marthe K","family":"Charles","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Infection Control, Department of Pathology and Laboratory Medicine, Vancouver General Hospital , Vancouver Coastal Health, Vancouver, British Columbia ,","place":["Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1725-1407","authenticated-orcid":false,"given":"Sara","family":"Belga","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of British Columbia Department of Medicine, , Vancouver, British Columbia ,","place":["Canada"]},{"name":"Immunity and Infection Research Centre, Vancouver Coastal Health Research Institute , Vancouver, British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026101701120745900_ofag627-B1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/sj.bmt.1702123","article-title":"Incidence and outcome of vancomycin-resistant enterococcal bacteremia following autologous peripheral blood stem cell 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