{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:40:28Z","timestamp":1783086028401,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Little is known about the epidemiology and management of gram\u2010negative bloodstream infections (GN\u2010BSIs) in patients after solid organ transplant (SOT). We describe epidemiology, treatment approaches, and outcomes in a subset of patients with SOT from a larger cohort with GN\u2010BSI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a multicenter, retrospective cohort study that enrolled unique, consecutive adults with GN\u2010BSI hospitalized at any of 24 participating hospitals between January and December 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 4581 adults in the overall cohort, 298 (6.5%) were SOT recipients, including kidney (177, 59%), liver (67, 22%), heart (23, 8%), lung (12, 4%), and multiorgan (19, 6%) recipients. The most common organisms were <jats:italic>Escherichia coli<\/jats:italic> (45%), <jats:italic>Klebsiella pneumoniae<\/jats:italic> (20%), and <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (15%). Twenty\u2010two percent of <jats:italic>E. coli, Klebsiella spp<\/jats:italic>., or <jats:italic>Proteus spp<\/jats:italic>. isolates had extended\u2010spectrum beta\u2010lactamase phenotype. Sixty\u2010six (22%) subjects did not receive active empirical therapy within the first 48\u00a0h. Median treatment duration was 15 days (IQR 12\u201318 days). Transition to oral therapy occurred in 161 (54%) patients at a median of 4 days (IQR 3\u20137 days). Thirty\u2010one patients (10%) had recurrent bacteremia, and 10% of the cohort died within 90 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In this large cohort of SOT patients with GN\u2010BSI, durations exceeded 14 days in most patients, while more than half transitioned to oral antibiotics. Approximately 1 in 5 did not receive active empirical antibiotics, highlighting the impact of drug resistance and the importance of access to rapid diagnostic tools in this patient population. Mortality aligned with published estimates from other studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70160","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T11:48:33Z","timestamp":1745322513000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Epidemiology, Treatment, and Outcomes of Gram\u2010Negative Bacteremia in a Multicenter Cohort of Solid Organ Transplant Recipients"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-6014","authenticated-orcid":false,"given":"Sarah B.","family":"Doernberg","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6644-6684","authenticated-orcid":false,"given":"Emily L.","family":"Heil","sequence":"additional","affiliation":[{"name":"Department of Practice Sciences, and Health\u2010Outcomes Research University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suiyini","family":"Fiawoo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara E.","family":"Cosgrove","sequence":"additional","affiliation":[{"name":"Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-7432","authenticated-orcid":false,"given":"David M.","family":"Dobrzynski","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy NYU Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9794-5665","authenticated-orcid":false,"given":"Ryan K.","family":"Shields","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Spivak","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8324-6414","authenticated-orcid":false,"given":"Erica J.","family":"Stohs","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Nebraska Medical Center  Omaha Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranita D.","family":"Tamma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-2225","authenticated-orcid":false,"given":"Erin K.","family":"McCreary","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlad158"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02559.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.07.021"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.01964.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad247"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1054"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6348"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad670"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.52314"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2023.10.014"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.09.001"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2022.08.007"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad265"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_7_18_1","article-title":"Infectious Diseases Society of America 2023 Guidance on the Treatment of Antimicrobial Resistant Gram\u2010Negative Infections","author":"Tamma P. D.","year":"2023","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_7_19_1","volume-title":"Department of Health and Human Services","author":"Centers for Disease Control and Prevention"},{"key":"e_1_2_7_20_1","first-page":"1065","article-title":"Antibiotic Treatment for 7 versus 14 Days in Patients With Bloodstream Infections","volume":"392","author":"Balance Investigators, f.t.C.C.C.T.G.t.A.o.M.M","year":"2024","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu789"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad148"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13969"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70160","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T01:37:08Z","timestamp":1746322628000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/ctr.70160"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70160","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70160"}}