{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:33:21Z","timestamp":1790469201640,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,10,10]],"date-time":"2016-10-10T00:00:00Z","timestamp":1476057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bloodstream infections (<jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content>s) are a significant complication of treatment for multiple myeloma (<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>). The objective of this study was to define the epidemiology of <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content> with current era <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> treatment regimens, including immunomodulatory drugs, proteasome inhibitors and autologous haematopoietic stem cell transplantation (<jats:styled-content style=\"fixed-case\">ASCT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and microbiology records of patients with <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> diagnosed between 2008 and 2012 were reviewed using a standardised tool to capture patient demographics, myeloma characteristics and <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content> characteristics (type, severity, outcomes). Conditional risk set modelling was used to determine clinical predictors of <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 199 studied patients, 71 (35.6%) had confirmed <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content> (98 infection episodes). Peak incidence was 65.1 infections\/100 patient\u2010years at 4\u20136 months following <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> diagnosis with a late peak at 64\u201366 months. Gram\u2010positive pathogens were responsible for the majority (54.5%) of infections during induction, whilst gram\u2010negative pathogens were responsible for the majority (57.7%) of infections during disease progression. Overall, <jats:italic>Escherichia coli<\/jats:italic> was the most frequently identified pathogen. <jats:italic>Streptococcus pneumoniae<\/jats:italic> comprised 6.1% of all <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content>s at a median of 7.5 months following <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> diagnosis. Highest rates of <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> admission (23.1%) and mortality (11.5%) were seen with <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content>s in patients with progressive disease. Recent <jats:styled-content style=\"fixed-case\">ASCT<\/jats:styled-content> was independently associated with increased <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content> risk (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 3.09, <jats:italic>P<\/jats:italic> = 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment of progressive disease is a high\u2010risk period for infection, evidenced by high proportions of <jats:styled-content style=\"fixed-case\">BSI<\/jats:styled-content> due to gram\u2010negative pathogens and <jats:italic>S. pneumoniae<\/jats:italic>. Targeted evaluation of preventative strategies (prophylaxis, vaccination) to reduce morbidity and mortality during this period is required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12813","type":"journal-article","created":{"date-parts":[[2016,9,26]],"date-time":"2016-09-26T13:56:21Z","timestamp":1474898181000},"page":"149-153","source":"Crossref","is-referenced-by-count":33,"title":["Epidemiology of bloodstream infections in patients with myeloma receiving current era therapy"],"prefix":"10.1111","volume":"98","author":[{"given":"Benjamin W.","family":"Teh","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre Parkville Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology Peter MacCallum Cancer Centre Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Sir Peter MacCallum Department of Oncology Peter MacCallum Cancer Centre Parkville Victoria Australia"},{"name":"Department of Haematology Peter MacCallum Cancer Centre Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A.","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne Parkville Victoria Australia"},{"name":"Victorian Infectious Diseases Service Doherty Institute for Infection and Immunity Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon J.","family":"Worth","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2014.01.004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1973.03650100076014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.48.3.260"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13532"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(81)90303-X"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2005.01298.x"},{"key":"e_1_2_7_9_1","first-page":"1022","article-title":"Risk factors for the development of bacterial infections in multiple myeloma treated with two different vincristine\u2010adriamycin\u2010dexamethasone schedules","volume":"88","author":"Cesana C","year":"2003","journal-title":"Haematologica"},{"key":"e_1_2_7_10_1","first-page":"517","article-title":"Perspectives in multiple myeloma: survival, prognostic factors and disease complications in a single centre between 1975 and 1988","volume":"79","author":"Rayner H","year":"1991","journal-title":"QJM"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-96-1-47"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ803"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/523583"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1586\/14760584.2014.859990"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fejh.12813","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fejh.12813","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.12813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T11:19:34Z","timestamp":1696331974000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.12813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,10]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1111\/ejh.12813"],"URL":"https:\/\/doi.org\/10.1111\/ejh.12813","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,10]]}}}