{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:54:20Z","timestamp":1767650060937,"version":"3.41.2"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of prophylactic antibiotics in the pre\u2010engraftment period to minimize the risk of bacteremia is debatable given concerns of <jats:italic>Clostridioides difficile<\/jats:italic> (<jats:italic>C.\u00a0diff<\/jats:italic>), antibiotics resistance, and disruption of gut microbiota.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the rate and characteristics of bacteremia and <jats:italic>C.\u00a0diff<\/jats:italic> infections within the first 100\u2009days post\u2010HSCT in all pediatric patients who received routine antibacterial prophylaxis during HSCT from 2015 to 2018. <jats:italic>C.\u00a0diff<\/jats:italic> infection was defined by the presence of three or more unformed stools in 24\u00a0h and positive stool test for <jats:italic>C.\u00a0diff<\/jats:italic> or its toxins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and thirty\u2010five (100 allogeneic and 35 autologous) transplants in 123 patients were eligible for analysis. Median age at transplant was 7.1 (range 0.2\u201313.7), 67 (55%) were women, and diagnosis was malignant condition in 68 patients. Median time to neutrophil engraftment was 18\u2009days (13\u201323). Cefepime or piperacillin\u2010tazobactam prophylaxis was used in 105 (78%) and 28 (21%) of patients, respectively. Only five (3%) patients had bacteremia during the pre\u2010engraftment period, and 13 (11%) patients developed bacteremia postengraftment. Septic shock was present in only one patient pre\u2010engraftment and was due to gram\u2010negative bacteria. All patients who developed bacteremia received MAC. Thirteen patients (10%) of patients fulfilled <jats:italic>C.\u00a0diff<\/jats:italic> infection definition. There was no mortality related to bacterial infections among our patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of antibiotic prophylaxis was associated with low rate of bacteremia in the pre\u2010engraftment period and a 10% risk of <jats:italic>C.\u00a0diff<\/jats:italic> infections. More studies are needed to better evaluate the efficacy of antibiotic prophylaxis in HSCT patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14375","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T08:20:20Z","timestamp":1660119620000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Antimicrobial prophylaxis and the rate of blood stream infections and <i>Clostridioides difficile<\/i> in pediatric stem cell transplantation: A single\u2010center retrospective study"],"prefix":"10.1111","volume":"27","author":[{"given":"Trad","family":"Alrugaib","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology, King Abdullah Specialist Children's Hospital Ministry of National Guard Health Affairs  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5577-3228","authenticated-orcid":false,"given":"Abdulrahman","family":"Alsultan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics King Saud University  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enas","family":"Elbashir","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology, King Abdullah Specialist Children's Hospital Ministry of National Guard Health Affairs  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayan","family":"Albdah","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center National Guard Health Affairs  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Musaed","family":"Alharbi","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center National Guard Health Affairs  Riyadh Saudi Arabia"},{"name":"College of Medicine King Saud bin Abdulaziz University for Health Sciences  Riyadh Saudi Arabia"},{"name":"Department of Pediatrics, King Abdullah Specialist Children's Hospital Ministry of National Guard Health Affairs  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4860-0796","authenticated-orcid":false,"given":"Mohammed F.","family":"Essa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology, King Abdullah Specialist Children's Hospital Ministry of National Guard Health Affairs  Riyadh Saudi Arabia"},{"name":"King Abdullah International Medical Research Center National Guard Health Affairs  Riyadh Saudi Arabia"},{"name":"College of Medicine King Saud bin Abdulaziz University for Health Sciences  Riyadh Saudi 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