{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T10:38:03Z","timestamp":1768819083810,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"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":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Blood stream infections (BSI) frequently cause morbidity and mortality in allogeneic (allo) hematopoietic cell transplant (HCT) recipients. Characteristics of causative organisms shortly before death have not been previously described. Early treatment with antimicrobial agents targeting the recent surge in multidrug\u2010resistant (MDR) pathogens may lead to better outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is retrospective study including 529 allo HCT recipients who died between 2000 and 2013. All patients who had BSI that happened 72\u00a0hours before death were included. BSI and criteria for antimicrobial resistance were defined according to the Centers for Disease Control and Prevention and the National Healthcare Safety Network surveillance criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 104 BSI were identified from 91 patients. Bacterial infections accounted for 87% of the infections which were comprised by 37% gram\u2010negative organisms and 50% gram\u2010positive bacteria. The most common species were Enterococcus (30%), Staphylococcus (16%), and Pseudomonas (16%). Most enterococci were vancomycin resistant (87%), 100% of staphylococci were resistant to methicillin, and 64% of Pseudomonas were MDR. Over time there was a significant increase in vancomycin\u2010resistant enterococcal (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) and gram\u2010negative BSI (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.01). Blood stream infections were either the primary or secondary cause of death in 53% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In allo HCT recipients, vancomycin\u2010resistant enterococcal infections caused the majority of BSI 72\u00a0hours prior to death. Our findings provide information that may guide empiric antibiotic coverage in critically ill HCT recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13631","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T02:57:26Z","timestamp":1620615446000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Secular trends of Blood stream infections in allogeneic hematopoietic cell transplant recipients 72 hours prior to death"],"prefix":"10.1111","volume":"23","author":[{"given":"Shylaja","family":"Mani","sequence":"first","affiliation":[{"name":"Department of Hematology Oncology Adena Cancer Center Chillicothe OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9329-6044","authenticated-orcid":false,"given":"Gabriel F. 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