{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:24:01Z","timestamp":1792167841605,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"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":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bloodstream infections are a leading cause of death in patients who undergo hematopoietic stem cell transplantation (HSCT) and are more severe when caused by multidrug\u2010resistant (MDR) bacteria. This study proposed to investigate if colonization by MDR bacteria negatively affects the clinical outcomes in hematological patients after HSCT, as well as to evaluate possible risk factors for death due to bacteremia by the same colonizing agent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single\u2010center retrospective cohort study was conducted with 405 hematological patients submitted to a single HSCT procedure between 2015 and 2021. Patients were classified as colonized (\n                      <jats:italic>n<\/jats:italic>\n                      = 132) or noncolonized (\n                      <jats:italic>n<\/jats:italic>\n                      = 273) based on the surveillance cultures from D\u221230 to D+30 of transplantation, and their relevant clinical and laboratory data were collected until D+100.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Colonization by MDR bacteria increased blood culture positivity by all micro\u2010organisms and also specifically by MDR bacteria, with a more pronounced effect when caused by carbapenemase\u2010producing\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      . Patients colonized with carbapenem\u2010resistant\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      had increased overall mortality (HR = 4.07, 95% CI 1.85\u20138.91,\n                      <jats:italic>P<\/jats:italic>\n                      = .0005) and had prolonged hospital length of stay in the context of autologous transplantation. Risk factors for death due to bacteremia by the same colonizing agent were neutropenia, colonization by carbapenem\u2010resistant\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      and use of high\u2010dose total body irradiation in conditioning.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Hematological patients colonized by MDR bacteria presented a higher incidence of bloodstream infections, and colonization by carbapenemase\u2010producing\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      was associated with reduced overall survival.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14119-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.14119","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T10:56:55Z","timestamp":1691665015000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Colonization by multidrug\u2010resistant bacteria in hematological patients undergoing hematopoietic stem cell transplantation and clinical outcomes: A single\u2010center retrospective cohort study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5838-3492","authenticated-orcid":false,"given":"Eduardo Sbrana","family":"Santos","sequence":"first","affiliation":[{"name":"Clinical Analysis and Pathological Anatomy Unit Complexo do Hospital de Cl\u00ednicas Federal University of Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Cardoso Martins","family":"Lima","sequence":"additional","affiliation":[{"name":"Clinical Analysis and Pathological Anatomy Unit Complexo do Hospital de Cl\u00ednicas Federal University of Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Lu\u00eds","family":"Breda","sequence":"additional","affiliation":[{"name":"Infectious Diseases Division Complexo do Hospital de Cl\u00ednicas Federal University of Paran\u00e1 Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula de Oliveira","family":"Tomaz","sequence":"additional","affiliation":[{"name":"Clinical Analysis and Pathological Anatomy Unit Complexo do Hospital de Cl\u00ednicas Federal University of Paran\u00e1 Curitiba 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