{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T19:30:35Z","timestamp":1784143835280,"version":"3.55.0"},"reference-count":61,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bacteremia is a common complication in allogeneic hematopoietic cell transplant recipients (alloHCTr), especially during the pre\u2010engraftment period. International guidelines recommend antibacterial prophylaxis (ABP), despite potential selection for multidrug\u2010resistant organisms (MDRO). Limited contemporary data exist on the epidemiology of pre\u2010engraftment bacteremia in alloHCTr, who do not receive ABP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective observational single\u2010center cohort study including all consecutive adult alloHCTr (2015\u20132021), investigating the incidence, risk factors, and outcomes of bacteremia during the engraftment period. Primary fluoroquinolone (FQ) ABP is not routinely administered in our center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 421 patients identified, 124 bacteremia episodes were observed in 121\/421 (29%) alloHCTr. The median time to the 1st bacteremia episode was 9 days (IQR 6\u201311). Most (105\/124, 85%) episodes were monomicrobial, while &gt;1 pathogens were identified in 19\/124 (15%) episodes. Overall, 152 pathogens were isolated, with a predominance of Gram\u2010positive (118\/152, 78%), including coagulase\u2010negative staphylococci (<jats:italic>n<\/jats:italic>:47), streptococci (<jats:italic>n<\/jats:italic>:46), and enterococci (<jats:italic>n<\/jats:italic>:15), followed by Gram\u2010negative bacteria (GNB, 30\/152, 20%), and anaerobes (4\/152, 3%). There were 2\/152 (1%) MDRO (extended\u2010spectrum beta\u2010lactamase producing) GNB. Multivariable analyses identified age &gt;40\u2010year\u2010old (OR 2.4, <jats:italic>P<\/jats:italic> = 0.02), male gender (OR 1.8, <jats:italic>P<\/jats:italic> = 0.02), and a haploidentical\/mismatched unrelated donor (OR 2.5, <jats:italic>P<\/jats:italic> &lt; 0.001) as independent risk factors for bacteremia. All cause 30\u2010day mortality among alloHCTr with bacteremia was 0.8% (1\/121): one patient died due to an HCT\u2010related complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite lack of primary FQ ABP, low rates of bacteremia were observed during the pre\u2010engraftment period, with low MDRO prevalence and mortality. Our findings may allow to revisit the need for primary universal FQ ABP in high\u2010risk neutropenic hematology patients.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14375-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14375","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T15:22:31Z","timestamp":1727104951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pre\u2010engraftment bacteremia after allogeneic hematopoietic cell transplantation without primary fluoroquinolone antibacterial prophylaxis"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9640-5146","authenticated-orcid":false,"given":"Aude","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Geneva University Hospitals  Geneva Switzerland"},{"name":"Infection Control Program and WHO Collaborating Centre Geneva University Hospitals and Faculty of Medicine  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Fender","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rehabilitation and Geriatrics Internal Medicine and Rehabilitation Unit Geneva University Hospitals and University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Courjon","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit University C\u00f4te d'Azur CHU Nice  Nice 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