{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:36:55Z","timestamp":1792798615726,"version":"4.5.0"},"reference-count":28,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["JR20\/00012, PI21\/00498, ICI21\/00103"],"award-info":[{"award-number":["JR20\/00012, PI21\/00498, ICI21\/00103"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI21\/01640, ICI21\/00103"],"award-info":[{"award-number":["PI21\/01640, ICI21\/00103"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004099","name":"La Ligue Nationale contre le Cancer","doi-asserted-by":"crossref","award":["AAPMRC 2022\/OP"],"award-info":[{"award-number":["AAPMRC 2022\/OP"]}],"id":[{"id":"10.13039\/501100004099","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Agencia de Gestion de Ayudas Universitarias y de Investigacion","award":["SGR 01324 Q5856414G"],"award-info":[{"award-number":["SGR 01324 Q5856414G"]}],"id":[{"id":"https:\/\/ror.org\/01n4pqe45","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The study aimed to describe the epidemiology of multidrug-resistant (MDR) bacteria among solid cancer (SC) patients with bloodstream infections (BSIs), evaluating inappropriate empiric antibiotic treatment (IEAT) use and mortality trends over a 25-year period. All BSI occurrences in adult SC patients at a university hospital were analyzed across five distinct five-year intervals. MDR bacteria were classified as extended-spectrum beta-lactamases (ESBL)-producing and\/or Carbapenem-resistant Enterobacterales, non-fermenting Gram-negative bacilli (GNB) resistant to at least three antibiotic classes, methicillin-resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (MRSA), and Vancomycin-resistant\n                      <jats:italic>Enterococci<\/jats:italic>\n                      . A multivariate regression model identified the risk factors for MDR BSI. Of 6,117 BSI episodes, Gram-negative bacilli (GNB) constituted 60.4% (3,695\/6,117), being the most common are\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      with 26.8% (1,637\/6,117),\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. with 12.4% (760\/6,117), and\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      with 8.6% (525\/6,117). MDR-GNB accounted for 644 episodes (84.8% of MDR or 644\/759), predominantly ESBL-producing strains (71.1% or 540\/759), which escalated significantly over time. IEAT was administered in 24.8% of episodes, mainly in MDR BSI, and was associated with higher mortality (22.9% vs. 14%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Independent factors for MDR BSI were prior antibiotic use [odds ratio (OR) 2.93, confidence interval (CI) 2.34\u20133.67], BSI during antibiotic treatment (OR 1.46, CI 1.18\u20131.81), biliary (OR 1.84, CI 1.34\u20132.52) or urinary source (OR 1.86, CI 1.43\u20132.43), admission period (OR) 1.28, CI 1.18\u20131.38, and community-acquired infection (OR 0.57, CI 0.39\u20130.82). The study showed an increase in MDR-GNB among SC patients with BSI. A quarter received IEAT, which was linked to increased mortality. Improving risk assessment for MDR infections and the judicious prescription of empiric antibiotics are crucial for better outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>Multidrug-resistant (MDR) bacteria pose a global public health threat as they are more challenging to treat, and they are on the rise. Solid cancer patients are often immunocompromised due to their disease and cancer treatments, making them more susceptible to infections. Understanding the changes and trends in bloodstream infections in solid cancer patients is crucial, to help physicians make informed decisions about appropriate antibiotic therapies, manage infections in this vulnerable population, and prevent infection. Solid cancer patients often require intensive and prolonged treatments, including surgery, chemotherapy, and radiation therapy. Infections can complicate these treatments, leading to treatment delays, increased healthcare costs, and poorer patient outcomes. Investigating new strategies to combat MDR infections and researching novel antibiotics in these patients is of paramount importance to avoid these negative impacts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02961-23","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T09:00:17Z","timestamp":1724835617000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":37,"title":["Prevalence and impact of multidrug-resistant bacteria in solid cancer patients with bloodstream infection: a 25-year trend analysis"],"prefix":"10.1128","volume":"12","author":[{"given":"Carlos","family":"Lopera","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Monz\u00f3","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4441-6318","authenticated-orcid":true,"given":"Tommaso Francesco","family":"Aiello","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-6444","authenticated-orcid":true,"given":"Mariana","family":"Chumbita","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Peyrony","sequence":"additional","affiliation":[{"name":"Emergency Department, H\u00f4pital Saint-Louis, Assistance Publique - H\u00f4pitaux de Paris, Paris, 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