{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:13:12Z","timestamp":1776755592790,"version":"3.51.2"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T00:00:00Z","timestamp":1619740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III","award":["FIS PI18\/01061"],"award-info":[{"award-number":["FIS PI18\/01061"]}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CM18\/00132"],"award-info":[{"award-number":["CM18\/00132"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>We aimed to describe the epidemiology of catheter-related bloodstream infections (CRBSIs) in onco-hematological neutropenic patients during a 25-year study period, to evaluate the risk factors for Gram-negative bacilli (GNB) CRBSI, as well as rates of inappropriate empirical antibiotic treatments (IEAT) and mortality.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials\/Methods<\/jats:title>\n<jats:p>All consecutive episodes of CRBSIs were prospectively collected (1994\u20132018). Changing epidemiology was evaluated comparing five-year time spans. A multivariate regression model was built to evaluate risk factors for GNB CRBSIs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>482 monomicrobial CRBSIs were documented. The proportion of CRBSIs among all BSIs decreased over time from 41.2% to 15.8% (p&lt;0.001). CRBSIs epidemiology has been changing: the rate of GNB increased over time (from 11.9% to 29.4%; p&lt;0.001), as well as the absolute number and rate of multidrug-resistant (MDR) GNB (from 9.5% to 40.0%; p = 0.039). <jats:italic>P<\/jats:italic>. <jats:italic>aeruginosa<\/jats:italic> increased and comprised up to 40% of all GNB. Independent factors related with GNB-CRBSIs were: longer duration of in-situ catheter (OR 1.007; 95%CI 1.004\u20131.011), older age (OR 1.016; 95%CI 1.001\u20131.033), prior antibiotic treatment with penicillins (OR 2.716; 95%CI 1.306\u20135.403), and current antibiotic treatment with glycopeptides (OR 1.931; 95%CI 1.001\u20133.306). IEATs were administered to 30.7% of patients, with the highest percentage among MDR <jats:italic>P<\/jats:italic>. <jats:italic>aeruginosa<\/jats:italic> (76.9%) and <jats:italic>S<\/jats:italic>. <jats:italic>maltophillia<\/jats:italic> (92.9%). Mortality rate was greater among GNB than GPC-CRBSI (14.4% vs 5.4%; p = 0.002), with mortality increasing over time (from 4.5% to 11.2%; p = 0.003).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>A significant shift towards GNB-CRBSIs was observed. Secondarily, and coinciding with an increasing number of GNB-MDR infections, mortality increased over time.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251010","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T17:30:33Z","timestamp":1619803833000},"page":"e0251010","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Changing epidemiology of catheter-related bloodstream infections in neutropenic oncohematological 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