{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:50:55Z","timestamp":1790279455731,"version":"4.1.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec010\">\n<jats:title>Importance<\/jats:title>\n<jats:p>Patients with Gram-negative bloodstream infections (GN-BSI) are classified as non-immunocompromised (n-IC) or immunocompromised (IC). However, immunosuppressive condition should not be considered univocally.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec011\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To investigate epidemiological characteristics, management and outcome of GN-BSI in IC and non-IC patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec012\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective single-center study of hospitalized patients with GN-BSI conducted over a 7-year period. Patients with GN-BSI were divided in: solid organ transplant (SOT) recipients, patients with hematologic malignancy (HM), patients with metastatic solid cancer (mSC), and non-major IC patients (nm-IC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec013\">\n<jats:title>Results<\/jats:title>\n<jats:p>3544 patients analysed: 76.7% nm-IC, 6.5% SOT, 8.0% HM and 8.8% mSC. SOT and HM patients were younger (SOT: 56.6\u2009\u00b1\u200913.1 years; HM: 56.4\u2009\u00b1\u200914.5; nm-IC: 72.4\u2009\u00b1\u200916.1; mSC: 68.6\u2009\u00b1\u200913.1, p\u2009&lt;\u20090.001) and had lower CCI value (SOT: 4.5\u2009\u00b1\u20092.4; HM: 4.1\u2009\u00b1\u20092.1; nm-IC: 5.5\u2009\u00b1\u20092.6; mSC: 9.7\u2009\u00b1\u20092.5, p\u2009&lt;\u20090.001). Urinary tract infection was the most common source of BSI in nm-IC (nm-IC: 50.1%, HM:15%; SOT: 33.3%; mSC: 25.9%, p\u2009&lt;\u20090.001), intra-abdominal infection was the more frequent source among SOT and mSC (SOT:42.3%; mSC: 49.3%, nm-IC: 27.8%, HM:29%; p\u2009&lt;\u20090.001). Primary BSI was the first cause of GN-BSI in HM (HM: 62.1%; SOT: 18.5%; nm-IC: 17.2%; mSC: 10.6%, p\u2009&lt;\u20090.001). The lowest rate of death was observed in SOT and the highest in mSC (SOT 8.2%; nm-IC 13.4%; HM 14.9%; mSC 19.9%, p\u2009&lt;\u20090.001). Relapse rate was highest in SOT (SOT: 18.8%; HM: 11.8%; NMIC: 7.2%; aST: 7.1%, p\u2009&lt;\u20090.001). Follow-up bloodcultures were associated with a lower mortality only among NMIC (HR\u2009=\u20090.317, 95% CI 0.178\u20130.563, p\u2009&lt;\u20090.001) and aST (HR\u2009=\u20090.198, 95% CI 0.058\u20130.673, p\u2009=\u20090.010). The role of treatment duration on relapse was not evident in any group, conversely receiving at least 7 days of treatment was associated with a lower risk of 90-day mortality in SOT and HM patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec014\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The characteristics and outcome of GN-BSI are peculiar between specific IC categories, therefore a personalized management should be implemented.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0327535","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T17:41:30Z","timestamp":1751910090000},"page":"e0327535","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiological characteristics and management of Gram-negative bacteraemia in different immunocompromised hosts: Observational single-center 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