{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:08:59Z","timestamp":1792084139773,"version":"4.4.0"},"reference-count":56,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The aim of this study was to investigate the prevalence of intestinal colonization by major multidrug-resistant (MDR) bacteria and fungi in patients with hematological malignancies (HM) and its relationship with subsequent bloodstream infections (BSIs). The study was performed between December 2023 and June 2024 at the University Hospital \u201cSaint Marina\u201d, Varna, Bulgaria. A total of 180 HM patients were screened for intestinal colonization by 3rd generation cephalosporin-resistant (3rdGCephR) and carbapenem-resistant (CR)\n                    <jats:italic>Enterobacterales<\/jats:italic>\n                    ,\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    ,\n                    <jats:italic>Stenotrophomonas maltophilia<\/jats:italic>\n                    , Vancomycin-Resistant Enterococci (VRE) and\n                    <jats:italic>Candida<\/jats:italic>\n                    sp. according to our own protocol. Blood cultures were taken according to clinical indications. Multiplex PCR was used to detect beta-lactamase genes in all invasive\n                    <jats:italic>Enterobacterales<\/jats:italic>\n                    isolates. A total of 100 patients (55.6%) were colonized by one or more of the screened agents. Among these, 88 patients were MDR carriers (48.9%, 88\/180) and the highest colonization rates were found for CR\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (CRKP) (42%),\n                    <jats:italic>Candida<\/jats:italic>\n                    sp. (34%), VRE (25%) and 3rdGCephR\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (23%). A total of 29 patients (16.1%; 29\/180) developed BSIs, with\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    responsible for 44.8%. Of these, 76.9% (10\/13) were CR and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM<\/jats:sub>\n                    positive isolates. Related BSIs were diagnosed in 57.9% of the MDR carriers with BSIs (11\/19). The related BSIs percentage according to the colonizing agent was 21.4% for CRKP (9\/42), 7.1% for 3rdGCephR\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    (1\/14) and 25% for\n                    <jats:italic>P. aeruginosa<\/jats:italic>\n                    (1\/4). CRKP colonization was significantly higher among patients with CRKP BSIs than those with non-CRKP BSIs (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). The MDR intestinal colonization, specifically by CRKP is an important source for subsequent BSIs in this high-risk patient population.\n                  <\/jats:p>","DOI":"10.1556\/030.2025.02730","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T14:21:48Z","timestamp":1760624508000},"page":"341-349","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence of intestinal colonization by multidrug-resistant bacteria and related bloodstream infections in patients with hematological malignancies"],"prefix":"10.1556","volume":"72","author":[{"given":"Temenuga","family":"Stoeva","sequence":"first","affiliation":[{"name":"Microbiology Laboratory, University Hospital \u201cSt. Marina\u201d \u2013 Varna, Varna, Bulgaria"},{"name":"Department of Microbiology and Virology, Medical University of Varna, Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3666-3802","authenticated-orcid":true,"given":"Denis","family":"Niyazi","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, University Hospital \u201cSt. Marina\u201d \u2013 Varna, Varna, Bulgaria"},{"name":"Department of Microbiology and Virology, Medical University of Varna, Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyuben","family":"Stoev","sequence":"additional","affiliation":[{"name":"Clinic of General and Clinical Pathology, University Hospital \u201cSt. Marina\u201d \u2013 Varna, Varna, Bulgaria"},{"name":"Department of General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Dokova","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Healthcare Organization, Medical University of Varna, Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"Virulence","first-page":"280","article-title":"Bloodstream infections in neutropenic cancer patients: a practical update","volume":"7","author":"Gustinetti G","year":"2016","unstructured":"Gustinetti G, Mikulska M. 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