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Background <p>Bloodstream infections (BSIs) caused by carbapenem-resistant (CR) Gram-negative bacteria (GNB) represent a critical challenge in febrile neutropenia (FN). This study investigated temporal resistance trends, clinical features, and predictors of CR-GNB BSIs in hematology patients over a 10-year period.</p> Methods <p>A retrospective cohort analysis was conducted on GNB BSIs in febrile neutropenic patients hospitalized between 2014 and 2025. Microbiologic, demographic, and clinical data were collected and analyzed.</p> Results <p>A total of 604 patients with hematologic malignancies experienced 975 FN episodes with microbiologically confirmed BSIs, yielding 1096 isolates. Of these episodes, 57.5% occurred in males, with a median patient age of 49.5 years (IQR: 34–60.5). GNB accounted for 732 (66.9%) isolates. Among all GN isolates, 22.8% were CR-GNB. CR-GNB BSIs were significantly more common during Period 1 (OR: 0.492; 95% CI: 0.277–0.876 for Period 2; OR: 0.496; 95% CI: 0.285–0.864 for Period 3; OR: 0.455; 95% CI: 0.258–0.804 for Period 4). Independent predictor factors for CR-GNB BSIs included prior CRE colonization or infection within the last year (OR: 3.723; 95% CI: 2.218–6.251), intravenous antibiotic use within the preceding three months (OR: 1.825; 95% CI: 1.076–3.094), and geographic origin from Asia (OR: 2.308; 95% CI: 1.065–5.002).</p> Conclusions <p>Our findings highlight a reduction in both carbapenem resistance and mortality over time, reflecting improvements in antimicrobial stewardship and infection control. Patients with recent antibiotic exposure or prior CRE colonization at high risk and warrant close monitoring and early targeted therapy.</p> Clinical trial number <p>Not applicable.</p>

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Temporal dynamics and predictors of carbapenem-resistant gram-negative bacteria in bloodstream infections in hematological patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月13日

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  • Meyha Sahin,
  • Ali Mert,
  • Ayse Istanbullu Tosun,
  • Ezgi Yilmaz,
  • Hüseyin Saffet Bekoz,
  • Leylagul Kaynar,
  • Bahadir Ceylan

摘要

Background

Bloodstream infections (BSIs) caused by carbapenem-resistant (CR) Gram-negative bacteria (GNB) represent a critical challenge in febrile neutropenia (FN). This study investigated temporal resistance trends, clinical features, and predictors of CR-GNB BSIs in hematology patients over a 10-year period.

Methods

A retrospective cohort analysis was conducted on GNB BSIs in febrile neutropenic patients hospitalized between 2014 and 2025. Microbiologic, demographic, and clinical data were collected and analyzed.

Results

A total of 604 patients with hematologic malignancies experienced 975 FN episodes with microbiologically confirmed BSIs, yielding 1096 isolates. Of these episodes, 57.5% occurred in males, with a median patient age of 49.5 years (IQR: 34–60.5). GNB accounted for 732 (66.9%) isolates. Among all GN isolates, 22.8% were CR-GNB. CR-GNB BSIs were significantly more common during Period 1 (OR: 0.492; 95% CI: 0.277–0.876 for Period 2; OR: 0.496; 95% CI: 0.285–0.864 for Period 3; OR: 0.455; 95% CI: 0.258–0.804 for Period 4). Independent predictor factors for CR-GNB BSIs included prior CRE colonization or infection within the last year (OR: 3.723; 95% CI: 2.218–6.251), intravenous antibiotic use within the preceding three months (OR: 1.825; 95% CI: 1.076–3.094), and geographic origin from Asia (OR: 2.308; 95% CI: 1.065–5.002).

Conclusions

Our findings highlight a reduction in both carbapenem resistance and mortality over time, reflecting improvements in antimicrobial stewardship and infection control. Patients with recent antibiotic exposure or prior CRE colonization at high risk and warrant close monitoring and early targeted therapy.

Clinical trial number

Not applicable.