{"doi":"10.1093/cid/ciac638","title":"Clinical and Molecular Analyses of Recurrent Gram-Negative Bloodstream Infections","abstract":"BACKGROUND: The causes and clinical characteristics of recurrent gram-negative bacterial bloodstream infections (GNB-BSI) are poorly understood. METHODS: We used a cohort of patients with GNB-BSI to identify clinical characteristics, microbiology, and risk factors associated with recurrent GNB-BSI. Bacterial genotyping (pulsed-field gel electrophoresis [PFGE] and whole-genome sequencing [WGS]) was used to determine whether episodes were due to relapse or reinfection. Multivariable logistic regression was used to identify risk factors for recurrence. RESULTS: Of the 1423 patients with GNB-BSI in this study, 60 (4%) had recurrent GNB-BSI. Non-White race (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.38-4.01; P = .002), admission to a surgical service (OR, 2.18; 95% CI, 1.26-3.75; P = .005), and indwelling cardiac device (OR, 2.73; 95% CI, 1.21-5.58; P = .009) were associated with increased risk for recurrent GNB-BSI. Among the 48 patients with recurrent GNB-BSI whose paired bloodstream isolates underwent genotyping, 63% were due to relapse (30 of 48) and 38% were due to reinfection (18 of 48) based on WGS. Compared with WGS, PFGE correctly differentiated relapse and reinfection in 98% (47 of 48) of cases. Median time to relapse and reinfection was similar (113 days; interquartile range [IQR], 35-222 vs 174 days; IQR, 69-599; P = .13). Presence of a cardiac device was associated with relapse (relapse: 7 of 27, 26%; nonrelapse: 65 of 988, 7%; P = .002). CONCLUSIONS: In this study, recurrent GNB-BSI was most commonly due to relapse. PFGE accurately differentiated relapse from reinfection when compared with WGS. Cardiac device was a risk factor for relapse.","journal":"Clinical Infectious Diseases","year":2022,"id":264364,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.96,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":232743,"name":"Blake Hanson","orcid":"0000-0003-2949-7818","position":1,"is_corresponding":false},{"id":37805,"name":"Felicia Ruffin","orcid":"0000-0003-2176-6462","position":2,"is_corresponding":false},{"id":921973,"name":"Joshua B. Parsons","orcid":"0000-0002-0589-3587","position":3,"is_corresponding":false},{"id":303612,"name":"Lawrence P. Park","orcid":null,"position":4,"is_corresponding":false},{"id":331149,"name":"Batu K. Sharma‐Kuinkel","orcid":"0000-0002-7217-3213","position":5,"is_corresponding":false},{"id":716803,"name":"Michael Mohnasky","orcid":"0000-0002-2536-0200","position":6,"is_corresponding":false},{"id":232742,"name":"César A. Arias","orcid":"0000-0001-9054-9774","position":7,"is_corresponding":false},{"id":32929,"name":"Vance G. Fowler","orcid":"0000-0002-8048-0897","position":8,"is_corresponding":false},{"id":302598,"name":"Joshua T. Thaden","orcid":"0000-0002-3250-0697","position":9,"is_corresponding":false},{"id":922420,"name":"Andrew Bock","orcid":null,"position":0,"is_corresponding":true}],"reference_count":26,"raw_metadata":null,"created_at":"2026-07-19T00:26:37.567338Z","pmid":"35929656","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}