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Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: the impact of cytomegalovirus disease and lymphopenia
dc.contributor.advisor | ||
dc.creator | Pérez Nadales, Elena | es |
dc.creator | Gutiérrez Gutiérrez, Belén | es |
dc.creator | Natera, Alejandra M. | es |
dc.creator | Abdala, Edson | es |
dc.creator | Magalhães, Maira Reina | es |
dc.creator | Mularoni, Alessandra | es |
dc.creator | Pascual Hernández, Álvaro | es |
dc.creator | Rodríguez-Baño, Jesús | es |
dc.creator | Cordero Matia, María Elisa | es |
dc.creator | Lepe Jiménez, José Antonio | es |
dc.creator | REIPI/INCREMENT-SOT Investigators | es |
dc.date.accessioned | 2024-04-08T15:18:41Z | |
dc.date.available | 2024-04-08T15:18:41Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Pérez Nadales, E., Gutiérrez Gutiérrez, B., Natera, A.M., Abdala, E., Magalhães, M.R., Mularoni, A.,...,REIPI/INCREMENT-SOT Investigators, (2020). Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: the impact of cytomegalovirus disease and lymphopenia. american Journal of Transplantation, 20 (6), 1629-1641. https://doi.org/10.1111/ajt.15769. | |
dc.identifier.issn | 1600-0315 | es |
dc.identifier.issn | 1600-6143 | es |
dc.identifier.uri | https://hdl.handle.net/11441/156717 | |
dc.description.abstract | Treatment of carbapenemase-producing Enterobacterales bloodstream infections in solid organ transplant recipients is challenging. The objective of this study was to develop a specific score to predict mortality in solid organ transplant recipients with carbapenemase-producing Enterobacterales bloodstream infections. A multina- tional, retrospective (2004-2016) cohort study (INCREMENT-SOT, ClinicalTrials.gov NCT02852902) was performed. The main outcome variable was 30-day all-cause mortality. The INCREMENT-SOT-CPE score was developed using logistic regression. Theglobal cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score ≥8 (8 points), no source control (3points), inappropriate empirical therapy (2 points), cytomegalovirus disease (7 points), lymphopenia (4 points), and the interaction between INCREMENT-CPE score ≥8 and CMV disease (minus 7 points). This score showed an area under the receiver operatng characteristic curve of 0.82 (95% confidence interval [CI] 0.76-0.88) and classified patients into 3 strata: 0-7 (low mortality), 8-11 (high mortality), and 12-17 (very-high mortality). We performed a stratified analysis of the effect of monotherapy vs combination therapy among 165 patients who received appropriate therapy. Monotherapy was associated with higher mortality only in the very-high (adjusted hazard ratio [HR] 2.82, 95% CI 1.13-7.06, P = .03) and high (HR 9.93, 95% CI 2.08-47.40, P = .004) mortality risk strata. A score-based algorithm is provided for therapy guidance. | es |
dc.format | application/pdf | es |
dc.format.extent | 13 p. | es |
dc.language.iso | eng | es |
dc.publisher | BMC | es |
dc.relation.ispartof | american Journal of Transplantation, 20 (6), 1629-1641. | |
dc.rights | Atribución 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject | Antibiotic drug resistance | es |
dc.subject | Clinical research/practice | es |
dc.subject | Infection and infectious agents - bacterial | es |
dc.subject | Infectious disease | es |
dc.subject | Organ transplantation in general | es |
dc.title | Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: the impact of cytomegalovirus disease and lymphopenia | es |
dc.type | info:eu-repo/semantics/article | es |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Microbiología | |
dc.relation.publisherversion | https://www.sciencedirect.com/science/article/pii/S1600613522223624?via%3Dihub | es |
dc.identifier.doi | 10.1111/ajt.15769 | es |
dc.journaltitle | american Journal of Transplantation | es |
dc.publication.volumen | 20 | es |
dc.publication.issue | 6 | es |
dc.publication.initialPage | 1629 | es |
dc.publication.endPage | 1641 | es |