Pérez Nadales, ElenaGutiérrez Gutiérrez, BelénNatera, Alejandra M.Abdala, EdsonMagalhães, Maira ReinaMularoni, AlessandraPascual Hernández, ÁlvaroRodríguez-Baño, JesúsCordero Matia, María ElisaLepe Jiménez, José AntonioREIPI/INCREMENT-SOT Investigators2024-04-082024-04-082020Pérez 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.15769.1600-03151600-6143https://hdl.handle.net/11441/156717Treatment 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.application/pdf13 p.engAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Antibiotic drug resistanceClinical research/practiceInfection and infectious agents - bacterialInfectious diseaseOrgan transplantation in generalinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccesshttps://doi.org/10.1111/ajt.15769