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.buuauthor | Kazak, Esra | |
dc.contributor.department | Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji. | tr_TR |
dc.contributor.researcherid | CZK-6380-2022 | |
dc.contributor.scopusid | 24921238200 | tr_TR |
dc.date.accessioned | 2024-02-09T10:39:58Z | |
dc.date.available | 2024-02-09T10:39:58Z | |
dc.date.issued | 2020-06 | |
dc.description | Çalışmada 63 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. | tr_TR |
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 multinational, 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. The global cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score >= 8 (8 points), no source control (3 points), 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 operating 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. | en_US |
dc.description.sponsorship | Innovacion Y Universidades | en_US |
dc.description.sponsorship | Spanish Network for Research in Infectious Diseases | en_US |
dc.description.sponsorship | Ministerio de Ciencia, Innovación y Universidades | en_US |
dc.description.sponsorship | Instituto de Salud Carlos III | en_US |
dc.description.sponsorship | European Regional Development Fund | en_US |
dc.description.sponsorship | Sociedad Andaluza de Neurologia | en_US |
dc.identifier.citation | Nadales, P. E. vd. (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. | en_US |
dc.identifier.doi | https://doi.org/10.1111/ajt.15769 | |
dc.identifier.endpage | 1641 | tr_TR |
dc.identifier.issn | 1600-6135 | |
dc.identifier.issn | 1600-6143 | |
dc.identifier.issue | 6 | tr_TR |
dc.identifier.pubmed | 31891235 | tr_TR |
dc.identifier.scopus | 2-s2.0-85079069508 | tr_TR |
dc.identifier.startpage | 1629 | tr_TR |
dc.identifier.uri | https://onlinelibrary.wiley.com/doi/10.1111/ajt.15769 | |
dc.identifier.uri | https://hdl.handle.net/11452/39608 | |
dc.identifier.volume | 20 | tr_TR |
dc.identifier.wos | 000511239900001 | tr_TR |
dc.indexed.pubmed | PubMed | en_US |
dc.indexed.scopus | Scopus | en_US |
dc.indexed.wos | SCIE | en_US |
dc.language.iso | en | en_US |
dc.publisher | Wiley | en_US |
dc.relation.collaboration | Yurt içi | tr_TR |
dc.relation.collaboration | Yurt dışı | tr_TR |
dc.relation.collaboration | Sanayi | tr_TR |
dc.relation.journal | American Journal of Transplantation | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi | tr_TR |
dc.rights | info:eu-repo/semantics/closedAccess | en_US |
dc.subject | Antibiotic drug resistance | en_US |
dc.subject | Clinical research | en_US |
dc.subject | Practice | en_US |
dc.subject | Infection and infectious agents - bacterial | en_US |
dc.subject | Infectious disease | en_US |
dc.subject | Organ transplantation in general | en_US |
dc.subject | Resistant enterobacteriaceae | en_US |
dc.subject | Pneumoniae | en_US |
dc.subject | Management | en_US |
dc.subject | Guidelines | en_US |
dc.subject | Surgery | en_US |
dc.subject | Transplantation | en_US |
dc.subject.emtree | Antibiotic agent | en_US |
dc.subject.emtree | Azathioprine | en_US |
dc.subject.emtree | Bbasiliximab | en_US |
dc.subject.emtree | Corticosteroid | en_US |
dc.subject.emtree | Cyclosporine | en_US |
dc.subject.emtree | Everolimus | en_US |
dc.subject.emtree | Mycophenolic acid | en_US |
dc.subject.emtree | Rapamycin | en_US |
dc.subject.emtree | Tacrolimus | en_US |
dc.subject.emtree | Thymocyte antibody | en_US |
dc.subject.emtree | Adult | en_US |
dc.subject.emtree | All cause mortality | en_US |
dc.subject.emtree | Antibiotic therapy | en_US |
dc.subject.emtree | Article | en_US |
dc.subject.emtree | Bloodstream infection | en_US |
dc.subject.emtree | Carbapenemase producing Enterobacteriaceae | en_US |
dc.subject.emtree | Catheter infection | en_US |
dc.subject.emtree | Charlson Comorbidity Index | en_US |
dc.subject.emtree | Chronic lung disease | en_US |
dc.subject.emtree | Clinical practice | en_US |
dc.subject.emtree | Cohort analysis | en_US |
dc.subject.emtree | Cytomegalovirus infection | en_US |
dc.subject.emtree | Female | en_US |
dc.subject.emtree | Graft recipient | en_US |
dc.subject.emtree | Hepatobiliary system infection | en_US |
dc.subject.emtree | Human | en_US |
dc.subject.emtree | Immunosuppressive treatment | en_US |
dc.subject.emtree | Kidney disease | en_US |
dc.subject.emtree | Klebsiella pneumoniae | en_US |
dc.subject.emtree | Lung infection | en_US |
dc.subject.emtree | Lymphocytopenia | en_US |
dc.subject.emtree | Major clinical study | en_US |
dc.subject.emtree | Male | en_US |
dc.subject.emtree | Monotherapy | en_US |
dc.subject.emtree | Mortality | en_US |
dc.subject.emtree | Mortality rate | en_US |
dc.subject.emtree | Outcome assessment | en_US |
dc.subject.emtree | Priority journal | en_US |
dc.subject.emtree | Retrospective study | en_US |
dc.subject.emtree | Urinary tract infection | en_US |
dc.subject.scopus | Beta-Lactamases; Carbapenem-Resistant Enterobacteriaceae; Klebsiella Pneumoniae | en_US |
dc.subject.wos | Surgery | en_US |
dc.subject.wos | Transplantation | en_US |
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 | en_US |
dc.type | Article | en_US |
dc.wos.quartile | Q1 | en_US |
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