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.buuauthorKazak, Esra
dc.contributor.departmentBursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji.tr_TR
dc.contributor.researcheridCZK-6380-2022
dc.contributor.scopusid24921238200tr_TR
dc.date.accessioned2024-02-09T10:39:58Z
dc.date.available2024-02-09T10:39:58Z
dc.date.issued2020-06
dc.descriptionÇalışmada 63 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır.tr_TR
dc.description.abstractTreatment 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.sponsorshipInnovacion Y Universidadesen_US
dc.description.sponsorshipSpanish Network for Research in Infectious Diseasesen_US
dc.description.sponsorshipMinisterio de Ciencia, Innovación y Universidadesen_US
dc.description.sponsorshipInstituto de Salud Carlos IIIen_US
dc.description.sponsorshipEuropean Regional Development Funden_US
dc.description.sponsorshipSociedad Andaluza de Neurologi­aen_US
dc.identifier.citationNadales, 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.doihttps://doi.org/10.1111/ajt.15769
dc.identifier.endpage1641tr_TR
dc.identifier.issn1600-6135
dc.identifier.issn1600-6143
dc.identifier.issue6tr_TR
dc.identifier.pubmed31891235tr_TR
dc.identifier.scopus2-s2.0-85079069508tr_TR
dc.identifier.startpage1629tr_TR
dc.identifier.urihttps://onlinelibrary.wiley.com/doi/10.1111/ajt.15769
dc.identifier.urihttps://hdl.handle.net/11452/39608
dc.identifier.volume20tr_TR
dc.identifier.wos000511239900001tr_TR
dc.indexed.pubmedPubMeden_US
dc.indexed.scopusScopusen_US
dc.indexed.wosSCIEen_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.collaborationYurt içitr_TR
dc.relation.collaborationYurt dışıtr_TR
dc.relation.collaborationSanayitr_TR
dc.relation.journalAmerican Journal of Transplantationen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAntibiotic drug resistanceen_US
dc.subjectClinical researchen_US
dc.subjectPracticeen_US
dc.subjectInfection and infectious agents - bacterialen_US
dc.subjectInfectious diseaseen_US
dc.subjectOrgan transplantation in generalen_US
dc.subjectResistant enterobacteriaceaeen_US
dc.subjectPneumoniaeen_US
dc.subjectManagementen_US
dc.subjectGuidelinesen_US
dc.subjectSurgeryen_US
dc.subjectTransplantationen_US
dc.subject.emtreeAntibiotic agenten_US
dc.subject.emtreeAzathioprineen_US
dc.subject.emtreeBbasiliximaben_US
dc.subject.emtreeCorticosteroiden_US
dc.subject.emtreeCyclosporineen_US
dc.subject.emtreeEverolimusen_US
dc.subject.emtreeMycophenolic aciden_US
dc.subject.emtreeRapamycinen_US
dc.subject.emtreeTacrolimusen_US
dc.subject.emtreeThymocyte antibodyen_US
dc.subject.emtreeAdulten_US
dc.subject.emtreeAll cause mortalityen_US
dc.subject.emtreeAntibiotic therapyen_US
dc.subject.emtreeArticleen_US
dc.subject.emtreeBloodstream infectionen_US
dc.subject.emtreeCarbapenemase producing Enterobacteriaceaeen_US
dc.subject.emtreeCatheter infectionen_US
dc.subject.emtreeCharlson Comorbidity Indexen_US
dc.subject.emtreeChronic lung diseaseen_US
dc.subject.emtreeClinical practiceen_US
dc.subject.emtreeCohort analysisen_US
dc.subject.emtreeCytomegalovirus infectionen_US
dc.subject.emtreeFemaleen_US
dc.subject.emtreeGraft recipienten_US
dc.subject.emtreeHepatobiliary system infectionen_US
dc.subject.emtreeHumanen_US
dc.subject.emtreeImmunosuppressive treatmenten_US
dc.subject.emtreeKidney diseaseen_US
dc.subject.emtreeKlebsiella pneumoniaeen_US
dc.subject.emtreeLung infectionen_US
dc.subject.emtreeLymphocytopeniaen_US
dc.subject.emtreeMajor clinical studyen_US
dc.subject.emtreeMaleen_US
dc.subject.emtreeMonotherapyen_US
dc.subject.emtreeMortalityen_US
dc.subject.emtreeMortality rateen_US
dc.subject.emtreeOutcome assessmenten_US
dc.subject.emtreePriority journalen_US
dc.subject.emtreeRetrospective studyen_US
dc.subject.emtreeUrinary tract infectionen_US
dc.subject.scopusBeta-Lactamases; Carbapenem-Resistant Enterobacteriaceae; Klebsiella Pneumoniaeen_US
dc.subject.wosSurgeryen_US
dc.subject.wosTransplantationen_US
dc.titlePredictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: The impact of cytomegalovirus disease and lymphopeniaen_US
dc.typeArticleen_US
dc.wos.quartileQ1en_US

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