Efficacy of beta-lactam/beta-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project)

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Efficacy of beta-lactam/beta-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project)

Pierrotti, Ligia C. (författare): Univ Sao Paulo, Hosp Clin, Infect Dis Div, Med Sch, Sao Paulo, Brazil.

Perez-Nadales, Elena (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Infect Dis Grp, Cordoba, Spain.

Fernandez-Ruiz, Mario (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Complutense, 12 Octubre Univ Hosp, Inst Invest Sanitaria Hosp 12 Octubre imas12, Unit Infect Dis, Madrid, Spain.

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Gutierrez-Gutierrez, Belen (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Seville, Virgen Macarena Univ Hosp, Inst Biomed Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Seville, Spain.

Hock Tan, Ban (författare): Singapore Gen Hosp, Dept Infect Dis, Singapore, Singapore.

Carratala, Jordi (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Barcelona, Bellvitge Univ Hosp IDIBELL, Dept Infect Dis, Barcelona, Spain.

Oriol, Isabel (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Barcelona, Bellvitge Univ Hosp IDIBELL, Dept Infect Dis, Barcelona, Spain.

Paul, Mical (författare): Infect Dis Inst, Rambam Hlth Care Campus, Haifa, Israel.

Cohen-Sinai, Noa (författare): Technion Israel Inst Technol, Haifa, Israel.

Lopez-Medrano, Francisco (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Complutense, 12 Octubre Univ Hosp, Inst Invest Sanitaria Hosp 12 Octubre imas12, Unit Infect Dis, Madrid, Spain.

San-Juan, Rafael (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Complutense, 12 Octubre Univ Hosp, Inst Invest Sanitaria Hosp 12 Octubre imas12, Unit Infect Dis, Madrid, Spain.

Montejo, Miguel (författare): Cruces Univ Hosp, Infect Dis Unit, Bilbao, Spain.

Freire, Maristela P. (författare): Univ Sao Paulo, Working Comm Hosp Epidemiol & Infect Control, Hosp Clin, Med Sch, Sao Paulo, Brazil.

Cordero, Elisa (författare): Univ Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Inst Biomed Seville, Univ Hosp Virgen Rocio,CSIC, Seville, Spain.

David, Miruna D. (författare): Univ Hosp Birmingham NHS Fdn Trust, Birmingham, W Midlands, England.

Merino, Esperanza (författare): Hosp Gen Univ Alicante, Unit Infect Dis, ISABIAL, Alicante, Spain.

Mehta Steinke, Seema (författare): Johns Hopkins Univ, Sch Med, Baltimore, MD USA.

Grossi, Paolo A. (författare): Univ Insubria, Dept Med & Surg, Varese, Italy.

Cano, Angela (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Seville, Virgen Macarena Univ Hosp, Inst Biomed Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Seville, Spain.

Seminari, Elena M. (författare): Fdn IRCCS Policlin San Matteo, Infect Dis Clin, Pavia, Italy.

Valerio, Maricela (författare): Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain.

Gunseren, Filiz (författare): Akdeniz Univ, Dept Infect Dis & Clin Microbiol, Fac Med, Antalya, Turkey.

Rana, Meenakshi (författare): Icahn Sch Med Mt Sinai, New York, NY 10029 USA.

Mularoni, Alessandra (författare): Ist Mediterraneo Trapianti & Terapie Ad Alta Spec, IRCCS ISMETT, Palermo, Italy.

Martin-Davila, Pilar (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Ramon y Cajal Univ Hosp, Infect Dis Dept, Madrid, Spain.

van Delden, Christian (författare): Univ Hosp Geneva, Unit Transplant Infect Dis, Geneva, Switzerland.

Hamiyet Demirkaya, Melike (författare): Baskent Univ, Sch Med, Ankara, Turkey.

Kocak Tufan, Zeliha (författare): Ankara Yildirim Beyazit Univ, Infect Dis & Clin Microbiol Dept, Med Sch, Ankara, Turkey.

Loeches, Belen (författare): Hosp Univ La Paz, Infect Dis Unit, IdiPAZ, Madrid, Spain.

Iyer, Ranganathan N. (författare): Global Hosp, Clin Microbiol ID & Infect Control, Hyderabad, India.

Soldani, Fabio (författare): Azienda Osped Univ Integrata Verona, Dept Med, Div Infect Dis, Verona, Italy.

Eriksson, Britt-Marie, Docent, 1952- (författare): Uppsala universitet,Infektionssjukdomar

Pilmis, Benoit (författare): Paris Descartes Univ, Necker Enfants Malades Univ Hosp, Dept Infect Dis & Trop Med, Ctr Infectiol Necker Pasteur,AP HP,Inst Imagine, Paris, France.

Rizzi, Marco (författare): ASST Papa Giovanni XXIII, Infect Dis Unit, Bergamo, Italy.

Coussement, Julien (författare): Univ Libre Bruxelles, Div Infect Dis, CUB Hop Erasme, Brussels, Belgium.

Clemente, Wanessa T. (författare): Univ Fed Minas Gerais UFMG, Hosp Clin UFMG, Liver Transplant Program, Transplant Infect Dis,Fac Med, Belo Horizonte, MG, Brazil.

Roilides, Emmanuel (författare): Aristotle Univ Thessaloniki, Hippokrat Hosp, Infect Dis Unit, Sch Hlth Sci, Thessaloniki, Greece.;Aristotle Univ Thessaloniki, Hippokrat Hosp, Dept Pediat 3, Sch Hlth Sci, Thessaloniki, Greece.

Pascual, Alvaro (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Seville, Virgen Macarena Univ Hosp, Inst Biomed Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Seville, Spain.

Martinez-Martinez, Luis (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Cordoba, Clin Unit Microbiol, Maimonides Biomed Res Inst Cordoba IMIBIC, Dept Microbiol,Reina Sofia Univ Hosp, Cordoba, Spain.

Rodriguez-Bano, Jesus (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Seville, Virgen Macarena Univ Hosp, Inst Biomed Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Seville, Spain.

Torre-Cisneros, Julian (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Clin Unit Infect Dis, Cordoba, Spain.

Maria Aguado, Jose (författare): ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Complutense, 12 Octubre Univ Hosp, Inst Invest Sanitaria Hosp 12 Octubre imas12, Unit Infect Dis, Madrid, Spain.

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Univ Sao Paulo, Hosp Clin, Infect Dis Div, Med Sch, Sao Paulo, Brazil ISCIII, Spanish Network Res Infect Dis REIPI, Madrid, Spain.;Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Infect Dis Grp, Cordoba, Spain. (creator_code:org_t)

2021-01-04
2021
Engelska.
Ingår i: Transplant Infectious Disease. - : John Wiley & Sons. - 1398-2273 .- 1399-3062. ; 23:3

Relaterad länk:: https://repositorio....; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Background Whether active therapy with beta-lactam/beta-lactamase inhibitors (BLBLI) is as affective as carbapenems for extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) bloodstream infection (BSI) secondary to urinary tract infection (UTI) in kidney transplant recipients (KTRs) remains unclear. Methods We retrospectively evaluated 306 KTR admitted to 30 centers from January 2014 to October 2016. Therapeutic failure (lack of cure or clinical improvement and/or death from any cause) at days 7 and 30 from ESBL-E BSI onset was the primary and secondary study outcomes, respectively. Results Therapeutic failure at days 7 and 30 occurred in 8.2% (25/306) and 13.4% (41/306) of patients. Hospital-acquired BSI (adjusted OR [aOR]: 4.10; 95% confidence interval [CI]: 1.50-11.20) and Pitt score (aOR: 1.47; 95% CI: 1.21-1.77) were independently associated with therapeutic failure at day 7. Age-adjusted Charlson Index (aOR: 1.25; 95% CI: 1.05-1.48), Pitt score (aOR: 1.72; 95% CI: 1.35-2.17), and lymphocyte count <= 500 cells/mu L at presentation (aOR: 3.16; 95% CI: 1.42-7.06) predicted therapeutic failure at day 30. Carbapenem monotherapy (68.6%, primarily meropenem) was the most frequent active therapy, followed by BLBLI monotherapy (10.8%, mostly piperacillin-tazobactam). Propensity score (PS)-adjusted models revealed no significant impact of the choice of active therapy (carbapenem-containing vs any other regimen, BLBLI- vs carbapenem-based monotherapy) within the first 72 hours on any of the study outcomes. Conclusions Our data suggest that active therapy based on BLBLI may be as effective as carbapenem-containing regimens for ESBL-E BSI secondary to UTI in the specific population of KTR. Potential residual confounding and unpowered sample size cannot be excluded (ClinicalTrials.gov identifier: NCT02852902).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)

Nyckelord

bloodstream infection
carbapenem&#8208
sparing regimen
extended&#8208
spectrum &#946
&#8208
lactamase&#8208
producing Enterobacterales
kidney transplantation
outcomes
urinary tract infection

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Av författaren/redakt...: Pierrotti, Ligia ...; Perez-Nadales, E ...; Fernandez-Ruiz, ...; Gutierrez-Gutier ...; Hock Tan, Ban; Carratala, Jordi; visa fler...; Oriol, Isabel; Paul, Mical; Cohen-Sinai, Noa; Lopez-Medrano, F ...; San-Juan, Rafael; Montejo, Miguel; Freire, Maristel ...; Cordero, Elisa; David, Miruna D.; Merino, Esperanz ...; Mehta Steinke, S ...; Grossi, Paolo A.; Cano, Angela; Seminari, Elena ...; Valerio, Maricel ...; Gunseren, Filiz; Rana, Meenakshi; Mularoni, Alessa ...; Martin-Davila, P ...; van Delden, Chri ...; Hamiyet Demirkay ...; Kocak Tufan, Zel ...; Loeches, Belen; Iyer, Ranganatha ...; Soldani, Fabio; Eriksson, Britt- ...; Pilmis, Benoit; Rizzi, Marco; Coussement, Juli ...; Clemente, Waness ...; Roilides, Emmanu ...; Pascual, Alvaro; Martinez-Martine ...; Rodriguez-Bano, ...; Torre-Cisneros, ...; Maria Aguado, Jo ...; visa färre...

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