Efficacy of β-lactam/β-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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dc.creatorNicolas j Muller
dc.creatorOriol Manuel
dc.creatorHande Arslan
dc.creatorImran Hasanoglu
dc.creatorMaria López Oliva
dc.creatorSheila Chiese
dc.creatorNicola Duccio Salerno
dc.creatorOlivier Lortholary
dc.creatorMical Paul
dc.creatorAnne Scemla
dc.creatorElisa Grazia Calvi
dc.creatorLaurent Dewispelaere
dc.creatorPaulo Henrique Orlandi Mourão
dc.creatorAthina Pyrpasopoulou
dc.creatorIordanis Romiopoulos
dc.creatorElias Iosifidis
dc.creatorEdson Abdala
dc.creatorMarta Bodro
dc.creatorTania Mara Varejão Strabelli
dc.creatorNoa Cohen'sinai
dc.creatorMaría Carmen Fariñas
dc.creatorWarren Lowman
dc.creatorMarco Falcone
dc.creatorEsra Kazak
dc.creatorMario Tumbarello
dc.creatorErika Lease
dc.creatorNina Nestorova
dc.creatorLigia C.pierrotti
dc.creatorFrancisco López'medrano
dc.creatorRafael San'juan
dc.creatorMiguel Montejo
dc.creatorMaristela p. Freire
dc.creatorElisa Cordero
dc.creatorMiruna d. David
dc.creatorEsperanza Merino
dc.creatorSeema Mehta Steinke
dc.creatorPaolo a. Grossi
dc.creatorÁngela Cano
dc.creatorElena Pérez'nadales
dc.creatorElena m. Seminari
dc.creatorMaricela Valerio
dc.creatorFiliz Gunseren
dc.creatorMeenakshi Rana
dc.creatorAlessandra Mularoni
dc.creatorPilar Martín'dávila
dc.creatorChristian Delden
dc.creatorMelike Hamiyet Demirkaya
dc.creatorZeliha Koçak Tufan
dc.creatorBelén Loeches
dc.creatorMario Fernández'ruiz
dc.creatorRanganathan n. Iyer
dc.creatorFabio Soldani
dc.creatorBritt'marie Eriksson
dc.creatorBenoît Pilmis
dc.creatorMarco Rizzi
dc.creatorJulien Coussement
dc.creatorWanessa Trindade Clemente
dc.creatorEmmanuel Roilides
dc.creatorÁlvaro Pascual
dc.creatorLuis Martínez'martínez
dc.creatorBelén Gutiérrez'gutiérrez
dc.creatorJesús Rodríguez'baño
dc.creatorJulian Torre'cisneros
dc.creatorJosé María Aguado
dc.creatorTerence yi Shern Kee
dc.creatorNúria Sabé
dc.creatorMariana Camoez
dc.creatorMaría a Domínguez
dc.creatorFidi Koppel
dc.creatorJaime Lora'tamayo
dc.creatorLeyre Lopez'soria
dc.creatorBan Hock Tan
dc.creatorElias David'neto
dc.creatorFlávio Jota de Paula e Flávia Rossi
dc.creatorJose Antonio Lepe
dc.creatorGabriel Bernal Blanco
dc.creatorCecilia Martín'gandul
dc.creatorNoelia Balibrea
dc.creatorAntonio Franco
dc.creatorRobin Avery
dc.creatorDarin Ostrander
dc.creatorDaniela Dalla Gasperina
dc.creatorJordi Carratalà
dc.creatorCristina Rovelli
dc.creatorAlejandra m Natera
dc.creatorManuel Recio'rufián
dc.creatorJulia Guzmán'puche
dc.creatorCristina Leoni
dc.creatorPatricia Muñoz
dc.creatorCarlos Sánchez'carrillo
dc.creatorSara Lardo
dc.creatorDeena Rose Altman
dc.creatorJesús Fortún
dc.creatorIsabel Oriol
dc.creatorRosa Escudero
dc.creatorFrancesca Gioia
dc.date.accessioned2023-07-04T20:46:10Z
dc.date.accessioned2025-09-08T23:07:43Z
dc.date.available2023-07-04T20:46:10Z
dc.date.issued2021
dc.format.mimetypepdf
dc.identifier.doi10.1111/tid.13520
dc.identifier.issn13982273
dc.identifier.urihttps://hdl.handle.net/1843/55781
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofTransplant Infectious Disease
dc.rightsAcesso Restrito
dc.subjectSepse
dc.subjectTransplante de rim
dc.subjectResultado de tratamento
dc.subjectInfecções Urinárias
dc.subject.otherBloodstream infection
dc.subject.otherCarbapenem-sparing regimen,
dc.subject.otherextended-spectrum β-lactamaseproducing Enterobacterales,
dc.subject.otherKidney transplatation
dc.subject.otherOutcomes
dc.subject.otherUrinary tract infecction
dc.titleEfficacy of β-lactam/β-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project)
dc.typeArtigo de periódico
local.citation.epage16
local.citation.spage1
local.citation.volume23
local.description.resumoBackground: Whether active therapy with β-lactam/β-lactamase inhibitors (BLBLI) is as affective as carbapenems for extended spectrum β-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/μL 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).
local.identifier.orcidhttps://orcid.org/0000-0003-0848-3740
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE PROPEDÊUTICA COMPLEMENTAR
local.publisher.initialsUFMG
local.url.externahttps://onlinelibrary.wiley.com/doi/10.1111/tid.13520

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