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

Pierrotti LC; Pérez-Nadales E; Fernández-Ruiz M; Gutiérrez-Gutiérrez B; Hock Tan B; Carratalà J; Oriol I; Paul M; Cohen-Sinai N; López-Medrano F; San-Juan R; Montejo M; Freire MP; Cordero E; David MD; Merino E; Mehta Steinke S; Grossi PA; Cano Á; Seminari EM; Valerio M; Gunseren F; Rana M; Mularoni A; Martín-Dávila P; van Delden C; Hamiyet Demirkaya M; Koçak Tufan Z; Loeches B; Iyer RN; Soldani F; Eriksson BM; Pilmis B; Rizzi M; Coussement J; Clemente WT; Roilides E; Pascual Á; Martínez-Martínez L; Rodríguez-Baño J; Torre-Cisneros J; María Aguado J; Investigators from the REIPI/INCREMENT-SOT Group

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

BACKGROUND: Whether active therapy with ß-lactam/ß-lactamase inhibitors (BLBLI) is as affective as carbapenems for extended-spectrum ß-lactamase-producing Enterobacterales (ESBL-E) bloodstream infection (BSI) secondary to urinary tract infection (UTI) in kidney transplant recipients (KTRs) remains u...

Descripción completa

Detalles Bibliográficos
Autores:	Pierrotti LC, Pérez-Nadales E, Fernández-Ruiz M, Gutiérrez-Gutiérrez B, Hock Tan B, Carratalà J, Oriol I, Paul M, Cohen-Sinai N, López-Medrano F, San-Juan R, Montejo M, Freire MP, Cordero E, David MD, Merino E, Mehta Steinke S, Grossi PA, Cano Á, Seminari EM, Valerio M, Gunseren F, Rana M, Mularoni A, Martín-Dávila P, van Delden C, Hamiyet Demirkaya M, Koçak Tufan Z, Loeches B, Iyer RN, Soldani F, Eriksson BM, Pilmis B, Rizzi M, Coussement J, Clemente WT, Roilides E, Pascual Á, Martínez-Martínez L, Rodríguez-Baño J, Torre-Cisneros J, María Aguado J, Investigators from the REIPI/INCREMENT-SOT Group
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2021
País:	España
Institución:	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:	oai:isabial.fundanetsuite.com:p6785
Acceso en línea:	https://isabial.portalinvestigacion.com/publicaciones6785
Access Level:	acceso abierto
Palabra clave:	bloodstream infection carbapenem-sparing regimen extended-spectrum ß-lactamase-producing Enterobacterales kidney transplantation outcomes urinary tract infection

id	ES_27e3040b57faba3bef929dfdcc1d8832
oai_identifier_str	oai:isabial.fundanetsuite.com:p6785
network_acronym_str	ES
network_name_str	España
repository_id_str
spelling	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).Pierrotti LCPérez-Nadales EFernández-Ruiz MGutiérrez-Gutiérrez BHock Tan BCarratalà JOriol IPaul MCohen-Sinai NLópez-Medrano FSan-Juan RMontejo MFreire MPCordero EDavid MDMerino EMehta Steinke SGrossi PACano ÁSeminari EMValerio MGunseren FRana MMularoni AMartín-Dávila Pvan Delden CHamiyet Demirkaya MKoçak Tufan ZLoeches BIyer RNSoldani FEriksson BMPilmis BRizzi MCoussement JClemente WTRoilides EPascual ÁMartínez-Martínez LRodríguez-Baño JTorre-Cisneros JMaría Aguado JInvestigators from the REIPI/INCREMENT-SOT Groupbloodstream infectioncarbapenem-sparing regimenextended-spectrum ß-lactamase-producing Enterobacteraleskidney transplantationoutcomesurinary tract infectionBACKGROUND: Whether active therapy with ß-lactam/ß-lactamase inhibitors (BLBLI) is as affective as carbapenems for extended-spectrum ß-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).Blackwell Publishing Inc.2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones6785TRANSPLANT INFECTIOUS DISEASEISSN: 13993062ISSNe: 13982273reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p67852026-06-12T10:20:37Z
dc.title.none.fl_str_mv	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
title	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
spellingShingle	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project). Pierrotti LC bloodstream infection carbapenem-sparing regimen extended-spectrum ß-lactamase-producing Enterobacterales kidney transplantation outcomes urinary tract infection
title_short	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
title_full	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
title_fullStr	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
title_full_unstemmed	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
title_sort	Efficacy of ß-lactam/ß-lactamase inhibitors to treat extended-spectrum beta-lactamase-producing Enterobacterales bacteremia secondary to urinary tract infection in kidney transplant recipients (INCREMENT-SOT Project).
dc.creator.none.fl_str_mv	Pierrotti LC Pérez-Nadales E Fernández-Ruiz M Gutiérrez-Gutiérrez B Hock Tan B Carratalà J Oriol I Paul M Cohen-Sinai N López-Medrano F San-Juan R Montejo M Freire MP Cordero E David MD Merino E Mehta Steinke S Grossi PA Cano Á Seminari EM Valerio M Gunseren F Rana M Mularoni A Martín-Dávila P van Delden C Hamiyet Demirkaya M Koçak Tufan Z Loeches B Iyer RN Soldani F Eriksson BM Pilmis B Rizzi M Coussement J Clemente WT Roilides E Pascual Á Martínez-Martínez L Rodríguez-Baño J Torre-Cisneros J María Aguado J Investigators from the REIPI/INCREMENT-SOT Group
author	Pierrotti LC
author_facet	Pierrotti LC Pérez-Nadales E Fernández-Ruiz M Gutiérrez-Gutiérrez B Hock Tan B Carratalà J Oriol I Paul M Cohen-Sinai N López-Medrano F San-Juan R Montejo M Freire MP Cordero E David MD Merino E Mehta Steinke S Grossi PA Cano Á Seminari EM Valerio M Gunseren F Rana M Mularoni A Martín-Dávila P van Delden C Hamiyet Demirkaya M Koçak Tufan Z Loeches B Iyer RN Soldani F Eriksson BM Pilmis B Rizzi M Coussement J Clemente WT Roilides E Pascual Á Martínez-Martínez L Rodríguez-Baño J Torre-Cisneros J María Aguado J Investigators from the REIPI/INCREMENT-SOT Group
author_role	author
author2	Pérez-Nadales E Fernández-Ruiz M Gutiérrez-Gutiérrez B Hock Tan B Carratalà J Oriol I Paul M Cohen-Sinai N López-Medrano F San-Juan R Montejo M Freire MP Cordero E David MD Merino E Mehta Steinke S Grossi PA Cano Á Seminari EM Valerio M Gunseren F Rana M Mularoni A Martín-Dávila P van Delden C Hamiyet Demirkaya M Koçak Tufan Z Loeches B Iyer RN Soldani F Eriksson BM Pilmis B Rizzi M Coussement J Clemente WT Roilides E Pascual Á Martínez-Martínez L Rodríguez-Baño J Torre-Cisneros J María Aguado J Investigators from the REIPI/INCREMENT-SOT Group
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	bloodstream infection carbapenem-sparing regimen extended-spectrum ß-lactamase-producing Enterobacterales kidney transplantation outcomes urinary tract infection
topic	bloodstream infection carbapenem-sparing regimen extended-spectrum ß-lactamase-producing Enterobacterales kidney transplantation outcomes urinary tract infection
description	BACKGROUND: Whether active therapy with ß-lactam/ß-lactamase inhibitors (BLBLI) is as affective as carbapenems for extended-spectrum ß-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).
publishDate	2021
dc.date.none.fl_str_mv	2021
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://isabial.portalinvestigacion.com/publicaciones6785
url	https://isabial.portalinvestigacion.com/publicaciones6785
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	Blackwell Publishing Inc.
publisher.none.fl_str_mv	Blackwell Publishing Inc.
dc.source.none.fl_str_mv	TRANSPLANT INFECTIOUS DISEASE ISSN: 13993062 ISSNe: 13982273 reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_	1869404913808703488
score	15.811543

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

Similares en LA Referencia