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Carbapenem-resistant Enterobacterales in solid organ transplant recipients
American Journal of Transplantation ( IF 8.9 ) Pub Date : 2024-11-09 , DOI: 10.1016/j.ajt.2024.10.020 Angelique E. Boutzoukas, Weixiao Dai, Eric Cober, Lilian M. Abbo, Lauren Komarow, Liang Chen, Carol Hill, Michael J. Satlin, Matthew Grant, Bettina C. Fries, Gopi Patel, Todd P. McCarty, Cesar A. Arias, Robert A. Bonomo, David van Duin, Antibacterial Resistance Leadership Group and the MDRO Network Investigators, Souha S. Kanj, Jean Francois (Jeff) Jabbour, Fujie Zhang, Judith J. Lok, Robert A. Salata, Martin Stryjewski, Valentina Di Castelnuovo, Jose Millan Oñate Gutierrez, Eric Cober, Susan Richter, Deverick J. Anderson, Beth Evans, Carol Hill, Heather R. Cross, Keri Baum, Rebekka Arias, Vance G. Fowler Jr., Karen Ordoñez, Jesse T. Jacob, Linghua Li, Barry N. Kreiswirth, Claudia Manca, Liang Chen, Samit Desai, Erica Herc, Ezequiel Cordova, Maria Rioseco, Samuel Vichez, Marisa L. Sanchez, Sandra Valderrama, Jairo Figueroa, Cesar A. Arias, An Q. Dinh, Diane Panesso, Kirsten Rydell, Truc T. Tran, Fupin Hu, Jiachun Su, Jianping Jiang, Minggui Wang, Xiaogang Xu, Yang Yang, Jose M. Munita, Maria Spencer, Thamer Alenazi, Robert A. Bonomo, Steven H. Marshall, Susan D. Rudin, Charles Huskins, Kerry, Robin Patel, Suzannah Schmidt-Malan, Sara Revolinski, Glenn Wortmann, Robert C. Kalayjian, Greg Weston, Belinda Ostrowsky, Gopi Patel, Daniel Eiras, Angela Kim, Julia Garcia-Diaz, Soraya Salcedo, John J. Farrell, Zhengyin Liu, Andrew Henderson, David L. Paterson, Qing Xie, Keith S. Kaye, Hainv Gao, Yunsong Yu, Mary Waters, Bettina C. Fries, Brandon Eilertson, Kalisvar Marimuthu, Kean Lee Chew, Nares Smitasin, Paul Ananth Tambyah, Jason C. Gallagher, Anton Peleg, Marcel Leroi, Lanjuan Li, Lauren Komarow, Lizhao Ge, Scott Evans, Todd McCarty, Henry F. Chambers, Omai B. Garner, Lilian M. Abbo, David van Duin, Ebbing Lautenbach, Jennifer H. Han, Yohei Doi, Darren Wong, Blake Hanson, Jinnethe Reyes, Maria Virginia Villegas Botero, Lorena Diaz, Federico Perez, Ritu Banerjee, Sorabh Dhar, Michael J. Satlin, Zhiyong Zong
American Journal of Transplantation ( IF 8.9 ) Pub Date : 2024-11-09 , DOI: 10.1016/j.ajt.2024.10.020 Angelique E. Boutzoukas, Weixiao Dai, Eric Cober, Lilian M. Abbo, Lauren Komarow, Liang Chen, Carol Hill, Michael J. Satlin, Matthew Grant, Bettina C. Fries, Gopi Patel, Todd P. McCarty, Cesar A. Arias, Robert A. Bonomo, David van Duin, Antibacterial Resistance Leadership Group and the MDRO Network Investigators, Souha S. Kanj, Jean Francois (Jeff) Jabbour, Fujie Zhang, Judith J. Lok, Robert A. Salata, Martin Stryjewski, Valentina Di Castelnuovo, Jose Millan Oñate Gutierrez, Eric Cober, Susan Richter, Deverick J. Anderson, Beth Evans, Carol Hill, Heather R. Cross, Keri Baum, Rebekka Arias, Vance G. Fowler Jr., Karen Ordoñez, Jesse T. Jacob, Linghua Li, Barry N. Kreiswirth, Claudia Manca, Liang Chen, Samit Desai, Erica Herc, Ezequiel Cordova, Maria Rioseco, Samuel Vichez, Marisa L. Sanchez, Sandra Valderrama, Jairo Figueroa, Cesar A. Arias, An Q. Dinh, Diane Panesso, Kirsten Rydell, Truc T. Tran, Fupin Hu, Jiachun Su, Jianping Jiang, Minggui Wang, Xiaogang Xu, Yang Yang, Jose M. Munita, Maria Spencer, Thamer Alenazi, Robert A. Bonomo, Steven H. Marshall, Susan D. Rudin, Charles Huskins, Kerry, Robin Patel, Suzannah Schmidt-Malan, Sara Revolinski, Glenn Wortmann, Robert C. Kalayjian, Greg Weston, Belinda Ostrowsky, Gopi Patel, Daniel Eiras, Angela Kim, Julia Garcia-Diaz, Soraya Salcedo, John J. Farrell, Zhengyin Liu, Andrew Henderson, David L. Paterson, Qing Xie, Keith S. Kaye, Hainv Gao, Yunsong Yu, Mary Waters, Bettina C. Fries, Brandon Eilertson, Kalisvar Marimuthu, Kean Lee Chew, Nares Smitasin, Paul Ananth Tambyah, Jason C. Gallagher, Anton Peleg, Marcel Leroi, Lanjuan Li, Lauren Komarow, Lizhao Ge, Scott Evans, Todd McCarty, Henry F. Chambers, Omai B. Garner, Lilian M. Abbo, David van Duin, Ebbing Lautenbach, Jennifer H. Han, Yohei Doi, Darren Wong, Blake Hanson, Jinnethe Reyes, Maria Virginia Villegas Botero, Lorena Diaz, Federico Perez, Ritu Banerjee, Sorabh Dhar, Michael J. Satlin, Zhiyong Zong
Carbapenem-resistant Enterobacterales (CRE) are an important threat to the health of solid organ transplant recipients (SOTr); data comparing outcomes of SOTr with CRE to non-SOTr with CRE are lacking. A matched cohort study was performed within 2 prospective, multicenter, cohort studies (Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacterales and Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacterales 2). The epidemiology, desirability of outcome rankings outcomes, and mortality of SOTr and non-SOTr hospitalized in the United States (December 2011-August 2017) with clinical isolates with Centers for Disease Control and Prevention-defined CRE were compared. In total, 121 SOTr and 242 matched non-SOTr were included. Fifty-one percent of isolates met infection criteria. SOTr were younger (P < .001), less acutely ill (P = .029), less often had a malignancy history (P = .006), and more often were admitted from home (P < .001) than non-SOTr. SOTr had more favorable adjusted desirability of outcome rankings outcomes; a randomly selected SOTr had a 58% (95% confidence interval, 53%-64%) probability of a better outcome as compared to a randomly selected non-SOTr. All-cause 30-day mortality was 14% (17/121) in SOTr vs 25% (60/242) in non-SOTr, P = .018. After stabilized inverse probability weighted adjustment, SOTr had a 7% lower 30-day mortality risk than non-SOTr (95% confidence interval, –15% to 1%). SOTr with CRE do not have worse outcomes than matched patients without transplant history.
中文翻译：
实体器官移植受者中碳青霉烯类耐药肠杆菌
耐碳青霉烯类肠杆菌 （CRE） 是对实体器官移植受者 （SOTr） 健康的重要威胁;缺乏比较 SOTr 伴 CRE 与非 SOTr 伴 CRE 结局的数据。在 2 项前瞻性、多中心、队列研究 （克雷伯菌和其他肠杆菌对碳青霉烯类耐药性联盟和克雷伯氏菌和其他肠杆菌类对碳青霉烯类耐药性联盟 2） 中进行匹配的队列研究。比较了在美国住院 （2011 年 12 月至 2017 年 8 月） 的 SOTr 和非 SOTr 与疾病控制和预防中心定义的 CRE 的临床分离株的流行病学、结果排序结果的可取性和死亡率。总共包括 121 个 SOTr 和 242 个匹配的非 SOTr。51% 的分离株符合感染标准。与非 SOTr 相比，SOTr 更年轻 （P < .001），病情较轻 （P = .029），有恶性肿瘤病史的可能性较小 （P = .006），并且更常从家中入院 （P < .001）。SOTr 对结果排名结果的调整后可取性更有利;与随机选择的非 SOTr 相比，随机选择的 SOTr 有 58% （95% 置信区间，53%-64%） 的结局概率更好。SOTr 的全因 30 天死亡率为 14% （17/121），非 SOTr 为 25% （60/242），P = .018。在稳定的逆概率加权调整后，SOTr 的 30 天死亡风险比非 SOTr 低 7%（95% 置信区间，-15% 至 1%）。患有 CRE 的 SOTr 的结果并不比没有移植史的匹配患者差。
更新日期：2024-11-09
中文翻译：
实体器官移植受者中碳青霉烯类耐药肠杆菌
耐碳青霉烯类肠杆菌 （CRE） 是对实体器官移植受者 （SOTr） 健康的重要威胁;缺乏比较 SOTr 伴 CRE 与非 SOTr 伴 CRE 结局的数据。在 2 项前瞻性、多中心、队列研究 （克雷伯菌和其他肠杆菌对碳青霉烯类耐药性联盟和克雷伯氏菌和其他肠杆菌类对碳青霉烯类耐药性联盟 2） 中进行匹配的队列研究。比较了在美国住院 （2011 年 12 月至 2017 年 8 月） 的 SOTr 和非 SOTr 与疾病控制和预防中心定义的 CRE 的临床分离株的流行病学、结果排序结果的可取性和死亡率。总共包括 121 个 SOTr 和 242 个匹配的非 SOTr。51% 的分离株符合感染标准。与非 SOTr 相比，SOTr 更年轻 （P < .001），病情较轻 （P = .029），有恶性肿瘤病史的可能性较小 （P = .006），并且更常从家中入院 （P < .001）。SOTr 对结果排名结果的调整后可取性更有利;与随机选择的非 SOTr 相比，随机选择的 SOTr 有 58% （95% 置信区间，53%-64%） 的结局概率更好。SOTr 的全因 30 天死亡率为 14% （17/121），非 SOTr 为 25% （60/242），P = .018。在稳定的逆概率加权调整后，SOTr 的 30 天死亡风险比非 SOTr 低 7%（95% 置信区间，-15% 至 1%）。患有 CRE 的 SOTr 的结果并不比没有移植史的匹配患者差。
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