Carbapenem-resistant Enterobacterales in solid organ transplant recipients

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; Susan Richter; Deverick J. Anderson; Beth Evans; Heather R. Cross; Keri Baum; Rebekka Arias; Vance G. Fowler; Karen Ordoñez; Jesse T. Jacob; Linghua Li; Barry N. Kreiswirth; Claudia Manca; Samit Desai; Erica Herc; Ezequiel Cordova; Maria Rioseco; Samuel Vichez; Marisa L. Sanchez; Sandra Valderrama; Jairo Figueroa; An Q. Dinh; Diane Panesso; Kirsten Rydell; Truc T. Tran; Fupin Hu; Jiachun Su; Blake Hanson

doi:10.1016/j.ajt.2024.10.020

Carbapenem-resistant Enterobacterales in solid organ transplant recipients

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. LokRobert A. Salata, Martin Stryjewski, Valentina Di Castelnuovo, Jose Millan Oñate Gutierrez, Susan Richter, Deverick J. Anderson, Beth Evans, Heather R. Cross, Keri Baum, Rebekka Arias, Vance G. Fowler, Karen Ordoñez, Jesse T. Jacob, Linghua Li, Barry N. Kreiswirth, Claudia Manca, Samit Desai, Erica Herc, Ezequiel Cordova, Maria Rioseco, Samuel Vichez, Marisa L. Sanchez, Sandra Valderrama, Jairo Figueroa, An Q. Dinh, Diane Panesso, Kirsten Rydell, Truc T. Tran, Fupin Hu, Jiachun Su, Blake Hanson

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English (US)
Journal	American Journal of Transplantation
DOIs	https://doi.org/10.1016/j.ajt.2024.10.020
State	E-pub ahead of print - Nov 2024

Keywords

carbapenem-resistant Enterobacterales
epidemiology
mortality
solid organ transplantation

ASJC Scopus subject areas

Immunology and Allergy
Transplantation
Pharmacology (medical)

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10.1016/j.ajt.2024.10.020

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Boutzoukas, A. E., Dai, W., Cober, E., Abbo, L. M., Komarow, L., Chen, L., Hill, C., Satlin, M. J., Grant, M., Fries, B. C., Patel, G., McCarty, T. P., Arias, C. A., Bonomo, R. A., van Duin, D., Antibacterial Resistance Leadership Group and the MDRO Network Investigators, Kanj, S. S., Francois (Jeff) Jabbour, J., Zhang, F., ... Hanson, B. (2024). Carbapenem-resistant Enterobacterales in solid organ transplant recipients. American Journal of Transplantation. Advance online publication. https://doi.org/10.1016/j.ajt.2024.10.020

Boutzoukas, AE, Dai, W, Cober, E, Abbo, LM, Komarow, L, Chen, L, Hill, C, Satlin, MJ, Grant, M, Fries, BC, Patel, G, McCarty, TP, Arias, CA, Bonomo, RA, van Duin, D, Antibacterial Resistance Leadership Group and the MDRO Network Investigators, Kanj, SS, Francois (Jeff) Jabbour, J, Zhang, F, Lok, JJ, Salata, RA, Stryjewski, M, Di Castelnuovo, V, Oñate Gutierrez, JM, Richter, S, Anderson, DJ, Evans, B, Cross, HR, Baum, K, Arias, R, Fowler, VG, Ordoñez, K, Jacob, JT, Li, L, Kreiswirth, BN, Manca, C, Desai, S, Herc, E, Cordova, E, Rioseco, M, Vichez, S, Sanchez, ML, Valderrama, S, Figueroa, J, Dinh, AQ, Panesso, D, Rydell, K, Tran, TT, Hu, F, Su, J & Hanson, B 2024, 'Carbapenem-resistant Enterobacterales in solid organ transplant recipients', American Journal of Transplantation. https://doi.org/10.1016/j.ajt.2024.10.020

@article{24706ceeaa23467f83771321572e1ffc,

title = "Carbapenem-resistant Enterobacterales in solid organ transplant recipients",

abstract = "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.",

keywords = "carbapenem-resistant Enterobacterales, epidemiology, mortality, solid organ transplantation",

author = "Boutzoukas, {Angelique E.} and Weixiao Dai and Eric Cober and Abbo, {Lilian M.} and Lauren Komarow and Liang Chen and Carol Hill and Satlin, {Michael J.} and Matthew Grant and Fries, {Bettina C.} and Gopi Patel and McCarty, {Todd P.} and Arias, {Cesar A.} and Bonomo, {Robert A.} and {van Duin}, David and {Antibacterial Resistance Leadership Group and the MDRO Network Investigators} and Kanj, {Souha S.} and {Francois (Jeff) Jabbour}, Jean and Fujie Zhang and Lok, {Judith J.} and Salata, {Robert A.} and Martin Stryjewski and {Di Castelnuovo}, Valentina and {O{\~n}ate Gutierrez}, {Jose Millan} and Susan Richter and Anderson, {Deverick J.} and Beth Evans and Cross, {Heather R.} and Keri Baum and Rebekka Arias and Fowler, {Vance G.} and Karen Ordo{\~n}ez and Jacob, {Jesse T.} and Linghua Li and Kreiswirth, {Barry N.} and Claudia Manca and Samit Desai and Erica Herc and Ezequiel Cordova and Maria Rioseco and Samuel Vichez and Sanchez, {Marisa L.} and Sandra Valderrama and Jairo Figueroa and Dinh, {An Q.} and Diane Panesso and Kirsten Rydell and Tran, {Truc T.} and Fupin Hu and Jiachun Su and Blake Hanson",

note = "Publisher Copyright: {\textcopyright} 2024 American Society of Transplantation & American Society of Transplant Surgeons",

year = "2024",

month = nov,

doi = "10.1016/j.ajt.2024.10.020",

language = "English (US)",

journal = "American Journal of Transplantation",

issn = "1600-6135",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Carbapenem-resistant Enterobacterales in solid organ transplant recipients

AU - Boutzoukas, Angelique E.

AU - Dai, Weixiao

AU - Cober, Eric

AU - Abbo, Lilian M.

AU - Komarow, Lauren

AU - Chen, Liang

AU - Hill, Carol

AU - Satlin, Michael J.

AU - Grant, Matthew

AU - Fries, Bettina C.

AU - Patel, Gopi

AU - McCarty, Todd P.

AU - Arias, Cesar A.

AU - Bonomo, Robert A.

AU - van Duin, David

AU - Antibacterial Resistance Leadership Group and the MDRO Network Investigators

AU - Kanj, Souha S.

AU - Francois (Jeff) Jabbour, Jean

AU - Zhang, Fujie

AU - Lok, Judith J.

AU - Salata, Robert A.

AU - Stryjewski, Martin

AU - Di Castelnuovo, Valentina

AU - Oñate Gutierrez, Jose Millan

AU - Richter, Susan

AU - Anderson, Deverick J.

AU - Evans, Beth

AU - Cross, Heather R.

AU - Baum, Keri

AU - Arias, Rebekka

AU - Fowler, Vance G.

AU - Ordoñez, Karen

AU - Jacob, Jesse T.

AU - Li, Linghua

AU - Kreiswirth, Barry N.

AU - Manca, Claudia

AU - Desai, Samit

AU - Herc, Erica

AU - Cordova, Ezequiel

AU - Rioseco, Maria

AU - Vichez, Samuel

AU - Sanchez, Marisa L.

AU - Valderrama, Sandra

AU - Figueroa, Jairo

AU - Dinh, An Q.

AU - Panesso, Diane

AU - Rydell, Kirsten

AU - Tran, Truc T.

AU - Hu, Fupin

AU - Su, Jiachun

AU - Hanson, Blake

PY - 2024/11

Y1 - 2024/11

N2 - 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.

AB - 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.

KW - carbapenem-resistant Enterobacterales

KW - epidemiology

KW - mortality

KW - solid organ transplantation

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UR - http://www.scopus.com/inward/citedby.url?scp=85210271978&partnerID=8YFLogxK

U2 - 10.1016/j.ajt.2024.10.020

DO - 10.1016/j.ajt.2024.10.020

M3 - Article

C2 - 39522694

AN - SCOPUS:85210271978

SN - 1600-6135

JO - American Journal of Transplantation

JF - American Journal of Transplantation

ER -

Carbapenem-resistant Enterobacterales in solid organ transplant recipients

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Keywords

ASJC Scopus subject areas

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