RT Journal Article
T1 Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing Enterobacterales in Kidney Transplant Recipients
A1 Gutierrez-Gutierrez, Belen
A1 Perez-Nadales, Elena
A1 Perez-Galera, Salvador
A1 Fernandez-Ruiz, Mario
A1 Carratala, Jordi
A1 Oriol, Isabel
A1 Cordero, Elisa
A1 Antonio Lepe, Jose
A1 Tan, Ban Hock
A1 Corbella, Laura
A1 Paul, Mical
A1 Natera, Alejandra M.
A1 David, Miruna D.
A1 Montejo, Miguel
A1 Iyer, Ranganathan N.
A1 Pierrotti, Ligia Camera
A1 Merino, Esperanza
A1 Steinke, Seema Mehta
A1 Rana, Meenakshi M.
A1 Munoz, Patricia
A1 Mularoni, Alessandra
A1 van Delden, Christian
A1 Grossi, Paolo Antonio
A1 Seminari, Elena Maria
A1 Gunseren, Filiz
A1 Lease, Erika D.
A1 Roilides, Emmanuel
A1 Fortun, Jesus
A1 Arslan, Hande
A1 Coussement, Julien
A1 Tufan, Zeliha Kocak
A1 Pilmis, Benoit
A1 Rizzi, Marco
A1 Loeches, Belen
A1 Eriksson, Britt Marie
A1 Abdala, Edson
A1 Soldani, Fabio
A1 Lowman, Warren
A1 Clemente, Wanessa Trindade
A1 Bodro, Marta
A1 Carmen Farinas, Maria
A1 Kazak, Esra
A1 Martinez-Martinez, Luis
A1 Maria Aguado, Jose
A1 Torre-Cisneros, Julian
A1 Pascual, Alvaro
A1 Rodriguez-Bano, Jesus
A1 Investigators REIPI ESGICH ESGBIS, 
K1 ertapenem
K1 extended-spectrum-beta-lactamase-producing Enterobacterales
K1 ESBL-E
K1 urinary tract infection
K1 UTI
K1 bloodstream infection
K1 BSI
K1 kidney transplant
K1 Blood-stream infections
K1 Pseudomonas-aeruginosa
K1 Escherichia-coli
K1 Klebsiella-pneumoniae
K1 Susceptibility
K1 Carbapenems
K1 Resistance
K1 Definitions
K1 Impact
K1 Smart
AB There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22; P = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29; P = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.
PB Amer soc microbiology
SN 0066-4804
YR 2021
FD 2021-10-01
LK https://hdl.handle.net/10668/25535
UL https://hdl.handle.net/10668/25535
LA en
DS RISalud
RD Apr 17, 2025