Gutiérrez-Gutiérrez, BelénPérez-Nadales, ElenaPérez-Galera, SalvadorFernández-Ruiz, MarioCarratalà, JordiOriol, IsabelCordero, ElisaLepe, José AntonioTan, Ban HockCorbella, LauraPaul, MicalNatera, Alejandra MDavid, Miruna DMontejo, MiguelIyer, Ranganathan NPierrotti, Ligia CameraMerino, EsperanzaSteinke, Seema MehtaRana, Meenakshi MMuñoz, PatriciaMularoni, Alessandravan Delden, ChristianGrossi, Paolo AntonioSeminari, Elena MaríaGunseren, FilizLease, Erika DRoilides, EmmanuelFortún, JesúsArslan, HandeCoussement, JulienTufan, Zeliha KoçakPilmis, BenoitRizzi, MarcoLoeches, BelénEriksson, Britt MarieAbdala, EdsonSoldani, FabioLowman, WarrenClemente, Wanessa TrindadeBodro, MartaFariñas, María CarmenKazak, EsraMartínez-Martínez, LuisAguado, José MaríaTorre-Cisneros, JuliánPascual, ÁlvaroRodríguez-Baño, JesúsInvestigators from the REIPI/ESGICH/ESGBIS/INCREMENT-SOT Group2025-01-072025-01-072021-08-09https://hdl.handle.net/10668/25533There 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.enBSIESBL-EUTIbloodstream infectionertapenemextended-spectrum-β-lactamase-producing Enterobacteraleskidney transplanturinary tract infectionAnti-Bacterial AgentsBacteremiaCohort StudiesErtapenemHumansKidney TransplantationPropensity ScoreRetrospective StudiesUrinary Tract Infectionsbeta-Lactamasesresearch article34370578open access10.1128/AAC.01102-211098-6596PMC8522723https://digital.csic.es/bitstream/10261/269737/1/Kidney_Transplant_Recipients.pdfhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8522723/pdf