Prediction models for carbapenem-resistant Enterobacterales carriage at liver transplantation: A multicenter retrospective study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFREIRE, Maristela Pinheiro
dc.contributor.authorRINALDI, Matteo
dc.contributor.authorTERRABUIO, Debora Raquel Benedita
dc.contributor.authorFURTADO, Mariane
dc.contributor.authorPASQUINI, Zeno
dc.contributor.authorBARTOLETTI, Michele
dc.contributor.authorOLIVEIRA, Tiago Almeida de
dc.contributor.authorNUNES, Nathalia Neves
dc.contributor.authorLEMOS, Gabriela Takeshigue
dc.contributor.authorMACCARO, Angelo
dc.contributor.authorSINISCALCHI, Antonio
dc.contributor.authorLAICI, Cristiana
dc.contributor.authorCESCON, Matteo
dc.contributor.authorDT'ALBUQUERQUE, Luiz Augusto Carneiro
dc.contributor.authorMORELLI, Maria Cristina
dc.contributor.authorSONG, Alice T. W.
dc.contributor.authorABDALA, Edson
dc.contributor.authorVIALE, Pierluigi
dc.contributor.authorCHIAVEGATTO FILHO, Alexandre Dias Porto
dc.contributor.authorGIANNELLA, Maddalena
dc.date.accessioned2023-02-23T14:54:09Z
dc.date.available2023-02-23T14:54:09Z
dc.date.issued2022
dc.description.abstractBackground: Carbapenem-resistant Enterobacterales (CRE) colonisation at liver transplantation (LT) increases the risk of CRE infection after LT, which impacts on recipients' survival. Colonization status usually becomes evident only near LT. Thus, predictive models can be useful to guide antibiotic prophylaxis in endemic centres. Aims: This study aimed to identify risk factors for CRE colonisation at LT in order to build a predictive model. Methods: Retrospective multicentre study including consecutive adult patients who underwent LT, from 2010 to 2019, at two large teaching hospitals. We excluded patients who had CRE infections within 90 days before LT. CRE screening was performed in all patients on the day of LT. Exposure variables were considered within 90 days before LT and included cirrhosis complications, underlying disease, time on the waiting list, MELD and CLIF-SOFA scores, antibiotic use, intensive care unit and hospital stay, and infections. A machine learning model was trained to detect the probability of a patient being colonized with CRE at LT. Results: A total of 1544 patients were analyzed, 116 (7.5%) patients were colonized by CRE at LT. The median time from CRE isolation to LT was 5 days. Use of antibiotics, hepato-renal syndrome, worst CLIF sofa score, and use of beta-lactam/beta-lactamase inhibitor increased the probability of a patient having pre-LT CRE. The proposed algorithm had a sensitivity of 66% and a specificity of 83% with a negative predictive value of 97%. Conclusions: We created a model able to predict CRE colonization at LT based on easyto-obtain features that could guide antibiotic prophylaxiseng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationTRANSPLANT INFECTIOUS DISEASE, v.24, n.6, article ID e13920, 11p, 2022
dc.identifier.doi10.1111/tid.13920
dc.identifier.eissn1399-3062
dc.identifier.issn1398-2273
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/51500
dc.language.isoeng
dc.publisherWILEYeng
dc.relation.ispartofTransplant Infectious Disease
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright WILEYeng
dc.subjectcarbapenem-resistanceeng
dc.subjectCLIF-SOFA scoreeng
dc.subjectmachine learningeng
dc.subjectperitonitis prophylaxiseng
dc.subjectprediction modeleng
dc.subject.otherprophylaxiseng
dc.subject.otherinfectionseng
dc.subject.wosImmunologyeng
dc.subject.wosInfectious Diseaseseng
dc.subject.wosTransplantationeng
dc.titlePrediction models for carbapenem-resistant Enterobacterales carriage at liver transplantation: A multicenter retrospective studyeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisoit
hcfmusp.author.externalRINALDI, Matteo:Univ Bologna, Dept Med & Surg Sci, Infect Dis Unit, Policlin St Orsola Malpighi, Bologna, Italy
hcfmusp.author.externalFURTADO, Mariane:Univ Sao Paulo, Sch Publ Hlth, Sao Paulo, Brazil
hcfmusp.author.externalPASQUINI, Zeno:Univ Bologna, Dept Med & Surg Sci, Infect Dis Unit, Policlin St Orsola Malpighi, Bologna, Italy
hcfmusp.author.externalBARTOLETTI, Michele:Univ Bologna, Dept Med & Surg Sci, Infect Dis Unit, Policlin St Orsola Malpighi, Bologna, Italy
hcfmusp.author.externalOLIVEIRA, Tiago Almeida de:Univ Sao Paulo, Sch Publ Hlth, Sao Paulo, Brazil; Paraiba State Univ Paraiba, Stat Dept, Campina Grande, Paraiba, Brazil
hcfmusp.author.externalMACCARO, Angelo:Univ Bologna, Dept Med & Surg Sci, Infect Dis Unit, Policlin St Orsola Malpighi, Bologna, Italy
hcfmusp.author.externalSINISCALCHI, Antonio:Univ Bologna, St Orsola Malpighi Hosp, Dept Gen Surg & Transplantat, Bologna, Italy
hcfmusp.author.externalLAICI, Cristiana:Univ Bologna, St Orsola Malpighi Hosp, Dept Gen Surg & Transplantat, Bologna, Italy
hcfmusp.author.externalCESCON, Matteo:Univ Bologna, Dept Med & Surg Sci, Bologna, Emilia Romagna, Italy
hcfmusp.author.externalMORELLI, Maria Cristina:Univ Bologna, St Orsola Malpighi Hosp, Dept Gen Surg & Transplantat, Bologna, Italy
hcfmusp.author.externalSONG, Alice T. W.:Univ Bologna, Dept Med & Surg Sci, Bologna, Emilia Romagna, Italy
hcfmusp.author.externalVIALE, Pierluigi:Univ Bologna, Policlin St Orsola, Infect Dis Unit, IRCCS Azienda Osped, Bologna, Italy
hcfmusp.author.externalCHIAVEGATTO FILHO, Alexandre Dias Porto:Univ Sao Paulo, Sch Publ Hlth, Sao Paulo, Brazil
hcfmusp.author.externalGIANNELLA, Maddalena:Univ Bologna, Policlin St Orsola, Infect Dis Unit, IRCCS Azienda Osped, Bologna, Italy
hcfmusp.citation.scopus4
hcfmusp.contributor.author-fmusphcMARISTELA PINHEIRO FREIRE
hcfmusp.contributor.author-fmusphcDEBORA RAQUEL BENEDITA TERRABUIO
hcfmusp.contributor.author-fmusphcNATHALIA NEVES NUNES
hcfmusp.contributor.author-fmusphcGABRIELA TAKESHIGUE LEMOS
hcfmusp.contributor.author-fmusphcLUIZ AUGUSTO CARNEIRO D ALBUQUERQUE
hcfmusp.contributor.author-fmusphcEDSON ABDALA
hcfmusp.description.articlenumbere13920
hcfmusp.description.issue6
hcfmusp.description.volume24
hcfmusp.origemWOS
hcfmusp.origem.pubmed35942941
hcfmusp.origem.scopus2-s2.0-85135567941
hcfmusp.origem.wosWOS:000837627200001
hcfmusp.publisher.cityHOBOKENeng
hcfmusp.publisher.countryUSAeng
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