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• W3011570757 abstract "Abstract Background Approximately 40% of all Enterobacterales (EB) bloodstream infections (BSIs) among solid organ transplant recipients (SOTRs) are due to extended-spectrum β-lactamase (ESBL)–producing organisms, but risk factors for such infections remain ill defined in this population. We sought to determine the risk factors for ESBL-EB BSIs among SOTRs. Methods A multicenter case-control study was performed. All SOTRs with an EB BSI at the Hospital of the University of Pennsylvania and University of Maryland Medical Center between 1 January 2007 and 30 June 2018 and at The Johns Hopkins Hospital between 1 January 2005 and 31 December 2015 were included. Cases were those with an ESBL-EB BSI. Controls were those with a non–ESBL-EB BSI. Multivariable logistic regression was performed to determine risk factors for ESBL-EB BSI. Results There were 988 episodes of EB BSI, of which 395 (40%) were due to an ESBL-EB. On multivariable analysis, the independent risk factors for ESBL-EB BSI included: ESBL-EB on prior culture (aOR, 12.75; 95% CI, 3.23–50.33; P &lt; .001), a corticosteroid-containing immunosuppression regimen (aOR 1.30; 95% CI 1.03–1.65; P = .030), acute rejection treated with corticosteroids (aOR 1.18; 95% CI 1.16–1.19; P &lt; .001), and exposure to third-generation cephalosporins (aOR 1.95; 95% CI 1.48–2.57; P &lt; .001), echinocandins (aOR 1.61; 95% CI 1.08–2.40; P = .020), and trimethoprim-sulfamethoxazole (aOR 1.35; 95% CI 1.10–1.64; P = .003). Conclusions We identified several novel risk factors that are uniquely important to the SOTR population, including exposure to trimethoprim-sulfamethoxazole and corticosteroid-containing immunosuppressive regimens. Further studies exploring these associations and testing interventions aimed at these modifiable risk factors among SOTRs are needed." @default.
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• W3011570757 date "2020-02-28" @default.
• W3011570757 modified "2023-10-18" @default.
• W3011570757 title "Risk Factors for Extended-Spectrum β-lactamase–Producing Enterobacterales Bloodstream Infection Among Solid-Organ Transplant Recipients" @default.
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• W3011570757 doi "https://doi.org/10.1093/cid/ciaa190" @default.
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