Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation

Autores
Herrera, Fabián; Torres, Diego; Laborde, Ana; Berruezo, Lorena; Jordán, Rosana; Roccia Rossi, Inés; Valledor, Alejandra; Costantini, Patricia; Dictar, Miguel; Nenna, Andrea; Pereyra, María Laura; Lambert, Sandra; Benso, José; Poletta, Fernando Adrián; Gonzalez Ibañez, María Luz; Baldoni, Nadia; Eusebio, María José; Lovano, Fiorella; Barcán, Laura; Luck, Martín; Racioppi, Agustina; Tula, Lucas Fernando; Pasterán, Fernando; Corso, Alejandra; Rapoport, Melina; Nicola, Federico; García Damiano, María Cristina; Carbone, Ruth; Monge, Renata; Reynaldi, Mariana; Greco, Graciela; Bronzi, Marcelo; Valle, Sandra; Chaves, María Laura; Vilches, Viviana; Blanco, Miriam Edith; Carena, Alberto Ángel
Año de publicación
2023
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Identifying the risk factors for carbapenem-resistant Enterobacterales (CRE) bacteremia in cancer and hematopoietic stem cell transplantation (HSCT) patients would allow earlier initiation of an appropriate empirical antibiotic treatment. This is a prospective multicenter observational study in patients from 12 centers in Argentina, who presented with cancer or hematopoietic stem-cell transplant and developed Enterobacterales bacteremia. A multiple logistic regression model identified risk factors for CRE bacteremia, and a score was developed according to the regression coefficient. This was validated by the bootstrap resampling technique. Four hundred and forty-three patients with Enterobacterales bacteremia were included: 59 with CRE and 384 with carbapenem-susceptible Enterobacterales (CSE). The risk factors that were identified and the points assigned to each of them were: ≥10 days of hospitalization until bacteremia: OR 4.03, 95% CI 1.88–8.66 (2 points); previous antibiotics > 7 days: OR 4.65, 95% CI 2.29–9.46 (2 points); current colonization with KPC-carbapenemase-producing Enterobacterales: 33.08, 95% CI 11.74–93.25 (5 points). With a cut-off of 7 points, a sensitivity of 35.59%, specificity of 98.43%, PPV of 77.7%, and NPV of 90.9% were obtained. The overall performance of the score was satisfactory (AUROC of 0.85, 95% CI 0.80–0.91). Finally, the post-test probability of CRE occurrence in patients with none of the risk factors was 1.9%, which would virtually rule out the presence of CRE bacteremia.
Fil: Herrera, Fabián. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Torres, Diego. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Laborde, Ana. Fundación Para Combatir la Leucemia; Argentina
Fil: Berruezo, Lorena. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; Argentina
Fil: Jordán, Rosana. Hospital Británico de Buenos Aires; Argentina
Fil: Roccia Rossi, Inés. Hospital International General Acute Gral San Martin; Argentina
Fil: Valledor, Alejandra. Hospital Italiano; Argentina
Fil: Costantini, Patricia. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina
Fil: Dictar, Miguel. Instituto Alexander Fleming; Argentina
Fil: Nenna, Andrea. Fundacion Marie Curie;
Fil: Pereyra, María Laura. Universidad Austral; Argentina
Fil: Lambert, Sandra. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Benso, José. Hospital Italiano; Argentina
Fil: Poletta, Fernando Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Gonzalez Ibañez, María Luz. Fundación Para Combatir la Leucemia; Argentina
Fil: Baldoni, Nadia. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; Argentina
Fil: Eusebio, María José. Hospital Británico de Buenos Aires; Argentina
Fil: Lovano, Fiorella. Hospital International General Acute Gral San Martin; Argentina
Fil: Barcán, Laura. Hospital Italiano; Argentina
Fil: Luck, Martín. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina
Fil: Racioppi, Agustina. Instituto Alexander Fleming; Argentina
Fil: Tula, Lucas Fernando. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Pasterán, Fernando. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; Argentina
Fil: Corso, Alejandra. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; Argentina
Fil: Rapoport, Melina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; Argentina
Fil: Nicola, Federico. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: García Damiano, María Cristina. Fundación Para Combatir la Leucemia; Argentina
Fil: Carbone, Ruth. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; Argentina
Fil: Monge, Renata. Hospital Británico de Buenos Aires; Argentina
Fil: Reynaldi, Mariana. Hospital International General Acute Gral San Martin; Argentina
Fil: Greco, Graciela. Hospital Italiano; Argentina
Fil: Bronzi, Marcelo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina
Fil: Valle, Sandra. Instituto Alexander Fleming; Argentina
Fil: Chaves, María Laura. Fundacion Marie Curie;
Fil: Vilches, Viviana. Universidad Austral; Argentina
Fil: Blanco, Miriam Edith. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Carena, Alberto Ángel. Centro de Educación Medica E Invest.clinicas; Argentina
Materia
BACTEREMIA
CANCER
ENTEROBACTERALES
SCORE
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/229089

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oai_identifier_str oai:ri.conicet.gov.ar:11336/229089
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell TransplantationHerrera, FabiánTorres, DiegoLaborde, AnaBerruezo, LorenaJordán, RosanaRoccia Rossi, InésValledor, AlejandraCostantini, PatriciaDictar, MiguelNenna, AndreaPereyra, María LauraLambert, SandraBenso, JoséPoletta, Fernando AdriánGonzalez Ibañez, María LuzBaldoni, NadiaEusebio, María JoséLovano, FiorellaBarcán, LauraLuck, MartínRacioppi, AgustinaTula, Lucas FernandoPasterán, FernandoCorso, AlejandraRapoport, MelinaNicola, FedericoGarcía Damiano, María CristinaCarbone, RuthMonge, RenataReynaldi, MarianaGreco, GracielaBronzi, MarceloValle, SandraChaves, María LauraVilches, VivianaBlanco, Miriam EdithCarena, Alberto ÁngelBACTEREMIACANCERENTEROBACTERALESSCOREhttps://purl.org/becyt/ford/3.1https://purl.org/becyt/ford/3Identifying the risk factors for carbapenem-resistant Enterobacterales (CRE) bacteremia in cancer and hematopoietic stem cell transplantation (HSCT) patients would allow earlier initiation of an appropriate empirical antibiotic treatment. This is a prospective multicenter observational study in patients from 12 centers in Argentina, who presented with cancer or hematopoietic stem-cell transplant and developed Enterobacterales bacteremia. A multiple logistic regression model identified risk factors for CRE bacteremia, and a score was developed according to the regression coefficient. This was validated by the bootstrap resampling technique. Four hundred and forty-three patients with Enterobacterales bacteremia were included: 59 with CRE and 384 with carbapenem-susceptible Enterobacterales (CSE). The risk factors that were identified and the points assigned to each of them were: ≥10 days of hospitalization until bacteremia: OR 4.03, 95% CI 1.88–8.66 (2 points); previous antibiotics > 7 days: OR 4.65, 95% CI 2.29–9.46 (2 points); current colonization with KPC-carbapenemase-producing Enterobacterales: 33.08, 95% CI 11.74–93.25 (5 points). With a cut-off of 7 points, a sensitivity of 35.59%, specificity of 98.43%, PPV of 77.7%, and NPV of 90.9% were obtained. The overall performance of the score was satisfactory (AUROC of 0.85, 95% CI 0.80–0.91). Finally, the post-test probability of CRE occurrence in patients with none of the risk factors was 1.9%, which would virtually rule out the presence of CRE bacteremia.Fil: Herrera, Fabián. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: Torres, Diego. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: Laborde, Ana. Fundación Para Combatir la Leucemia; ArgentinaFil: Berruezo, Lorena. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; ArgentinaFil: Jordán, Rosana. Hospital Británico de Buenos Aires; ArgentinaFil: Roccia Rossi, Inés. Hospital International General Acute Gral San Martin; ArgentinaFil: Valledor, Alejandra. Hospital Italiano; ArgentinaFil: Costantini, Patricia. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; ArgentinaFil: Dictar, Miguel. Instituto Alexander Fleming; ArgentinaFil: Nenna, Andrea. Fundacion Marie Curie;Fil: Pereyra, María Laura. Universidad Austral; ArgentinaFil: Lambert, Sandra. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; ArgentinaFil: Benso, José. Hospital Italiano; ArgentinaFil: Poletta, Fernando Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; ArgentinaFil: Gonzalez Ibañez, María Luz. Fundación Para Combatir la Leucemia; ArgentinaFil: Baldoni, Nadia. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; ArgentinaFil: Eusebio, María José. Hospital Británico de Buenos Aires; ArgentinaFil: Lovano, Fiorella. Hospital International General Acute Gral San Martin; ArgentinaFil: Barcán, Laura. Hospital Italiano; ArgentinaFil: Luck, Martín. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; ArgentinaFil: Racioppi, Agustina. Instituto Alexander Fleming; ArgentinaFil: Tula, Lucas Fernando. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; ArgentinaFil: Pasterán, Fernando. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; ArgentinaFil: Corso, Alejandra. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; ArgentinaFil: Rapoport, Melina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; ArgentinaFil: Nicola, Federico. Centro de Educación Medica E Invest.clinicas; ArgentinaFil: García Damiano, María Cristina. Fundación Para Combatir la Leucemia; ArgentinaFil: Carbone, Ruth. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; ArgentinaFil: Monge, Renata. Hospital Británico de Buenos Aires; ArgentinaFil: Reynaldi, Mariana. Hospital International General Acute Gral San Martin; ArgentinaFil: Greco, Graciela. Hospital Italiano; ArgentinaFil: Bronzi, Marcelo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; ArgentinaFil: Valle, Sandra. Instituto Alexander Fleming; ArgentinaFil: Chaves, María Laura. Fundacion Marie Curie;Fil: Vilches, Viviana. Universidad Austral; ArgentinaFil: Blanco, Miriam Edith. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; ArgentinaFil: Carena, Alberto Ángel. Centro de Educación Medica E Invest.clinicas; ArgentinaMDPI2023-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/229089Herrera, Fabián; Torres, Diego; Laborde, Ana; Berruezo, Lorena; Jordán, Rosana; et al.; Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation; MDPI; Antibiotics; 12; 2; 2-2023; 1-132079-6382CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.3390/antibiotics12020226info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:58:19Zoai:ri.conicet.gov.ar:11336/229089instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:58:19.612CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
title Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
spellingShingle Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
Herrera, Fabián
BACTEREMIA
CANCER
ENTEROBACTERALES
SCORE
title_short Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
title_full Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
title_fullStr Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
title_full_unstemmed Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
title_sort Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation
dc.creator.none.fl_str_mv Herrera, Fabián
Torres, Diego
Laborde, Ana
Berruezo, Lorena
Jordán, Rosana
Roccia Rossi, Inés
Valledor, Alejandra
Costantini, Patricia
Dictar, Miguel
Nenna, Andrea
Pereyra, María Laura
Lambert, Sandra
Benso, José
Poletta, Fernando Adrián
Gonzalez Ibañez, María Luz
Baldoni, Nadia
Eusebio, María José
Lovano, Fiorella
Barcán, Laura
Luck, Martín
Racioppi, Agustina
Tula, Lucas Fernando
Pasterán, Fernando
Corso, Alejandra
Rapoport, Melina
Nicola, Federico
García Damiano, María Cristina
Carbone, Ruth
Monge, Renata
Reynaldi, Mariana
Greco, Graciela
Bronzi, Marcelo
Valle, Sandra
Chaves, María Laura
Vilches, Viviana
Blanco, Miriam Edith
Carena, Alberto Ángel
author Herrera, Fabián
author_facet Herrera, Fabián
Torres, Diego
Laborde, Ana
Berruezo, Lorena
Jordán, Rosana
Roccia Rossi, Inés
Valledor, Alejandra
Costantini, Patricia
Dictar, Miguel
Nenna, Andrea
Pereyra, María Laura
Lambert, Sandra
Benso, José
Poletta, Fernando Adrián
Gonzalez Ibañez, María Luz
Baldoni, Nadia
Eusebio, María José
Lovano, Fiorella
Barcán, Laura
Luck, Martín
Racioppi, Agustina
Tula, Lucas Fernando
Pasterán, Fernando
Corso, Alejandra
Rapoport, Melina
Nicola, Federico
García Damiano, María Cristina
Carbone, Ruth
Monge, Renata
Reynaldi, Mariana
Greco, Graciela
Bronzi, Marcelo
Valle, Sandra
Chaves, María Laura
Vilches, Viviana
Blanco, Miriam Edith
Carena, Alberto Ángel
author_role author
author2 Torres, Diego
Laborde, Ana
Berruezo, Lorena
Jordán, Rosana
Roccia Rossi, Inés
Valledor, Alejandra
Costantini, Patricia
Dictar, Miguel
Nenna, Andrea
Pereyra, María Laura
Lambert, Sandra
Benso, José
Poletta, Fernando Adrián
Gonzalez Ibañez, María Luz
Baldoni, Nadia
Eusebio, María José
Lovano, Fiorella
Barcán, Laura
Luck, Martín
Racioppi, Agustina
Tula, Lucas Fernando
Pasterán, Fernando
Corso, Alejandra
Rapoport, Melina
Nicola, Federico
García Damiano, María Cristina
Carbone, Ruth
Monge, Renata
Reynaldi, Mariana
Greco, Graciela
Bronzi, Marcelo
Valle, Sandra
Chaves, María Laura
Vilches, Viviana
Blanco, Miriam Edith
Carena, Alberto Ángel
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv BACTEREMIA
CANCER
ENTEROBACTERALES
SCORE
topic BACTEREMIA
CANCER
ENTEROBACTERALES
SCORE
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.1
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Identifying the risk factors for carbapenem-resistant Enterobacterales (CRE) bacteremia in cancer and hematopoietic stem cell transplantation (HSCT) patients would allow earlier initiation of an appropriate empirical antibiotic treatment. This is a prospective multicenter observational study in patients from 12 centers in Argentina, who presented with cancer or hematopoietic stem-cell transplant and developed Enterobacterales bacteremia. A multiple logistic regression model identified risk factors for CRE bacteremia, and a score was developed according to the regression coefficient. This was validated by the bootstrap resampling technique. Four hundred and forty-three patients with Enterobacterales bacteremia were included: 59 with CRE and 384 with carbapenem-susceptible Enterobacterales (CSE). The risk factors that were identified and the points assigned to each of them were: ≥10 days of hospitalization until bacteremia: OR 4.03, 95% CI 1.88–8.66 (2 points); previous antibiotics > 7 days: OR 4.65, 95% CI 2.29–9.46 (2 points); current colonization with KPC-carbapenemase-producing Enterobacterales: 33.08, 95% CI 11.74–93.25 (5 points). With a cut-off of 7 points, a sensitivity of 35.59%, specificity of 98.43%, PPV of 77.7%, and NPV of 90.9% were obtained. The overall performance of the score was satisfactory (AUROC of 0.85, 95% CI 0.80–0.91). Finally, the post-test probability of CRE occurrence in patients with none of the risk factors was 1.9%, which would virtually rule out the presence of CRE bacteremia.
Fil: Herrera, Fabián. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Torres, Diego. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: Laborde, Ana. Fundación Para Combatir la Leucemia; Argentina
Fil: Berruezo, Lorena. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; Argentina
Fil: Jordán, Rosana. Hospital Británico de Buenos Aires; Argentina
Fil: Roccia Rossi, Inés. Hospital International General Acute Gral San Martin; Argentina
Fil: Valledor, Alejandra. Hospital Italiano; Argentina
Fil: Costantini, Patricia. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina
Fil: Dictar, Miguel. Instituto Alexander Fleming; Argentina
Fil: Nenna, Andrea. Fundacion Marie Curie;
Fil: Pereyra, María Laura. Universidad Austral; Argentina
Fil: Lambert, Sandra. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Benso, José. Hospital Italiano; Argentina
Fil: Poletta, Fernando Adrián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina
Fil: Gonzalez Ibañez, María Luz. Fundación Para Combatir la Leucemia; Argentina
Fil: Baldoni, Nadia. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; Argentina
Fil: Eusebio, María José. Hospital Británico de Buenos Aires; Argentina
Fil: Lovano, Fiorella. Hospital International General Acute Gral San Martin; Argentina
Fil: Barcán, Laura. Hospital Italiano; Argentina
Fil: Luck, Martín. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina
Fil: Racioppi, Agustina. Instituto Alexander Fleming; Argentina
Fil: Tula, Lucas Fernando. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Pasterán, Fernando. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; Argentina
Fil: Corso, Alejandra. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; Argentina
Fil: Rapoport, Melina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbrán"; Argentina
Fil: Nicola, Federico. Centro de Educación Medica E Invest.clinicas; Argentina
Fil: García Damiano, María Cristina. Fundación Para Combatir la Leucemia; Argentina
Fil: Carbone, Ruth. Gobierno de la Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal General de Agudos "prof. Dr. Rodolfo Rossi".; Argentina
Fil: Monge, Renata. Hospital Británico de Buenos Aires; Argentina
Fil: Reynaldi, Mariana. Hospital International General Acute Gral San Martin; Argentina
Fil: Greco, Graciela. Hospital Italiano; Argentina
Fil: Bronzi, Marcelo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; Argentina
Fil: Valle, Sandra. Instituto Alexander Fleming; Argentina
Fil: Chaves, María Laura. Fundacion Marie Curie;
Fil: Vilches, Viviana. Universidad Austral; Argentina
Fil: Blanco, Miriam Edith. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; Argentina
Fil: Carena, Alberto Ángel. Centro de Educación Medica E Invest.clinicas; Argentina
description Identifying the risk factors for carbapenem-resistant Enterobacterales (CRE) bacteremia in cancer and hematopoietic stem cell transplantation (HSCT) patients would allow earlier initiation of an appropriate empirical antibiotic treatment. This is a prospective multicenter observational study in patients from 12 centers in Argentina, who presented with cancer or hematopoietic stem-cell transplant and developed Enterobacterales bacteremia. A multiple logistic regression model identified risk factors for CRE bacteremia, and a score was developed according to the regression coefficient. This was validated by the bootstrap resampling technique. Four hundred and forty-three patients with Enterobacterales bacteremia were included: 59 with CRE and 384 with carbapenem-susceptible Enterobacterales (CSE). The risk factors that were identified and the points assigned to each of them were: ≥10 days of hospitalization until bacteremia: OR 4.03, 95% CI 1.88–8.66 (2 points); previous antibiotics > 7 days: OR 4.65, 95% CI 2.29–9.46 (2 points); current colonization with KPC-carbapenemase-producing Enterobacterales: 33.08, 95% CI 11.74–93.25 (5 points). With a cut-off of 7 points, a sensitivity of 35.59%, specificity of 98.43%, PPV of 77.7%, and NPV of 90.9% were obtained. The overall performance of the score was satisfactory (AUROC of 0.85, 95% CI 0.80–0.91). Finally, the post-test probability of CRE occurrence in patients with none of the risk factors was 1.9%, which would virtually rule out the presence of CRE bacteremia.
publishDate 2023
dc.date.none.fl_str_mv 2023-02
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/229089
Herrera, Fabián; Torres, Diego; Laborde, Ana; Berruezo, Lorena; Jordán, Rosana; et al.; Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation; MDPI; Antibiotics; 12; 2; 2-2023; 1-13
2079-6382
CONICET Digital
CONICET
url http://hdl.handle.net/11336/229089
identifier_str_mv Herrera, Fabián; Torres, Diego; Laborde, Ana; Berruezo, Lorena; Jordán, Rosana; et al.; Development of a Clinical Score to Stratify the Risk for Carbapenem-Resistant Enterobacterales Bacteremia in Patients with Cancer and Hematopoietic Stem Cell Transplantation; MDPI; Antibiotics; 12; 2; 2-2023; 1-13
2079-6382
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.3390/antibiotics12020226
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432