{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:59:43Z","timestamp":1791201583545,"version":"4.2.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23AI175676"],"award-info":[{"award-number":["K23AI175676"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01-AI-165671"],"award-info":[{"award-number":["R01-AI-165671"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study was to determine whether the addition of immunologic biosignatures to a predictive model based solely on clinical data could improve the model's ability to predict patient outcome among solid organ transplant (SOT) recipients with gram-negative bacteremia (GNB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Plasma was prospectively collected from SOT recipients with GNB. Twenty-seven cytokines, chemokines, and immunoglobulin levels were quantified. Two logistic regression models were specified: a clinical model including age, transplanted organ, and time since transplant and a clinical-immunologic model that additionally incorporated the first two principal components. Model performance was evaluated using area under the curve (AUC). Internal validation was performed by repeated 10-fold cross-validation. AUCs were compared with a paired t test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 169 SOT recipients with GNB, 45 (26.6%) experienced an adverse outcome (septic shock or death). When compared with the clinical model alone, the clinical-immunologic model demonstrated superior discrimination (AUC, 0.70 vs 0.84; P &amp;lt; .001). Principal component 1, characterized by broad immune dysregulation, was associated with increased risk for adverse outcome (odds ratio, 1.43; 95% CI, 1.24\u20131.69) and was characterized by strong contributions from innate proinflammatory mediators (TNF-\u03b1, IL-1\u03b2, IL-6, IL-8, MCP-1, MIP-1\u03b2, IL12p70, MIP-1\u03b1, and GMCSF), anti-inflammatory mediators (IL-10, IL-4, and IL-13), and IL-2. In contrast, principal component 2 was associated with a favorable outcome (odds ratio, 0.61; 95% CI, .43\u2013.84) and reflected coordinated adaptive immunity, with dominant contributions from Th1, Th17, and humoral pathways (TNF\u03b2, IFNg, IP-10, IL-17A, IgG, IgM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immune biosignatures significantly improved prediction of adverse outcomes beyond clinical factors in SOT recipients with GNB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag466","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:27:50Z","timestamp":1791199670000},"source":"Crossref","is-referenced-by-count":0,"title":["Host Immune Biosignatures Predict Septic Shock and Mortality in Solid Organ Transplant Recipients With Gram-Negative Bacteremia"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-0638","authenticated-orcid":false,"given":"Emily M","family":"Eichenberger","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2176-6462","authenticated-orcid":false,"given":"Felicia","family":"Ruffin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0267-9665","authenticated-orcid":false,"given":"Geeta M","family":"Karadkhele","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emory University School of Medicine , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6573-2649","authenticated-orcid":false,"given":"Christian P","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emory University School of Medicine , Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8048-0897","authenticated-orcid":false,"suffix":"Jr","given":"Vance G","family":"Fowler","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100507270333900_jiag466-B1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.cmi.2021.07.021","article-title":"Bacterial and fungal bloodstream infections in solid organ transplant 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