{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T08:53:28Z","timestamp":1778489608467,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["FOA#CK16\u2010004"],"award-info":[{"award-number":["FOA#CK16\u2010004"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5 UM 1AI104681\u201005"],"award-info":[{"award-number":["5 UM 1AI104681\u201005"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01\u2010AI137317"],"award-info":[{"award-number":["K01\u2010AI137317"]}],"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":["K24\u2010AI080942"],"award-info":[{"award-number":["K24\u2010AI080942"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multidrug\u2010resistant Gram\u2010negative bacterial infections are increasingly common among solid organ transplant (SOT) recipients, leading to challenges in the selection of empiric antimicrobial therapy. We sought to develop a clinical tool to predict which SOT recipients are at high risk for extended\u2010spectrum beta\u2010lactamase (ESBL)\u2010producing Enterobacterales (EB) bloodstream infection (BSI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter case\u2010control study was performed. The source population included SOT recipients with an EB BSI between 2005 and 2018. Cases were those with ESBL\u2010EB BSI; controls were those with non\u2010ESBL EB BSI. The population was subdivided into derivation and validation cohorts based on study site. The predictive tool was developed in the derivation cohort through iterative multivariable logistic regression analyses that maximized the area under the receiver\u2010operating curve (AUC). External validity was assessed using the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 897 SOT recipients with an EB BSI were included, of which 539 were assigned to the derivation cohort (135, 25% ESBL\u2010EB) and 358 to the validation cohort (221, 62% ESBL\u2010EB). Using multivariable analyses, the most parsimonious model that was predictive of ESBL\u2010EB BSI consisted of 10 variables, which fell into four clinical categories: prior colonization or infection with EB organisms, recent antimicrobial exposures, severity of preceding illness, and immunosuppressive regimen. This model achieved an AUC of 0.81 in the derivation cohort and 0.68 in the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Though further refinements are needed in additional populations, this tool shows promise for guiding empiric therapy for SOT recipients with EB BSI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13599","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T12:38:01Z","timestamp":1615898281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical prediction tool for extended\u2010spectrum beta\u2010lactamase\u2010producing enterobacterales as the etiology of a bloodstream infection in solid organ transplant recipients"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-4743","authenticated-orcid":false,"given":"Rebecca","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer H.","family":"Han","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline Rockville MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"},{"name":"Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"},{"name":"Department of Biostatistics, Epidemiology, and Informatics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranita D.","family":"Tamma","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics The Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerri A.","family":"Thom","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University of Maryland School of Medicine Baltimore MD USA"},{"name":"Division of Infectious Diseases, Department of Medicine University of Maryland School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Alby","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of North Carolina School of Medicine Chapel Hill NC 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