{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:02:05Z","timestamp":1792450925620,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Management of infections due to carbapenemase\u2010resistant Enterobacterales (CRE) in solid organ transplant (SOT) recipients remains a difficult challenge. The INCREMENT\u2010SOT\u2010CPE score has been specifically developed from SOT recipients to stratify mortality risk, but an external validation is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicenter retrospective cohort study of liver transplant (LT) recipients colonized with CRE infection who developed infection after transplant over 7\u2010year period. Primary endpoint was all\u2010cause 30\u2010day mortality from infection onset. A comparison between INCREMENT\u2010SOT\u2010CPE and other selected scores was performed. A two\u2010level mixed effects logistic regression model with random effects for the center was fitted. Performance characteristics at optimal cut\u2010point were calculated. Multivariable Cox regression analysis of risk factors for all\u2010cause 30\u2010day mortality was carried out.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 250 CRE carriers developed infection after LT and were analyzed. The median age was 55\u00a0years (interquartile range [IQR]: 46\u201362) and 157 were males (62.8%). All\u2010cause 30\u2010day mortality was 35.6%. A sequential organ failure assessment (SOFA) score\u00a0\u2265\u00a011 showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 69.7%, 76.4%, 62.0%, 82.0%, and 74.0%, respectively. An INCREMENT\u2010SOT\u2010CPE\u00a0\u2265\u00a011 reported a sensitivity, specificity, PPV, NPV, and accuracy of 73.0%, 62.1%, 51.6%, 80.6% and 66.0%, respectively. At multivariable analysis acute renal failure, prolonged mechanical ventilation, INCREMENT\u2010SOT\u2010CPE score\u00a0\u2265\u00a011 and SOFA score\u00a0\u2265\u00a011 were independently associated with all\u2010cause 30\u2010day mortality, while a tigecycline\u2010based targeted regimen was found to be protective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both INCREMENT\u2010SOT\u2010CPE\u00a0\u2265\u00a011 and SOFA\u00a0\u2265\u00a011 were identified as strong predictors of all\u2010cause 30\u2010day mortality in a large cohort of CRE carriers developing infection after LT.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14036-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14036","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T12:18:41Z","timestamp":1678191521000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Validation of the INCREMENT\u2010SOT\u2010CPE score in a large cohort of liver transplant recipients with carbapenem\u2010resistant Enterobacterales infection"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3568-5973","authenticated-orcid":false,"given":"Matteo","family":"Rinaldi","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit IRCCS Sant'Orsola Hospital  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna  Bologna 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