{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:11:29Z","timestamp":1789207889901,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Urinary tract infections (UTIs) in kidney transplant (KT) recipients are frequent and associated with increased morbidity and mortality. Traditional outcome measures may underestimate its true clinical burden. The Desirability of Outcome Ranking (DOOR), developed by the Antibacterial Resistance Leadership Group, is a patient\u2010centered composite outcome designed to capture the full spectrum of infectious complications.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We refined the DOOR framework for complicated UTIs by incorporating transplant\u2010specific variables and evaluated its application in a cohort of KT recipients with UTIs between 2013 and 2023.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ninety\u2010seven patients with carbapenem\u2010resistant (CR) UTIs were matched 1:1 by infection year to patients with carbapenem\u2010susceptible (CS) infections. Compared with the standard cUTI DOOR, the KT\u2010UTI DOOR reclassified 41 patients to worse outcome ranks. Using the KT\u2010UTI DOOR, the probability of a more favorable outcome in CR versus CS infections was 41.3% (95% CI: 34.2%\u201348.7%,\n p<\/jats:italic>\n \u00a0=\u00a00.02) in the unadjusted analysis and 43.4% (95% CI: 36.2%\u201350.9%,\n p<\/jats:italic>\n \u00a0=\u00a00.08) after adjustment. Transplant\u2010related complications were the only events independently associated with CR infections. In contrast, using the established cUTI DOOR, the corresponding probability was 45.8% (95% CI: 38.8%\u201352.9%,\n p<\/jats:italic>\n \u00a0=\u00a00.24) in the adjusted analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Incorporating transplant\u2010related variables improves the clinical relevance of DOOR in KT recipients.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tid.70191","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:39:34Z","timestamp":1772991574000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Kidney Transplant\u2010Specific DOOR for Urinary Tract Infections Assessing the Impact of Carbapenem Resistance"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5528-0758","authenticated-orcid":false,"given":"Giulia Soska","family":"Baldissera","sequence":"first","affiliation":[{"name":"Medical Sciences Post\u2010Graduation Program Universidade Federal Do Rio Grande Do Sul Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-6014","authenticated-orcid":false,"given":"Sarah B.","family":"Doernberg","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-3227","authenticated-orcid":false,"given":"David","family":"van Duin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4928-1160","authenticated-orcid":false,"given":"Toshimitsu","family":"Hamasaki","sequence":"additional","affiliation":[{"name":"The Biostatistics Center and the Department of Biostatistics and Bioinformatics Milken Institute School of Public Health The George Washington University Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3421-6603","authenticated-orcid":false,"given":"Yijie","family":"He","sequence":"additional","affiliation":[{"name":"The Biostatistics Center and the Department of Biostatistics and Bioinformatics Milken Institute School of Public Health The George Washington University Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2794-7944","authenticated-orcid":false,"given":"Vin\u00edcius da Silva","family":"Gregory","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul Medical School Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3720-4045","authenticated-orcid":false,"given":"Murilo","family":"Martini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service Hospital de Cl\u00ednicas de Porto Alegre Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-2613","authenticated-orcid":false,"given":"Maria Helena","family":"Rigatto","sequence":"additional","affiliation":[{"name":"Medical Sciences Post\u2010Graduation Program Universidade Federal Do Rio Grande Do Sul Porto Alegre Brazil"},{"name":"Universidade Federal do Rio Grande do Sul Medical School Porto Alegre Brazil"},{"name":"Infectious Diseases Service Hospital de Cl\u00ednicas de Porto Alegre Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3186-172X","authenticated-orcid":false,"given":"Scott R","family":"Evans","sequence":"additional","affiliation":[{"name":"The Biostatistics Center and the Department of Biostatistics and Bioinformatics Milken Institute School of Public Health The George Washington University Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(19)32977\u20100"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2015.12.003"},{"key":"e_1_2_9_4_1","unstructured":"\u201cSummary \u201dGlobal Observatory on Donation and Transplantation 2016 https:\/\/www.transplant\u2010observatory.org\/summary\/."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16106"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IDC.2024.03.008"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/19466315.2016.1207561"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13888"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ495"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac692"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16248"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13507"},{"key":"e_1_2_9_14_1","first-page":"22","article-title":"EAU Guidelines on Urological Infections","volume":"18","author":"Bonkat G.","year":"2017","journal-title":"European Association of 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P.","year":"2019"},{"key":"e_1_2_9_17_1","unstructured":"\u201cDOOR Analyses: Standard Edition. BSC Methods \u201dGeorge Washington University accessed December 28 2024 https:\/\/methods.bsc.gwu.edu\/."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/2175\u20108239\u2010jbn\u20102024\u20100002en"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.4103\/1319\u20102442.390256"},{"key":"e_1_2_9_20_1","first-page":"30","article-title":"Prevalence and Antibiogram of Urinary Tract Infections in Renal Transplant Recipients at a Tertiary Care Hospital in North India","volume":"68","author":"Halim I.","year":"2020","journal-title":"Journal of Association of Physicians of India"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12923"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2016.05.005"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12450"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000863"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201025451\u20104"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12112217"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S343505"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01102\u201021"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.70191","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.70191","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.70191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:57:03Z","timestamp":1789207023000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.70191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/tid.70191"],"URL":"https:\/\/doi.org\/10.1111\/tid.70191","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"assertion":[{"value":"2025-12-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70191"}}