{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:09:24Z","timestamp":1789207764034,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"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":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Vancomycin\u2010resistant\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      (VRE) infection is a life\u2010threatening complication after liver transplantation (LT). This study aimed to identify risk factors and develop a predictive score for post\u2010transplant VRE infection in LT recipients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center, retrospective cohort study including all adult patients who underwent LT between 2010 and 2022. Patients were followed from 90\u00a0days before to 180\u00a0days after LT. The primary endpoint was time to the first VRE infection after LT, with death before infection treated as a competing event. We applied a stacked landmarking approach at weekly intervals during the first post\u2010transplant month, incorporating post\u2010LT VRE colonization as a time\u2010dependent covariate in Fine\u2013Gray models. Random forests were used as machine\u2010learning comparators. Model discrimination was assessed by the AUC\u2010ROC, and sensitivity, specificity, and accuracy were calculated at thresholds determined by Youden's index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1209 LT recipients, 76 (6.3%) developed VRE infection, most commonly intra\u2010abdominal (58.4%). Time\u2010updated post\u2010LT VRE colonization was the strongest predictor (HR 7.59). Additional risk factors included intraoperative bleeding (HR 4.06), early re\u2010transplantation (HR 3.85), pre\u2010LT VRE colonization (HR 3.20), renal replacement therapy (HR 2.01), and intensive care unit length of stay (HR 1.01\/day). Viral hepatitis (HR 0.55), autoimmune hepatitis (HR 0.34), higher Charlson Comorbidity Index (HR 0.84), and deceased donors (HR 0.24) were associated with a lower risk of VRE infection. The final model showed good discrimination (AUROC\u00a0=\u00a00.76\u20130.85) with balanced sensitivity (75%\u201393%) and specificity (75%\u201386%).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70195","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T09:09:01Z","timestamp":1772960941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting VRE Infection After Liver Transplantation With a Time\u2010Updated Colonization Score"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-3238","authenticated-orcid":false,"given":"Nathalia N.","family":"Nunes","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"},{"name":"Itajuba School of Medicine  Itajuba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adhemar","family":"Villani Junior","sequence":"additional","affiliation":[{"name":"Information Systems Program School of Arts Sciences and Humanities University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lohayne A.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Spadao","sequence":"additional","affiliation":[{"name":"Hospital Epidemiology and Infection Control Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice T. W.","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Liver and Gastrointestinal Transplant Department of Surgery Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora Raquel B.","family":"Terrabuio","sequence":"additional","affiliation":[{"name":"Division of Liver and Gastrointestinal Transplant Department of Surgery Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Augusto C.","family":"D'Albuquerque","sequence":"additional","affiliation":[{"name":"Division of Liver and Gastrointestinal Transplant Department of Surgery Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima L S","family":"Nunes","sequence":"additional","affiliation":[{"name":"Information Systems Program School of Arts Sciences and Humanities University of Sao Paulo  Sao Paulo Brazil"},{"name":"Centres for Antimicrobial Optimization Network (CAMO\u2010Net)  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sara S.","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"},{"name":"Centres for Antimicrobial Optimization Network (CAMO\u2010Net)  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edson","family":"Abdala","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9691-192X","authenticated-orcid":false,"given":"Maristela P.","family":"Freire","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"},{"name":"Hospital Epidemiology and Infection Control Hospital das Clinicas Faculdade de Medicina University of Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469\u20100691.12687"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2024.12469"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2024.03.036"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/LVT.0000000000000702"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlad158"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2019.02.064"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13251"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15285"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12784"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11061606"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf121"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890\u2010199802150\u201000027"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/23.4.760"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1563235"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2020.01.09"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2025.2509785"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab109"},{"key":"e_1_2_11_19_1","unstructured":"\u201cCDC\/NHSN Surveillance Definitions for Specific Types of Infections \u201dNHSN accessed April 24 2021 https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/17pscnosinfdef_current.pdf."},{"key":"e_1_2_11_20_1","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing. 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