Evidence map›Paper›PMID 32978863›Full record

ArticleTransplant infectious disease : an official journal of the Transplantation Society2021

Treatment of multidrug-resistant gram-negative bacilli after solid organ transplant: Outcomes and complications.

Madeleine R Heldman, Kexin Guo, Brett Nelson, Tenzin Babu, Michael G Ison

Open access · greenAbstract read
In one paragraph

Article in Transplant infectious disease : an official journal of the Transplantation Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
  3. Pathogens (Basel, Switzerland) · 2022
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Madeleine R HeldmanDivision of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.ORCID https://orcid.org/0000-0002-9424-1870
Kexin GuoComprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Brett NelsonRosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Tenzin BabuUniversity of Southern California, Los Angeles, CA, USA.
Michael G IsonComprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID https://orcid.org/0000-0003-3347-9671
Northwestern University · USRosalind Franklin University of Medicine and Science · USUniversity of Southern California · USUniversity of Washington · US

Funding

Training Program in Infectious Diseases in the Immunocompromised HostT32AI118690 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI BOECKH, MICHAEL J · 2016 to 2025
$4.0M
NIAID NIH HHS T32 AI118690
6 · The paper itself

Abstract

backgroundInfections caused by multidrug-resistant gram-negative bacilli (GNB) cause significant morbidity and mortality in solid organ transplant (SOT) recipients.

methodsWe retrospectively collected data from all SOT recipients at a single center from 1 January 2007 to 15 April 2017 treated for infections caused by multi-drug-resistant GNB. This study examined the effects of specific antibiotics on nephrotoxicity, neurotoxicity, 30-day mortality, and length of stay in the hospital and intensive care unit.

resultsA total of 225 infections were identified among 143 patients. Carbapenem-sensitive organisms were present in 112 (49.8%) infections and were associated with decreased 30-day mortality (OR 0.35, 95% CI 0.16-0.75). Neurotoxicity was associated with polymyxin use with an 8% increase in odds of neurotoxicity per day of exposure (P=.03). There was no relationship between nephrotoxicity and any individual antibiotic class. Increased hospital length-of-stay occurred among patients exposed to aminoglycosides (β-statistic = 0.48 (0.23); P = .04), while there was no relationship between antibiotic class and intensive care unit (ICU) length-of-stay. Mortality at 30 days occurred in 37 infections (16%). Carbapenem exposure was associated with decreased 30-day mortality (OR 0.93; 95% CI 0.90-0.98; P = .02). No other antibiotic class had a significant impact on 30-day mortality.

conclusionsCarbapenems appear to be a safe and effective treatment for solid-organ transplant recipients with infections caused by carbapenem-sensitive multidrug-resistant GNB; treatment of carbapenem-resistant gram-negatives remains challenging.

Indexed as

Gram-Negative Bacterial InfectionsOrgan TransplantationAnti-Bacterial AgentsGram-Negative BacteriaHumansRetrospective StudiesRisk FactorsAnti-Bacterial Agentsantibioticbacterial infectionscomplicationsresistance

Identifiers

PMID32978863
PMCPMC9435024
OpenAlexW3088985295

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.