Evidence map›Paper›PMID 41755365›Full record

ArticleTransplant infectious disease : an official journal of the Transplantation Society

Development of a Kidney Transplant-Specific DOOR for Urinary Tract Infections Assessing the Impact of Carbapenem Resistance.

Giulia Soska Baldissera, Sarah B Doernberg, David van Duin, Toshimitsu Hamasaki, Yijie He, Vinícius da Silva Gregory, Murilo Martini, Maria Helena Rigatto, Scott R Evans

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In one paragraph

Article in Transplant infectious disease : an official journal of the Transplantation Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. A DOOR to Defining New Outcomes for Research in Transplant Recipients' Infections.Transplant infectious disease : an official journal of the Transplantation Society
    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

9 authors.

Giulia Soska BaldisseraMedical Sciences Post-Graduation Program, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.ORCID https://orcid.org/0009-0007-5528-0758
Sarah B DoernbergDivision of Infectious Diseases, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-1727-6014
David van DuinDivision of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-4784-3227
Toshimitsu HamasakiThe Biostatistics Center and the Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Bethesda, Maryland, USA.ORCID https://orcid.org/0000-0002-4928-1160
Yijie HeThe Biostatistics Center and the Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Bethesda, Maryland, USA.ORCID https://orcid.org/0000-0003-3421-6603
Vinícius da Silva GregoryUniversidade Federal do Rio Grande do Sul, Medical School, Porto Alegre, Brazil.ORCID https://orcid.org/0009-0005-2794-7944
Murilo MartiniInfectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.ORCID https://orcid.org/0000-0002-3720-4045
Maria Helena RigattoMedical Sciences Post-Graduation Program, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.ORCID https://orcid.org/0000-0001-9465-2613
Scott R EvansThe Biostatistics Center and the Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Bethesda, Maryland, USA.ORCID https://orcid.org/0000-0003-3186-172X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUrinary 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-centered composite outcome designed to capture the full spectrum of infectious complications.

methodsWe refined the DOOR framework for complicated UTIs by incorporating transplant-specific variables and evaluated its application in a cohort of KT recipients with UTIs between 2013 and 2023.

resultsNinety-seven patients with carbapenem-resistant (CR) UTIs were matched 1:1 by infection year to patients with carbapenem-susceptible (CS) infections. Compared with the standard cUTI DOOR, the KT-UTI DOOR reclassified 41 patients to worse outcome ranks. Using the KT-UTI DOOR, the probability of a more favorable outcome in CR versus CS infections was 41.3% (95% CI: 34.2%-48.7%, p = 0.02) in the unadjusted analysis and 43.4% (95% CI: 36.2%-50.9%, p = 0.08) after adjustment. Transplant-related 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%-52.9%, p = 0.24) in the adjusted analysis.

conclusionIncorporating transplant-related variables improves the clinical relevance of DOOR in KT recipients.

Indexed as

Anti-Bacterial AgentsCarbapenemsKidney TransplantationUrinary Tract InfectionsAdultDrug Resistance, BacterialFemaleHumansMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsCarbapenemscarbapenem resistanceDesirability of Outcome Ranking (DOOR)Gram‐negativekidney transplantationurinary tract infection

Identifiers

PMID41755365
PMCPMC13570399

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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.