{"doi":"10.1093/cid/ciaa190","title":"Risk Factors for Extended-Spectrum β-lactamase–Producing Enterobacterales Bloodstream Infection Among Solid-Organ Transplant Recipients","abstract":"BACKGROUND: Approximately 40% of all Enterobacterales (EB) bloodstream infections (BSIs) among solid organ transplant recipients (SOTRs) are due to extended-spectrum β-lactamase (ESBL)-producing organisms, but risk factors for such infections remain ill defined in this population. We sought to determine the risk factors for ESBL-EB BSIs among SOTRs. METHODS: A multicenter case-control study was performed. All SOTRs with an EB BSI at the Hospital of the University of Pennsylvania and University of Maryland Medical Center between 1 January 2007 and 30 June 2018 and at The Johns Hopkins Hospital between 1 January 2005 and 31 December 2015 were included. Cases were those with an ESBL-EB BSI. Controls were those with a non-ESBL-EB BSI. Multivariable logistic regression was performed to determine risk factors for ESBL-EB BSI. RESULTS: There were 988 episodes of EB BSI, of which 395 (40%) were due to an ESBL-EB. On multivariable analysis, the independent risk factors for ESBL-EB BSI included: ESBL-EB on prior culture (aOR, 12.75; 95% CI, 3.23-50.33; P < .001), a corticosteroid-containing immunosuppression regimen (aOR 1.30; 95% CI 1.03-1.65; P = .030), acute rejection treated with corticosteroids (aOR 1.18; 95% CI 1.16-1.19; P < .001), and exposure to third-generation cephalosporins (aOR 1.95; 95% CI 1.48-2.57; P < .001), echinocandins (aOR 1.61; 95% CI 1.08-2.40; P = .020), and trimethoprim-sulfamethoxazole (aOR 1.35; 95% CI 1.10-1.64; P = .003). CONCLUSIONS: We identified several novel risk factors that are uniquely important to the SOTR population, including exposure to trimethoprim-sulfamethoxazole and corticosteroid-containing immunosuppressive regimens. Further studies exploring these associations and testing interventions aimed at these modifiable risk factors among SOTRs are needed.","journal":"Clinical Infectious Diseases","year":2020,"id":92029,"datarank":0.5676284450877392,"base_score":3.784189633918261,"endowment":3.784189633918261,"self_citation_contribution":0.5676284450877392,"citation_network_contribution":0.0,"self_endowment_contribution":0.5676284450877392,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":43,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9434,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":287738,"name":"Ebbing Lautenbach","orcid":"0000-0003-4772-2409","position":1,"is_corresponding":false},{"id":287739,"name":"Pranita D. Tamma","orcid":"0000-0002-4143-6324","position":2,"is_corresponding":false},{"id":462329,"name":"Kerri A. Thom","orcid":null,"position":3,"is_corresponding":false},{"id":460815,"name":"Emily A. Blumberg","orcid":"0000-0002-5193-6170","position":4,"is_corresponding":false},{"id":351310,"name":"Kevin Alby","orcid":"0000-0003-4637-8474","position":5,"is_corresponding":false},{"id":356701,"name":"Warren B. Bilker","orcid":"0000-0002-2704-7525","position":6,"is_corresponding":false},{"id":462330,"name":"Alissa Werzen","orcid":null,"position":7,"is_corresponding":false},{"id":460816,"name":"Pam Tolomeo","orcid":"0000-0001-5594-8884","position":8,"is_corresponding":false},{"id":462331,"name":"Jacqueline Omorogbe","orcid":null,"position":9,"is_corresponding":false},{"id":336851,"name":"Lisa Pineles","orcid":"0000-0002-2377-5971","position":10,"is_corresponding":false},{"id":287737,"name":"Jennifer Han","orcid":"0000-0003-4744-8067","position":11,"is_corresponding":false},{"id":460814,"name":"Judith A. Anesi","orcid":"0000-0001-6671-4557","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T22:29:54.256205Z","pmid":"32149327","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}