Abstract
AIM: To assess the ability of Giannella Risk Score (GRS), Increment Score (IS), and modified-Increment Score (m-IS) to predict the risk of infection after colonization by OXA-48 producing Enterobacterales (OXA-48-Ent) and mortality after infection. METHODS: A retrospective cohort study (2020-2022) including 273 patients colonized with OXA-48-Ent. univariable and multivariable analysis to identify predictors for OXA-48-Ent infection at 30 days after colonization and 30-day mortality among infection episodes, including GRS, IS, and m-IS, were performed. RESULTS: Fifty-seven (20.1%) patients developed an infection during the first year after colonization, with 51 (90%) of 66 infection episodes occurring within the first 30 days. Seventeen (7.8%) of 219 patients with a GRS < 7 developed an infection whereas this occurred in 34 (63%) of 54 with a GRS ≥ 7 (P < .01). GRS was the only independent risk factor for infection at 30 days [aOR = 1.41; (95% CI: 1.26-1.58), P < .01]. 30-day mortality of OXA-48-Ent infection episodes was 27%. Two (7.7%) of 26 infected patients with a modified IS < 8 died whereas this occurred in 15 (40.5%) of 41 with an IS ≥ 8 (P < .01). Independent risk factors for 30-day mortality after infection was IS [aOR = 1.32 (95% CI: 1.10-1.58), P = .01]. CONCLUSIONS: A significant proportion of patients colonized by OXA-48-Ent develop infection by its colonizing strain within the first 30 days after colonization. The application of GRS, IS, and m-IS identified OXA-48-Ent colonized patients with a low risk for infection and with low risk of mortality in the case of a confirmed OXA-48-Ent infection.