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Incidence densities per 1,000 patient\u2011days were calculated, and Fine\u2013Gray sub-distribution hazard models were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 2,971 ESBL-E carriers and 2,971 non-carriers were included. Among carriers, incidence densities were 3.29 (95% CI 2.76\u20133.93) per 1,000 patient days for HAI with ESBL-E, and 4.41 (95% CI 3.78\u20135.14) for HAI with other pathogens. In contrast, ESBL-E HAI among non-carriers was rare with an incidence density of 0.05 (95% CI 0.01\u20130.21) per 1,000 patient days. ESBL-E colonization was identified as most important risk factor specific for ESBL-E HAI followed by peptic ulcer, congestive heart failure and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incidence of HAI with ESBL-E was high among ESBL-E carriers, but HAI with other pathogens remained more common. ESBL\u2011E colonization was the dominant determinant of ESBL\u2011E HAI, with cases occurring almost exclusively in carriers. In conclusion, a known ESBL-E colonization status is an important predictor, but should not be the only factor to rationalize an empirical strategy targeting ESBL-E without considering additional factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02966-w","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:49:33Z","timestamp":1789393773000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The enemy in our gut? 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