{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:10:10Z","timestamp":1777439410500,"version":"3.51.4"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2016,3,30]],"date-time":"2016-03-30T00:00:00Z","timestamp":1459296000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec id=\"S0899823X1600060X_abs1\" sec-type=\"objectives\"><jats:title>OBJECTIVES<\/jats:title><jats:p>To describe the burden of extended-spectrum \u03b2-lactamase (ESBL) <jats:italic>Enterobacteriaceae<\/jats:italic> in veterans with spinal cord injury or disorder (SCI\/D), to identify risk factors for ESBL acquisition, and to assess impact on clinical outcomes<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1600060X_abs2\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Retrospective case-case-control study<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1600060X_abs3\" sec-type=\"general\"><jats:title>PATIENTS AND SETTING<\/jats:title><jats:p>Veterans with SCI\/D and utilization at a Veterans\u2019 Affairs medical center from January 1, 2012, to December 31, 2013.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1600060X_abs4\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Patients with a positive culture for ESBL <jats:italic>Klebsiella pneumoniae<\/jats:italic>, <jats:italic>Escherichia coli<\/jats:italic>, or <jats:italic>Proteus mirabilis<\/jats:italic> were matched with patients with non-ESBL organisms by organism, facility, and level of care and to uninfected controls by facility and level of care. Inpatients were also matched by time at risk. Univariate and multivariate matched models were assessed for differences in risk factors and outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1600060X_abs5\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>A total of 492 cases (62.6% outpatients) were matched 1:1 with each comparison group. Recent prior use of fluoroquinolones and prior use of third- and fourth-generation cephalosporins were independently associated with ESBL compared to the non-ESBL group (adjusted odds ratio [aOR], 2.61; 95% confidence interval [CI], 1.77\u20133.84; <jats:italic>P<\/jats:italic>&lt;.001 for fluoroquinolones and aOR, 3.86; 95% CI, 2.06\u20137.25; <jats:italic>P<\/jats:italic>&lt;.001 for third- and fourth-generation cephalosporins) and the control group (aOR, 2.10; 95% CI, 1.29\u20133.43; <jats:italic>P<\/jats:italic> = .003 for fluoroquinolones; and aOR, 3.31; 95% CI, 1.56\u20137.06; <jats:italic>P<\/jats:italic>=.002 for third- and fourth-generation cephalosporins). Although there were no differences in mortality rate, the ESBL group had a longer post-culture length of stay (LOS) than the non-ESBL group (incidence rate ratio, 1.36; 95% CI, 1.13\u20131.63; <jats:italic>P<\/jats:italic>=.001).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X1600060X_abs6\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>All SCI\/D patients with ESBL were more likely to have had recent exposure to fluoroquinolones or third- and fourth-generation cephalosporins, and hospitalized patients were more likely to have increased post-culture LOS. Programs targeted toward reduced antibiotic use in SCI\/D patients may prevent subsequent ESBL acquisition.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2016;37:768\u2013776<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2016.60","type":"journal-article","created":{"date-parts":[[2016,3,30]],"date-time":"2016-03-30T02:16:54Z","timestamp":1459304214000},"page":"768-776","source":"Crossref","is-referenced-by-count":25,"title":["Unique Risks and Clinical Outcomes Associated With Extended-Spectrum \u03b2-Lactamase <i>Enterobacteriaceae<\/i> in Veterans With Spinal Cord Injury or Disorder: A Case-Case-Control Study"],"prefix":"10.1017","volume":"37","author":[{"given":"Margaret A.","family":"Fitzpatrick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katie J.","family":"Suda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasia","family":"Safdar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto M.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Poggensee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swetha","family":"Ramanathan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"LeWan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlesnika T.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,3,30]]},"reference":[{"key":"S0899823X1600060X_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dku077"},{"key":"S0899823X1600060X_ref9","doi-asserted-by":"publisher","DOI":"10.2307\/30144194"},{"key":"S0899823X1600060X_ref15","doi-asserted-by":"publisher","DOI":"10.1067\/mic.2000.107424"},{"key":"S0899823X1600060X_ref2","doi-asserted-by":"publisher","DOI":"10.1086\/604713"},{"key":"S0899823X1600060X_ref27","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2011.601756"},{"key":"S0899823X1600060X_ref29","doi-asserted-by":"publisher","DOI":"10.1086\/649537"},{"key":"S0899823X1600060X_ref24","unstructured":"VA research on spinal cord injury. 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