{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T03:36:07Z","timestamp":1648524967853},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T00:00:00Z","timestamp":1466467200000},"content-version":"unspecified","delay-in-days":3581,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:sec id=\"S0899823X00196254_abs1\"><jats:title>Objective.<\/jats:title><jats:p>To evaluate whether resistance to third-generation cephalosporins and\/or aztreonam was associated with a higher mortality rate among patients with nosocomial<jats:italic>Klebsiella pneumoniae<\/jats:italic>infections.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00196254_abs2\"><jats:title>Design.<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00196254_abs3\"><jats:title>Setting.<\/jats:title><jats:p>Tertiary care university hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00196254_abs4\"><jats:title>Methods.<\/jats:title><jats:p>A total of 143 patients with nosocomial infections due to<jats:italic>K. pneumoniae<\/jats:italic>were evaluated. Death within 21 days after diagnosis of infection was the outcome. Demographic data, invasive procedures, presence and severity of underlying conditions, infection diagnosis, anatomic site of isolation, and treatment of infection, as well as resistance to third-generation cephalosporins and\/or aztreonam, were evaluated for association with the outcome.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00196254_abs5\"><jats:title>Results.<\/jats:title><jats:p>The mortality associated with nosocomial<jats:italic>K. pneumoniae<\/jats:italic>infections was 22% in our study. Drug resistance was found in isolates from 48% of case patients. Multivariate analysis demonstrated that the severity of the patient's underlying condition (odds ratio, 12.50;<jats:italic>P<\/jats:italic>&lt;.01) and isolation of the microorganism from the blood or from another usually sterile site (odds ratio, 2.94;<jats:italic>P<\/jats:italic>= .03) were associated with death. On the other hand, the presence of resistance to cephalosporins and\/or aztreonam did not affect mortality, and the use of inadequate treatment was not significantly associated with increased mortality. When only the severe cases of infection were analyzed, the results were unchanged.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X00196254_abs6\"><jats:title>Conclusions.<\/jats:title><jats:p>Resistance to cephalosporins and\/or aztreonam did not affect mortality, and the use of inadequate treatment was not significantly associated with increased mortality. The reasons for this are not clear. It is possible that the severity of the underlying disease and the patient's condition have a larger role than the<jats:italic>K. pneumoniae<\/jats:italic>infection in determining the outcome, and initially inadequate treatment may not have an impact sufficient to cause irreversible damage, allowing treatment to be changed to an effective drug.<\/jats:p><\/jats:sec>","DOI":"10.1086\/507276","type":"journal-article","created":{"date-parts":[[2006,8,25]],"date-time":"2006-08-25T19:38:10Z","timestamp":1156534690000},"page":"907-912","source":"Crossref","is-referenced-by-count":5,"title":["Nosocomial Infection With Cephalosporin-Resistant<i>Klebsiella pneumoniae<\/i>Is Not Associated With Increased Mortality"],"prefix":"10.1017","volume":"27","author":[{"given":"Cristiana C.","family":"Gomes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelina","family":"Vormittag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cleide R.","family":"Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna S.","family":"Levin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,6,21]]},"reference":[{"key":"S0899823X00196254_ref005","volume-title":"Performance for Antimicrobial Susceptibility Testing M100-S10 (M7)","year":"1999"},{"key":"S0899823X00196254_ref012","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/s15010-003-2176-8","article-title":"Resistance to extended-spectrum cephalosporins and mortality in patients with Citrobacter freundii bacteremia","volume":"31","author":"Kim","year":"2003","journal-title":"Infection"},{"key":"S0899823X00196254_ref004","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(88)90053-3"},{"key":"S0899823X00196254_ref003","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.6.2206-2212.2001"},{"key":"S0899823X00196254_ref002","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0691.2000.00107.x"},{"key":"S0899823X00196254_ref008","doi-asserted-by":"publisher","DOI":"10.1086\/345476"},{"key":"S0899823X00196254_ref009","doi-asserted-by":"publisher","DOI":"10.1086\/375594"},{"key":"S0899823X00196254_ref010","doi-asserted-by":"publisher","DOI":"10.1086\/379321"},{"key":"S0899823X00196254_ref014","doi-asserted-by":"publisher","DOI":"10.1086\/420816"},{"key":"S0899823X00196254_ref001","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(00)00152-8"},{"key":"S0899823X00196254_ref006","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"S0899823X00196254_ref007","first-page":"2S10","article-title":"Challenges, treatment strategies and clinical progression of MRSA bacteremia","volume":"33","author":"Pittet","year":"2004","journal-title":"Presse Med"},{"key":"S0899823X00196254_ref013","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(03)00100-2"},{"key":"S0899823X00196254_ref011","doi-asserted-by":"publisher","DOI":"10.1089\/109629602753681113"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X00196254","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T00:35:44Z","timestamp":1587170144000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X00196254\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,9]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2006,9]]}},"alternative-id":["S0899823X00196254"],"URL":"https:\/\/doi.org\/10.1086\/507276","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,9]]}}}