{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:23:36Z","timestamp":1777922616095,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T00:00:00Z","timestamp":1298937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Aims:<\/jats:italic>\n                    <\/jats:bold>\n                    To identify outbreak episodes of either carriage or infection due to extended spectrum beta-lactamases producing aerobic Gram-negative bacilli (AGNB-ESBL); to establish whether AGNB-ESBL, sensitive to tobramycin, become resistant over time; and to evaluate the impact of selective decontamination of the digestive tract (SDD) on abnormal carriage of AGNB-ESBL.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Design and Setting:<\/jats:italic>\n                    <\/jats:bold>\n                    All children admitted to the pediatric intensive care unit (PICU) over a 12-month period had biweekly surveillance cultures of throat and rectum and diagnostic cultures when clinically indicated. All AGNB were tested for ESBL, and the positive isolates were sent for molecular typing. The PICU uses SDD (parenteral cefotaxime and enteral polymyxin E\/tobramycin) to control abnormal carriage. Patients who had at least one AGNB-ESBL were included in the study.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:bold>\n                    During the study period, 1,101 children were admitted to the PICU. There were 39 patients (3.5%) with a total of 236 cultures positive for AGNB-ESBL. Twenty-eight patients (2.5%) were carriers, and 11 (1%) had proven infections. Organisms isolated from the first culture were 14 patients with\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    , 8 with\n                    <jats:italic toggle=\"yes\">Enterobacter cloacae<\/jats:italic>\n                    , 7 with\n                    <jats:italic toggle=\"yes\">Citrobacter freundii<\/jats:italic>\n                    , 5 with\n                    <jats:italic toggle=\"yes\">Klebsiella oxytoca<\/jats:italic>\n                    , and 5 with\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    . In the first sample, 59% of isolates showed tobramycin resistance. Molecular typing confirmed that there were five different strains of\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    and that similar strains were not isolated in the same period.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    <\/jats:bold>\n                    SDD is an effective measure to control AGNB-ESBL and to avoid outbreak episodes of either carriage or infection. When tobramycin resistance is found, replacing it with another aminoglycoside based on antibiogram may be more effective in achieving AGNB clearance.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2010.0060","type":"journal-article","created":{"date-parts":[[2011,1,26]],"date-time":"2011-01-26T14:20:02Z","timestamp":1296051602000},"page":"17-23","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Is Selective Digestive Decontamination Useful in Controlling Aerobic Gram-Negative Bacilli Producing Extended Spectrum Beta-Lactamases?"],"prefix":"10.1177","volume":"17","author":[{"given":"Francisco","family":"Abecasis","sequence":"first","affiliation":[{"name":"Alder Hey Children's Hospital","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard E.","family":"Sarginson","sequence":"additional","affiliation":[{"name":"Alder Hey Children's Hospital","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Kerr","sequence":"additional","affiliation":[{"name":"Alder Hey Children's Hospital","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nia","family":"Taylor","sequence":"additional","affiliation":[{"name":"University of Liverpool","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hendrik K.F.","family":"van Saene","sequence":"additional","affiliation":[{"name":"University of Liverpool","place":["United Kingdom"]},{"name":"Alder Hey Children's Hospital","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm127"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"4862","DOI":"10.1128\/JCM.43.9.4862-4864.2005","article-title":"Widespread transfer of resistant genes between bacterial species in an intensive care unit: implications for hospital epidemiology","volume":"43","author":"Al Naiemi N.","year":"2005","unstructured":"Al Naiemi N., , Duim B., , Savelkoul P.H. et al. 2005. 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