{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:02:55Z","timestamp":1791237775638,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2011,6,1]],"date-time":"2011-06-01T00:00:00Z","timestamp":1306886400000},"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":[[2011,6]]},"abstract":"<jats:p>\n                    There is limited clinical information regarding community-onset bacteremia caused by extended-spectrum \u03b2-lactamase (ESBL)\u2013producing\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    . This study was performed to evaluate risk factors and clinical outcomes of community-onset bacteremia caused by ESBL-producing\n                    <jats:italic toggle=\"yes\">K. pneumoniae.<\/jats:italic>\n                    A total of 435 patients with community-onset\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    bacteremia were included and data from patients with ESBL-producing\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    bacteremia were compared to those with non-ESBL-producing bacteremia. Isolates with ESBLs were microbiologically characterized. Of 435 patients with community-onset\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    bacteremia, 33 (7.6%) were infected with ESBL producers, of which 25 were further classified as healthcare-associated infections. The most common underlying diseases were solid tumors (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200920, 60.6%) and diabetes mellitus (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200910, 30.3%), and the most common infection was intra-abdominal infection (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200920, 60.6%). Multivariate analysis showed that corticosteroid use (odds ratio [OR]\u2009=\u200913.73, 95% confidence interval [CI]\u2009=\u20091.93\u201397.6,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.009), percutaneous tubes (OR\u2009=\u20097.30, 95% CI\u2009=\u20092.41\u201322.12,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and prior receipt of antibiotics (OR\u2009=\u20095.65, 95% CI\u2009=\u20092.43\u201314.16,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) were significant factors associated with ESBL producers. When the 30-day mortality rate was evaluated, no significant difference was found between ESBL group and non-ESBL group (12.1% [4\/32] vs. 16.0% [35\/192];\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.429). Among 16 isolates, for which the ESBL characterization was performed by PCR, the most common types of ESBLs were SHV (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200916) and cefotaxime-M-2 (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20095). Pulsed-field gel electrophoresis analysis of the ESBL-producing organisms showed extensive clonal diversity. ESBL-producing\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    is a significant cause of bacteremia, even in patients with community-onset infections, particularly in patients with corticosteroid use, percutaneous tube, prior receipt of antibiotics, or healthcare-associated infections.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2010.0134","type":"journal-article","created":{"date-parts":[[2011,3,9]],"date-time":"2011-03-09T15:41:19Z","timestamp":1299685279000},"page":"267-273","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Epidemiology and Clinical Features of Community-Onset Bacteremia Caused by Extended-Spectrum \u03b2-Lactamase\u2013Producing\n                    <i>Klebsiella pneumoniae<\/i>"],"prefix":"10.1177","volume":"17","author":[{"given":"Jeong-a","family":"Lee","sequence":"first","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]},{"name":"Konyang University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol-In","family":"Kang","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Jeong","family":"Joo","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Eun","family":"Ha","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Ji","family":"Kang","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Yeon","family":"Park","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doo Ryeon","family":"Chung","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyong Ran","family":"Peck","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwan Soo","family":"Ko","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam Yong","family":"Lee","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Hoon","family":"Song","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2011,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"3506","DOI":"10.1128\/AAC.47.11.3506-3514.2003","article-title":"Extended-spectrum beta-lactamase-producing Enterobacteriaceae in community and private health care centers","volume":"47","author":"Arpin C.","year":"2003","unstructured":"Arpin C., , Dubois V., , Coulange L., , Andre C., , Fischer I., , Noury P., , Grobost F., , Brochet J.P., , Jullin J., , Dutilh B., , Larribet G., , Lagrange I., , Quentin C. 2003. Extended-spectrum beta-lactamase-producing Enterobacteriaceae in community and private health care centers. Antimicrob. Agents Chemother., 47:3506\u20133514.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/j.1469-0691.2009.02941.x","article-title":"Risk factors for extended-spectrum beta-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections","volume":"16","author":"Azap O.K.","year":"2009","unstructured":"Azap O.K., , Arslan H., , Serefhanoglu K., , Colakoglu S., , Erdogan H., , Timurkaynak F., , Senger S.S. 2009. Risk factors for extended-spectrum beta-lactamase positivity in uropathogenic Escherichia coli isolated from community-acquired urinary tract infections. Clin. Microbiol. Infect., 16:147\u2013151.","journal-title":"Clin. Microbiol. Infect."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/604713"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl035"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"4061","DOI":"10.1128\/JCM.01577-08","article-title":"Evidence for clonal dissemination of the serotype K1 Klebsiella pneumoniae strain causing invasive liver abscesses in Korea","volume":"46","author":"Chung D.R.","year":"2008","unstructured":"Chung D.R., , Lee H.R., , Lee S.S., , Kim S.W., , Chang H.H., , Jung S.I., , Oh M.D., , Ko K.S., , Kang C.I., , Peck K.R., , Song J.H. 2008. Evidence for clonal dissemination of the serotype K1 Klebsiella pneumoniae strain causing invasive liver abscesses in Korea. J. Clin. Microbiol., 46:4061\u20134063.","journal-title":"J. Clin. Microbiol."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-003-1084-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.8.3655-3660.2003"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-10-200211190-00007"},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s10096-007-0401-6","article-title":"Clinical features and outcome of community-onset bloodstream infections caused by extended-spectrum beta-lactamase-producing Escherichia coli","volume":"27","author":"Kang C.I.","year":"2008","unstructured":"Kang C.I., , Cheong H.S., , Chung D.R., , Peck K.R., , Song J.H., , Oh M.D., , Choe K.W. 2008. Clinical features and outcome of community-onset bloodstream infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Eur. J. Clin. Microbiol. Infect. Dis., 27:85\u201388.","journal-title":"Eur. J. Clin. Microbiol. Infect. 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Dis."},{"key":"e_1_3_3_23_2","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1128\/AAC.49.5.2137-2139.2005","article-title":"High levels of antimicrobial coresistance among extended-spectrum-beta-lactamase-producing Enterobacteriaceae","volume":"49","author":"Schwaber M.J.","year":"2005","unstructured":"Schwaber M.J., , Navon-Venezia S., , Schwartz D., , Carmeli Y. 2005. High levels of antimicrobial coresistance among extended-spectrum-beta-lactamase-producing Enterobacteriaceae. Antimicrob. Agents Chemother., 49:2137\u20132139.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_24_2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/jac\/dki429","article-title":"CTX-M-15 extended-spectrum (beta)-lactamase from Nigerian Klebsiella pneumoniae","volume":"57","author":"Soge O.O.","year":"2006","unstructured":"Soge O.O., , Queenan A.M., , Ojo K.K., , Adeniyi B.A., , Roberts M.C. 2006. CTX-M-15 extended-spectrum (beta)-lactamase from Nigerian Klebsiella pneumoniae. J. Antimicrob. Chemother., 57:24\u201330.","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_3_3_25_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jinf.2009.02.002","article-title":"Incidence and clinical impact of extended-spectrum-beta-lactamase (ESBL) production and fluoroquinolone resistance in bloodstream infections caused by Escherichia coli in patients with hematological malignancies","volume":"58","author":"Trecarichi E.M.","year":"2009","unstructured":"Trecarichi E.M., , Tumbarello M., , Spanu T., , Caira M., , Fianchi L., , Chiusolo P., , Fadda G., , Leone G., , Cauda R., , Pagano L. 2009. Incidence and clinical impact of extended-spectrum-beta-lactamase (ESBL) production and fluoroquinolone resistance in bloodstream infections caused by Escherichia coli in patients with hematological malignancies. J. Infect., 58:299\u2013307.","journal-title":"J. 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