{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T04:51:25Z","timestamp":1793508685639,"version":"4.5.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Study Education and Research Committee of Pathology Queensland"},{"name":"Australian Infectious Disease Centre and Australian Genome Research Facility"},{"name":"Royal College of Pathologists of Australasia Foundation"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1157530"],"award-info":[{"award-number":["GNT1157530"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aims to assess the association of piperacillin\/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 320 isolates from 379 enrolled patients were available with susceptibility to piperacillin\/tazobactam 94% and meropenem 100%. The piperacillin\/tazobactam nonsusceptible breakpoint (MIC &amp;gt;16 mg\/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% confidence interval [CI] 2.8\u201387.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin\/tazobactam compared with meropenem was 9% (95% CI 3%\u201315%) and 8% (95% CI 2%\u201315%) for the original PA population and the post hoc MA populations, which reduced to 5% (95% CI \u22121% to 10%) after excluding strains with piperacillin\/tazobactam MIC values &amp;gt;16 mg\/L. Isolates coharboring extended spectrum \u03b2-lactamase (ESBL) and OXA-1 genes were associated with elevated piperacillin\/tazobactam MICs and the highest risk increase in 30-day mortality of 14% (95% CI 2%\u201328%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After excluding nonsusceptible strains, the 30-day mortality difference from the MERINO trial was less pronounced for piperacillin\/tazobactam. Poor reliability in susceptibility testing performance for piperacillin\/tazobactam and the high prevalence of OXA coharboring ESBLs suggests that meropenem remains the preferred choice for definitive treatment of ceftriaxone nonsusceptible Escherichia coli and Klebsiella.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1479","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T15:10:01Z","timestamp":1601737801000},"page":"e3842-e3850","source":"Crossref","is-referenced-by-count":154,"title":["Association Between Minimum Inhibitory Concentration, Beta-lactamase Genes and Mortality for Patients Treated With Piperacillin\/Tazobactam or Meropenem From the MERINO Study"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2149-0745","authenticated-orcid":false,"given":"A","family":"Henderson","sequence":"first","affiliation":[{"name":"University of Queensland, UQ Centre for Clinical Research, Brisbane, 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