{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T10:16:28Z","timestamp":1781950588040,"version":"3.54.5"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T00:00:00Z","timestamp":1560902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["282512"],"award-info":[{"award-number":["282512"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Carriers of extended-spectrum \u03b2-lactamase\u2013producing Enterobacteriaceae (ESBL-PE) who receive cephalosporin-based prophylaxis have twice the risk of surgical site infection (SSI) following colorectal surgery as noncarriers. We tested whether ESBL-PE screening and personalized prophylaxis with ertapenem reduces SSI risk among carriers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a prospective nonrandomized, nonblinded, interventional study in 3 hospitals in Israel, Switzerland, and Serbia. Patients were screened for ESBL-PE carriage before elective colorectal surgery. During the baseline phase, departmental guidelines advised prophylaxis with a cephalosporin plus metronidazole. In the intervention phase, guidelines were changed for ESBL-PE carriers to receive ertapenem. The primary outcome was any type of SSI within 30 days. We calculated adjusted risk differences (ARDs) following logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The intention-to-treat analysis compared 209 ESBL-PE carriers in the baseline phase to 269 in the intervention phase. SSI rates were 21.5% and 17.5%, respectively (ARD, \u20134.7% [95% confidence interval {CI}, \u201311.8% to 2.4%]). Unplanned crossover was high (15%), so to assess efficacy we performed an as-treated analysis comparing 247 patients who received cephalosporin-based prophylaxis with 221 who received ertapenem. SSI rates were 22.7% and 15.8%, respectively (ARD, \u20137.7% [95% CI, \u201314.6% to \u2013.8%]), and rates of SSI caused by ESBL-PE were 6.5% and 0.9%, respectively (ARD, \u20135.6% [95% CI, \u20138.9% to \u20132.3%]). There was no significant difference in the rate of deep SSI. The number needed to treat to prevent 1 SSI in ESBL-PE carriers was 13.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Screening for ESBL-PE carriage before colorectal surgery and personalizing prophylaxis for carriers is efficacious in reducing SSI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz524","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T11:10:14Z","timestamp":1560856214000},"page":"1891-1897","source":"Crossref","is-referenced-by-count":38,"title":["Personalized Ertapenem Prophylaxis for Carriers of Extended-spectrum \u03b2-Lactamase\u2013producing Enterobacteriaceae Undergoing Colorectal Surgery"],"prefix":"10.1093","volume":"70","author":[{"given":"Amir","family":"Nutman","sequence":"first","affiliation":[{"name":"National Center for Infection Control and Antibiotic Resistance, Tel-Aviv Sourasky Medical Center"},{"name":"Sackler Faculty of Medicine, Tel-Aviv University, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Temkin","sequence":"first","affiliation":[{"name":"National Center for Infection Control and Antibiotic Resistance, Tel-Aviv Sourasky Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Harbarth","sequence":"first","affiliation":[{"name":"Infection Control Program, Geneva University Hospitals and Faculty of Medicine, World Health Organization Collaborating Center, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biljana","family":"Carevic","sequence":"first","affiliation":[{"name":"Department of Hospital Epidemiology, Clinical Center of Serbia, Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Ris","sequence":"first","affiliation":[{"name":"Department of Surgery, Geneva University Hospitals and Faculty of Medicine, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Fankhauser-Rodriguez","sequence":"first","affiliation":[{"name":"Infection Control Program, Geneva University Hospitals and Faculty of Medicine, World Health Organization Collaborating Center, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Radovanovic","sequence":"first","affiliation":[{"name":"Department of Hospital Epidemiology, Clinical Center of Serbia, Belgrade"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biana","family":"Dubinsky-Pertzov","sequence":"first","affiliation":[{"name":"National Center for Infection Control and Antibiotic Resistance, Tel-Aviv Sourasky Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimrit","family":"Cohen-Percia","sequence":"first","affiliation":[{"name":"National Center for Infection Control and Antibiotic Resistance, Tel-Aviv Sourasky Medical 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