{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:36:52Z","timestamp":1791387412444,"version":"4.3.3"},"reference-count":37,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T00:00:00Z","timestamp":1285891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:italic>Escherichia coli<\/jats:italic>\n            is the leading cause of bloodstream infections (BSIs) caused by Gram-negative bacteria. The increasing prevalence of antibiotic-resistant\n            <jats:italic>E. coli<\/jats:italic>\n            strains, particularly those producing extended-spectrum \u03b2-lactamases (ESBLs), increases the odds that empirically prescribed antimicrobial therapy for these infections will be inadequate, but the economic impact of this risk has not been fully evaluated. In the present retrospective 1-year analysis of 134 consecutive\n            <jats:italic>E. coli<\/jats:italic>\n            BSIs in our hospital, we explored the clinical and economic impacts of (i) inadequate initial antimicrobial treatment (IIAT) (i.e., empirical treatment with drugs to which the isolate had displayed\n            <jats:italic>in vitro<\/jats:italic>\n            resistance) of these infections and (ii) ESBL production by the bloodstream isolate. Cost data were obtained from the hospital accounting system. Compared with the 107 (79.8%) adequately treated patients, the 27 (20.1%) who received IIAT had a higher proportion of ESBL BSIs (74.0% versus 15.8%), longer (+6 days) and more costly (+EUR 4,322.00) post-BSI-onset hospital stays, and higher 21-day mortality rates (40.7% versus 5.6%). Compared with the 97 non-ESBL infections, the 37 (27.6%) ESBL BSIs were also associated with longer (+7 days) and more costly (+EUR 5,026.00) post-BSI-onset hospital stays and increased 21-day mortality (29.7% versus 6.1%). These findings confirm that the hospital costs and mortality associated with\n            <jats:italic>E. coli<\/jats:italic>\n            BSIs are significantly increased by ESBL production and by IIAT.\n          <\/jats:p>","DOI":"10.1128\/aac.00143-10","type":"journal-article","created":{"date-parts":[[2010,7,27]],"date-time":"2010-07-27T00:51:41Z","timestamp":1280191901000},"page":"4085-4091","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":165,"title":["Costs of Bloodstream Infections Caused by\n            <i>Escherichia coli<\/i>\n            and Influence of Extended-Spectrum-\u03b2-Lactamase Production and Inadequate Initial Antibiotic Therapy"],"prefix":"10.1128","volume":"54","author":[{"given":"Mario","family":"Tumbarello","sequence":"first","affiliation":[{"name":"Institutes of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Spanu","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Di Bidino","sequence":"additional","affiliation":[{"name":"Health Technology Assessment Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Health Technology Assessment Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"Faculty of Economics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico Maria","family":"Trecarichi","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"De Pascale","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica Maria","family":"Proli","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy, Catholic University of the Sacred Heart, Largo A. 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