{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:45:20Z","timestamp":1791488720708,"version":"4.3.4"},"reference-count":51,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T00:00:00Z","timestamp":1180656000000},"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":[[2007,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Bloodstream infections (BSI) caused by extended-spectrum \u03b2-lactamase (ESBL)-producing organisms markedly increase the rates of treatment failure and death. We conducted a retrospective cohort analysis to identify risk factors for mortality in adult in-patients with BSI caused by ESBL-producing\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    (ESBL-BSI). Particular attention was focused on defining the impact on the mortality of inadequate initial antimicrobial therapy (defined as the initiation of treatment with active antimicrobial agents &gt;72 h after collection of the first positive blood culture). A total of 186 patients with ESBL-BSI caused by\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 104),\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 58), or\n                    <jats:italic>Proteus mirabilis<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 24) were identified by our microbiology laboratory from 1 January 1999 through 31 December 2004. The overall 21-day mortality rate was 38.2% (71 of 186). In multivariate analysis, significant predictors of mortality were inadequate initial antimicrobial therapy (odds ratio [OR] = 6.28; 95% confidence interval [CI] = 3.18 to 12.42;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001) and unidentified primary infection site (OR = 2.69; 95% CI = 1.38 to 5.27;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.004). The inadequately treated patients (89 of 186 [47.8%]) had a threefold increase in mortality compared to the adequately treated group (59.5% versus 18.5%; OR = 2.38; 95% CI = 1.76 to 3.22;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). The regimens most commonly classified as inadequate were based on oxyimino cephalosporin or fluoroquinolone therapy. Prompt initiation of effective antimicrobial treatment is essential in patients with ESBL-BSI, and empirical decisions must be based on a sound knowledge of the local distribution of pathogens and their susceptibility patterns.\n                  <\/jats:p>","DOI":"10.1128\/aac.01509-06","type":"journal-article","created":{"date-parts":[[2007,3,26]],"date-time":"2007-03-26T21:05:02Z","timestamp":1174943102000},"page":"1987-1994","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":374,"title":["Predictors of Mortality in Patients with Bloodstream Infections Caused by Extended-Spectrum-\u03b2-Lactamase-Producing\n                    <i>Enterobacteriaceae<\/i>\n                    : Importance of Inadequate Initial Antimicrobial Treatment"],"prefix":"10.1128","volume":"51","author":[{"given":"Mario","family":"Tumbarello","sequence":"first","affiliation":[{"name":"Institute of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Sanguinetti","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Montuori","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico M.","family":"Trecarichi","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brunella","family":"Posteraro","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Fiori","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Citton","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"D'Inzeo","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Fadda","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Cauda","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Spanu","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"1715","volume":"5","year":"2006","unstructured":"Anderson, D. J., J. J. Engemann, L. J. Harrell, Y. Carmeli, L. B. Reller, and K. S. Kaye. 2006. Predictors of mortality in patients with bloodstream infection due to ceftazidime-resistant Klebsiella pneumoniae. Antimicrob. Agents Chemother.5:1715-1720.","journal-title":"Antimicrob. 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