{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T03:11:42Z","timestamp":1771989102182,"version":"3.50.1"},"reference-count":51,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T00:00:00Z","timestamp":1338508800000},"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":[[2012,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Our aims were to identify (i) risk factors associated with the acquisition of multidrug-resistant (MDR, to 3 or more classes of antimicrobials)\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Proteus mirabilis<\/jats:named-content>\n            isolates responsible for bloodstream infections (BSIs) and (ii) the impact on mortality of such infections. Risk factors for acquiring MDR\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. mirabilis<\/jats:named-content>\n            BSIs were investigated in a case-case-control study; those associated with mortality were assessed by comparing survivors and nonsurvivors in a cohort study. The population consisted of 99 adult inpatients with\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. mirabilis<\/jats:named-content>\n            BSIs identified by our laboratory over an 11-year period (1999 to 2009), 36 (33.3%) of which were caused by MDR strains, and the overall 21-day mortality rate was 30.3%. Acquisition of an MDR strain was independently associated with admission from a long-term care facility (odds ratio [OR], 9.78; 95% confidence interval [CI], 1.94 to 49.16), previous therapy with fluoroquinolones (OR, 5.52; 95% CI, 1.30 to 23.43) or oxyimino-cephalosporins (OR, 4.72; 95% CI, 1.31 to 16.99), urinary catheterization (OR, 3.89; 95% CI, 1.50 to 10.09), and previous hospitalization (OR, 2.68; 95% CI, 10.4 to 6.89). Patients with MDR\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. mirabilis<\/jats:named-content>\n            BSIs received inadequate initial antimicrobial therapy (IIAT, i.e., treatment with drugs to which the isolate displayed\n            <jats:italic>in vitro<\/jats:italic>\n            resistance) more frequently than those with non-MDR infections; they also had increased mortality and (for survivors) longer post-BSI-onset hospital stays. In multivariate regression analysis, 21-day mortality was associated with septic shock at BSI onset (OR, 12.97; 95% CI, 32.2 to 52.23),\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. mirabilis<\/jats:named-content>\n            isolates that were MDR (OR, 6.62; 95% CI, 16.4 to 26.68), and IIAT (OR, 9.85; 95% CI, 26.7 to 36.25), the only modifiable risk factor of the 3. These findings can potentially improve clinicians' ability to identify\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">P. mirabilis<\/jats:named-content>\n            BSIs likely to be MDR, thereby reducing the risk of IIAT\u2014a major risk factor for mortality in these cases\u2014and facilitating the prompt implementation of appropriate infection control measures.\n          <\/jats:p>","DOI":"10.1128\/aac.05966-11","type":"journal-article","created":{"date-parts":[[2012,3,27]],"date-time":"2012-03-27T02:53:37Z","timestamp":1332816817000},"page":"3224-3231","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":51,"title":["Multidrug-Resistant Proteus mirabilis Bloodstream Infections: Risk Factors and Outcomes"],"prefix":"10.1128","volume":"56","author":[{"given":"Mario","family":"Tumbarello","sequence":"first","affiliation":[{"name":"Institutes of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico Maria","family":"Trecarichi","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Fiori","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela Raffaella","family":"Losito","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"D'Inzeo","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Campana","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenia","family":"Di Meco","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Liberto","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Fadda","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Cauda","sequence":"additional","affiliation":[{"name":"Institutes of Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Spanu","sequence":"additional","affiliation":[{"name":"Microbiology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/514916"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/604713"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1097\/CCM.0b013e31819da98e","article-title":"Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients","volume":"37","author":"Blot S","year":"2009","unstructured":"BlotS. 2009. 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