{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T08:59:36Z","timestamp":1778921976431,"version":"3.51.4"},"reference-count":37,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[1998,1,1]],"date-time":"1998-01-01T00:00:00Z","timestamp":883612800000},"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":[[1998,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            An outbreak due to extended-spectrum \u03b2-lactamase-producing\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            (ESBL-KP) was detected from May 1993 to June 1995. A total of 145 patients, particularly patients in intensive care units (ICUs) (107 patients [72%]), were colonized or infected. Infection developed in 92 (63%) patients, and primary bacteremia caused by ESBL-KP was the most frequent infection (40 of 92 patients [43%]). A single clone of ESBL-KP was identified by pulsed-field gel electrophoresis analysis throughout the whole period, and no molecular epidemiological relationship could be found between the epidemic strain and non-ESBL-KP isolates. To determine risk factors for ESBL-KP infection weekly rectal swabs were obtained in three serial incidence surveys (470 patients); the probabilities of carriage of ESBL-KP in the digestive tract were 33% (October and November 1993), 40% (May and June 1994), and 0% (October and November 1995) at 10 days of ICU admission. A logistic regression model identified prior carriage of ESBL-KP in the digestive tract (odds ratio, 3.4; 95% confidence interval 1.1 to 10.4) as an independent variable associated with ESBL-KP infection. A statistically significant correlation was observed between the restricted use of oxyimino-\u03b2-lactams (189 defined daily doses [DDD]\/1,000 patient-days to 24 DDD\/1,000 patient-days) and the trends of ESBL-KP infection (\n            <jats:italic>r<\/jats:italic>\n            = 0.7;\n            <jats:italic>P<\/jats:italic>\n            = 0.03).\n          <\/jats:p>","DOI":"10.1128\/aac.42.1.53","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T00:30:08Z","timestamp":1539045008000},"page":"53-58","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":238,"title":["Epidemiology and Successful Control of a Large Outbreak Due to\n            <i>Klebsiella pneumoniae<\/i>\n            Producing ExtendedSpectrum \u03b2-Lactamases"],"prefix":"10.1128","volume":"42","author":[{"given":"Carmen","family":"Pen\u0303a","sequence":"first","affiliation":[{"name":"<!--label omitted: 1-->Infectious Disease Service,1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miquel","family":"Pujol","sequence":"additional","affiliation":[{"name":"<!--label omitted: 1-->Infectious Disease Service,1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Ardanuy","sequence":"additional","affiliation":[{"name":"<!--label omitted: 2-->Microbiology Service,2 and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asumpta","family":"Ricart","sequence":"additional","affiliation":[{"name":"<!--label omitted: 3-->Intensive Care Unit Service,3 Hospital de Bellvitge, Universidad de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Pallares","sequence":"additional","affiliation":[{"name":"<!--label omitted: 1-->Infectious Disease Service,1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josefina","family":"Lin\u0303ares","sequence":"additional","affiliation":[{"name":"<!--label omitted: 2-->Microbiology Service,2 and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Ariza","sequence":"additional","affiliation":[{"name":"<!--label omitted: 1-->Infectious Disease Service,1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Gudiol","sequence":"additional","affiliation":[{"name":"<!--label omitted: 1-->Infectious Disease Service,1"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1007\/BF01967377","article-title":"Outbreak of nosocomial infections due to Klebsiella pneumoniae producing SHV-4 \u03b2-lactamase","volume":"9","author":"Arlet G.","year":"1990","unstructured":"Arlet G. Sanson-Le Pors M. J. Rouveau M. Fournier G. Marie O. Schlemmer B. Philippon A. Outbreak of nosocomial infections due to Klebsiella pneumoniae producing SHV-4 \u03b2-lactamase. Eur. J. Clin. Microbiol. Infect. Dis. 9 1990 797 803","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.32.10.2553-2558.1994"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.31.5.723"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/BF01739303","article-title":"Spread of Klebsiella pneumoniae producing SHV-5 \u03b2-lactamase among hospitalized patients","volume":"21","author":"Bauerfeind A.","year":"1993","unstructured":"Bauerfeind A. Rosenthal E. Eberlein E. Holley M. Schweighart S. Spread of Klebsiella pneumoniae producing SHV-5 \u03b2-lactamase among hospitalized patients. 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