{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:42:46Z","timestamp":1790811766375,"version":"4.1.0"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2002,1,1]],"date-time":"2002-01-01T00:00:00Z","timestamp":1009843200000},"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":[[2002,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            An Italian nationwide survey was carried out to assess the prevalences and the antimicrobial susceptibilities of members of the family\n            <jats:italic>Enterobacteriaceae<\/jats:italic>\n            producing extended-spectrum \u03b2-lactamases (ESBLs). Over a 6-month period, 8,015 isolates were obtained from hospitalized patients and screened for resistance to extended-spectrum cephalosporins and monobactams. On the basis of a synergistic effect between clavulanate and selected \u03b2-lactams (ceftazidime, aztreonam, cefotaxime, cefepime, and ceftriaxone), 509 isolates were found to be ESBL positive (6.3%). Colony blot hybridization with\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>TEM<\/jats:sub>\n            and\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>SHV<\/jats:sub>\n            DNA probes allowed one to distinguish four different genotypes: TEM-positive, SHV-positive, TEM- and SHV-positive, and non-TEM, non-SHV ESBL types. MICs for each isolate (E-test) were obtained for widely used \u03b2-lactams, combinations of \u03b2-lactams with \u03b2-lactamase inhibitors, aminoglycosides, and fluoroquinolones. Among ESBL-positive strains,\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            ,\n            <jats:italic>Proteus mirabilis<\/jats:italic>\n            , and\n            <jats:italic>Escherichia coli<\/jats:italic>\n            accounted for 73.6% of isolates. Overall, TEM-type ESBLs were more prevalent than SHV-type enzymes (234 versus 173), whereas the prevalence of strains producing both TEM- and SHV-type ESBLs was similar to that of isolates producing non-TEM, non-SHV enzymes (55 and 38, respectively). In vitro, all but one of the ESBL-producing isolates remained susceptible to imipenem. Susceptibility to other drugs varied: piperacillin-tazobactam, 91%; amoxicillin-clavulanic acid, 85%; cefoxitin, 78%; amikacin, 76%; ampicillin-sulbactam, 61%; ciprofloxacin, 58%; and gentamicin, 56%. Associated resistance to aminoglycosides and ciprofloxacin was observed most frequently among TEM-positive strains. Since therapeutic options for multiresistant\n            <jats:italic>Enterobacteriaceae<\/jats:italic>\n            are limited, combinations of \u03b2-lactams and \u03b2-lactamase inhibitors appear to represent an important alternative for treating infections caused by ESBL-producing\n            <jats:italic>Enterobacteriaceae<\/jats:italic>\n            .\n          <\/jats:p>","DOI":"10.1128\/aac.46.1.196-202.2002","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T09:56:57Z","timestamp":1027763817000},"page":"196-202","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":118,"title":["Occurrence of Extended-Spectrum \u03b2-Lactamases in Members of the Family\n            <i>Enterobacteriaceae<\/i>\n            in Italy: Implications for Resistance to \u03b2-Lactams and Other Antimicrobial Drugs"],"prefix":"10.1128","volume":"46","author":[{"given":"T.","family":"Spanu","sequence":"first","affiliation":[{"name":"Institute of Microbiology, Catholic University, Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Luzzaro","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Ospedale di Circolo and University of Insubria, Varese"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Perilli","sequence":"additional","affiliation":[{"name":"Department of Sciences and Biomedical Technology, University of L\u2019Aquila, L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Amicosante","sequence":"additional","affiliation":[{"name":"Department of Sciences and Biomedical Technology, University of L\u2019Aquila, L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Toniolo","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Ospedale di Circolo and University of Insubria, Varese"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Fadda","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Catholic University, Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"The Italian ESBL Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"415","volume":"42","year":"1999","unstructured":"Amyes, S. 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