{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:50:25Z","timestamp":1790707825815,"version":"4.1.0"},"reference-count":45,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2003,11,1]],"date-time":"2003-11-01T00:00:00Z","timestamp":1067644800000},"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":[[2003,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            A huge variety of extended-spectrum \u03b2-lactamases (ESBLs) have been detected during the last 20 years. The majority of these have been of the TEM or SHV lineage. We have assessed ESBLs occurring among a collection of 455 bloodstream isolates of\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            , collected from 12 hospitals in seven countries. Multiple \u03b2-lactamases were produced by isolates with phenotypic evidence of ESBL production (mean of 2.7 \u03b2-lactamases per isolate; range, 1 to 5). SHV-type ESBLs were the most common ESBL, occurring in 67.1% (49 of 73) of isolates with phenotypic evidence of ESBL production. In contrast, TEM-type ESBLs (TEM-10 type, -12 type, -26 type, and -63 type) were found in just 16.4% (12 of 73) of isolates. The finding of TEM-10 type and TEM-12 type represents the first detection of a TEM-type ESBL in South America. PER (for\n            <jats:italic>Pseudomonas<\/jats:italic>\n            extended resistance)-type \u03b2-lactamases were detected in five of the nine isolates from Turkey and were found with SHV-2-type and SHV-5-type ESBLs in two of the isolates. CTX-M-type ESBLs (\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-2<\/jats:sub>\n            type and\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-3<\/jats:sub>\n            type) were found in 23.3% (17 of 73) of isolates and were found in all study countries except for the United States. We also detected CTX-M-type ESBLs in four countries where they have previously not been described\u2014Australia, Belgium, Turkey, and South Africa. The widespread emergence and proliferation of CTX-M-type ESBLs is particularly noteworthy and may have important implications for clinical microbiology laboratories and for physicians treating patients with serious\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            infections.\n          <\/jats:p>","DOI":"10.1128\/aac.47.11.3554-3560.2003","type":"journal-article","created":{"date-parts":[[2003,10,24]],"date-time":"2003-10-24T02:33:30Z","timestamp":1066962810000},"page":"3554-3560","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":288,"title":["Extended-Spectrum \u03b2-Lactamases in\n            <i>Klebsiella pneumoniae<\/i>\n            Bloodstream Isolates from Seven Countries: Dominance and Widespread Prevalence of SHV- and CTX-M-Type \u03b2-Lactamases"],"prefix":"10.1128","volume":"47","author":[{"given":"David L.","family":"Paterson","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine M.","family":"Hujer","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland Ohio 44106"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Hujer","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland Ohio 44106"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Yeiser","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland Ohio 44106"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Bonomo","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland Ohio 44106"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis B.","family":"Rice","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland Ohio 44106"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Bonomo","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland Ohio 44106"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the International Klebsiella Study 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