{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:22:25Z","timestamp":1789593745384,"version":"build-2803163510"},"reference-count":13,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2003,6,1]],"date-time":"2003-06-01T00:00:00Z","timestamp":1054425600000},"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":[[2003,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Receipt of a broad-spectrum cephalosporin is a strong risk factor for isolation of broad-spectrum cephalosporin-resistant\n            <jats:italic>Enterobacter<\/jats:italic>\n            species, and yet the risk from other broad-spectrum \u03b2-lactams hydrolyzed by group 1 \u03b2-lactamases has not been well characterized. We compared the risk conferred by broad-spectrum cephalosporins to that conferred by piperacillin-tazobactam, alone or in combination with an aminoglycoside or a fluoroquinolone. A retrospective cohort was monitored from treatment onset until a broad-spectrum cephalosporin-resistant\n            <jats:italic>Enterobacter<\/jats:italic>\n            strain was isolated or the patient was discharged. There were 447 patients in the piperacillin-tazobactam group and 2,341 patients in the broad-spectrum cephalosporin group. Groups were similar in age (mean, 62.5 years). The piperacillin-tazobactam group had a smaller percentage of men (32% versus 44%,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001) and a lower rate of intensive care unit stay (25% versus 38%,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001) but a higher rate of surgery (41% versus 26%,\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). Groups differed in the distribution of comorbidities. Resistant\n            <jats:italic>Enterobacter<\/jats:italic>\n            strains were isolated from 62 patients, 2% in each group (hazard ratio [RR] = 1.02 [\n            <jats:italic>P<\/jats:italic>\n            = 0.95]). In multivariable analysis, risk was similar among treatment groups (RR = 0.71 [\n            <jats:italic>P<\/jats:italic>\n            = 0.32]). Intensive care unit stay and surgery were associated with increased risk (RR = 4.53 [\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001] and RR = 1.97 [\n            <jats:italic>P<\/jats:italic>\n            = 0.015], respectively), fluoroquinolones were protective (RR = 0.24 [\n            <jats:italic>P<\/jats:italic>\n            = 0.003]), and aminoglycosides did not affect risk (RR = 0.98 [\n            <jats:italic>P<\/jats:italic>\n            = 0.95]). The protective effect of fluoroquinolones against isolation of broad-spectrum cephalosporin-resistant\n            <jats:italic>Enterobacter<\/jats:italic>\n            spp. and the equivalence in risk associated with piperacillin-tazobactam and broad-spectrum cephalosporins may have important clinical and epidemiologic implications.\n          <\/jats:p>","DOI":"10.1128\/aac.47.6.1882-1886.2003","type":"journal-article","created":{"date-parts":[[2003,5,21]],"date-time":"2003-05-21T21:28:09Z","timestamp":1053552489000},"page":"1882-1886","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":38,"title":["Treatment with a Broad-Spectrum Cephalosporin versus Piperacillin-Tazobactam and the Risk for Isolation of Broad-Spectrum Cephalosporin-Resistant\n            <i>Enterobacter<\/i>\n            Species"],"prefix":"10.1128","volume":"47","author":[{"given":"Mitchell J.","family":"Schwaber","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Department of Medicine, Beth Israel Deaconess Medical Center"},{"name":"Unit of Epidemiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 64239, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla S.","family":"Graham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Department of Medicine, Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Sands","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard S.","family":"Gold","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Department of Medicine, Beth Israel Deaconess Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehuda","family":"Carmeli","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Department of Medicine, Beth Israel Deaconess Medical Center"},{"name":"Unit of Epidemiology, Tel-Aviv Sourasky Medical Center, Tel Aviv 64239, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.10.1127"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-8-585"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/0196-6553(94)90067-1","volume":"22","year":"1994","unstructured":"Chow, J. W., V. L. Yu, and D. M. Shlaes. 1994. Epidemiologic perspectives on Enterobacter for the infection control professional. Am. J. Infect. Control22:195-201.","journal-title":"Am. J. Infect. Control"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.2.185"},{"key":"e_1_3_2_6_2","first-page":"2602","volume":"10","year":"1997","unstructured":"D'Agata, E., L. Venkataraman, P. DeGirolami, and M. Samore. 1997. Molecular epidemiology of acquisition of ceftazidime-resistant gram-negative bacilli in a nonoutbreak setting. J. Clin. Microbiol.10:2602-2605.","journal-title":"J. Clin. Microbiol."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0691.2002.00492.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/319600"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1093\/clinids\/21.5.1107","volume":"21","year":"1995","unstructured":"Jacobson, K. L., S. H. Cohen, J. F. Inciardi, J. H. King, W. E. Lippert, T. Iglesias, and C. J. VanCouwenberghe. 1995. The relationship between antecedent antibiotic use and resistance to extended-spectrum cephalosporins in group I \u03b2-lactamase-producing organisms. Clin. Infect. Dis.21:1107-1113.","journal-title":"Clin. Infect. Dis."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.9.2628-2630.2001"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1067\/mic.2000.110544"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(99)70031-3"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.41.1.35"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.10.2.220"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.47.6.1882-1886.2003","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.47.6.1882-1886.2003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T18:13:00Z","timestamp":1645467180000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.47.6.1882-1886.2003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,6]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2003,6]]}},"alternative-id":["10.1128\/AAC.47.6.1882-1886.2003"],"URL":"https:\/\/doi.org\/10.1128\/aac.47.6.1882-1886.2003","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,6]]},"assertion":[{"value":"2002-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2003-03-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2003-06-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}