{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:09:17Z","timestamp":1790784557112,"version":"4.1.0"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2010,5,1]],"date-time":"2010-05-01T00:00:00Z","timestamp":1272672000000},"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":["J Clin Microbiol"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Extended-spectrum-\u03b2-lactamase (ESBL)-producing\n            <jats:italic>Escherichia coli<\/jats:italic>\n            (ESBLEC) is an increasing cause of community and nosocomial infections worldwide. However, there is scarce clinical information about nosocomial bloodstream infections (BSIs) caused by these pathogens. We performed a study to investigate the risk factors for and prognosis of nosocomial BSIs due to ESBLEC in 13 Spanish hospitals. Risk factors were assessed by using a case-control-control study; 96 cases (2 to 16% of all nosocomial BSIs due to\n            <jats:italic>E. coli<\/jats:italic>\n            in the participating centers) were included; the most frequent ESBL was CTX-M-14 (48% of the isolates). We found CTX-M-15 in 10% of the isolates, which means that this enzyme is emerging as a cause of invasive infections in Spain. By repetitive extragenic palindromic sequence-PCR, most isolates were found to be clonally unrelated. By multivariate analysis, the risk factors for nosocomial BSIs due to ESBLEC were found to be organ transplant (odds ratio [OR] = 4.8; 95% confidence interval [CI] = 1.4 to 15.7), the previous use of oxyimino-\u03b2-lactams (OR = 6.0; 95% CI = 3.0 to 11.8), and unknown BSI source (protective; OR = 0.4; 95% CI = 0.2 to 0.9), and duration of hospital stay (OR = 1.02; 95% CI = 1.00 to 1.03). The variables independently associated with mortality were a Pitt score of &gt;1 (OR = 3.9; 95% CI = 1.2 to 12.9), a high-risk source (OR = 5.5; 95% CI = 1.4 to 21.9), and resistance to more than three antibiotics, apart from penicillins and cephalosporins (OR = 6.5; 95% CI = 1.4 to 30.0). Inappropriate empirical therapy was not associated with mortality. We conclude that ESBLEC is an important cause of nosocomial BSIs. The previous use of oxyimino-\u03b2-lactams was the only modifiable risk factor found. Resistance to drugs other than penicillins and cephalosporins was associated with increased mortality.\n          <\/jats:p>","DOI":"10.1128\/jcm.02353-09","type":"journal-article","created":{"date-parts":[[2010,2,25]],"date-time":"2010-02-25T05:30:02Z","timestamp":1267075802000},"page":"1726-1731","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":138,"title":["Risk Factors and Prognosis of Nosocomial Bloodstream Infections Caused by Extended-Spectrum-\u03b2-Lactamase-Producing\n            <i>Escherichia coli<\/i>"],"prefix":"10.1128","volume":"48","author":[{"given":"Jesu\u0301s","family":"Rodri\u0301guez-Ban\u0303o","sequence":"first","affiliation":[{"name":"Seccio\u0301n de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Seville"},{"name":"Departamento de Medicina, Universidad de Seville, Seville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Encarnacio\u0301n","family":"Pico\u0301n","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Universitario Virgen Macarena, Seville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Gijo\u0301n","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Universitario Gregorio Maran\u0303o\u0301n, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose\u0301 Ramo\u0301n","family":"Herna\u0301ndez","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Universitario Virgen Macarena, Seville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose M.","family":"Cisneros","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Roci\u0301o, 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