{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:40:50Z","timestamp":1790844050130,"version":"4.1.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2006,5,1]],"date-time":"2006-05-01T00:00:00Z","timestamp":1146441600000},"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":[[2006,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Results of a 2003 survey carried out in Italy to evaluate the prevalence of extended-spectrum \u03b2-lactamase (ESBL)-producing enterobacteria are presented. Eleven Italian Microbiology Laboratories investigated 9,076 consecutive nonreplicate isolates (inpatients, 6,850; outpatients, 2,226). ESBL screening was performed by MIC data analysis. Confirmation was obtained using the double-disk synergy test and the combination disk test based on CLSI methodology. ESBL determinants were investigated by colony blot hybridization and confirmed by sequencing. Results were compared to those of the 1999 Italian survey (8,015 isolates). The prevalence of ESBL producers was 7.4% among isolates from inpatients (in 1999, 6.3%) and 3.5% among outpatients (no data were available for 1999). Among hospitalized patients, the most prevalent ESBL-positive species was\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    in 1999).\n                    <jats:italic>Proteus mirabilis<\/jats:italic>\n                    was the most prevalent ESBL-positive species among outpatients. In both groups, most ESBL-positive pathogens were obtained from urinary tract infections. TEM-type ESBLs were the most prevalent enzymes (45.4%). Non-TEM, non-SHV determinants emerged: CTX-M-type in\n                    <jats:italic>E. coli<\/jats:italic>\n                    and\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    , and PER-type in\n                    <jats:italic>P. mirabilis<\/jats:italic>\n                    ,\n                    <jats:italic>Providencia<\/jats:italic>\n                    spp., and\n                    <jats:italic>E. coli<\/jats:italic>\n                    . With the exception of 3\/163\n                    <jats:italic>P. mirabilis<\/jats:italic>\n                    isolates and 1\/44\n                    <jats:italic>Providencia stuartii<\/jats:italic>\n                    isolate (all of which were intermediate for imipenem), carbapenems were active against all ESBL-positive enterobacteria. Susceptibility to other drugs was as follows: 84.7% for amikacin, 84.4% for piperacillin-tazobactam, 48.0% for gentamicin, and 32.8% for ciprofloxacin. Carbapenems appear to be the drug of choice. Amikacin and \u03b2-lactam\/\u03b2-lactamase inhibitor combinations represent an alternative in non-life-threatening infections. The appearance of ESBL-positive enterobacteria in the community makes it mandatory that family physicians learn how to treat these pathogens.\n                  <\/jats:p>","DOI":"10.1128\/jcm.44.5.1659-1664.2006","type":"journal-article","created":{"date-parts":[[2006,5,3]],"date-time":"2006-05-03T22:48:14Z","timestamp":1146696494000},"page":"1659-1664","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":78,"title":["Trends in Production of Extended-Spectrum \u03b2-Lactamases among Enterobacteria of Medical Interest: Report of the Second Italian Nationwide Survey"],"prefix":"10.1128","volume":"44","author":[{"given":"Francesco","family":"Luzzaro","sequence":"first","affiliation":[{"name":"Laboratory of Microbiology, Ospedale di Circolo and University of Insubria, Varese"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilina","family":"Mezzatesta","sequence":"additional","affiliation":[{"name":"Department of Microbiological Sciences, University of Catania, Catania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Mugnaioli","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, University of Siena, Siena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariagrazia","family":"Perilli","sequence":"additional","affiliation":[{"name":"Department of Sciences and Biomedical Technologies, University of L'Aquila, L'Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Stefani","sequence":"additional","affiliation":[{"name":"Department of Microbiological Sciences, University of Catania, Catania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Amicosante","sequence":"additional","affiliation":[{"name":"Department of Sciences and Biomedical Technologies, University of L'Aquila, L'Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Maria","family":"Rossolini","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, University of Siena, Siena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Toniolo","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Ospedale di Circolo and University of Insubria, Varese"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/45.2.183"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.1-14.2004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2004.01.010"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.4.933-951.2001"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2004.09.013"},{"key":"e_1_3_2_7_2","unstructured":"Clinical and Laboratory Standards Institute. 2005. 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