{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:13:51Z","timestamp":1762866831452},"reference-count":0,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:p>BACKGROUND: Clinical features associated with Gram\u2010negative bacterial isolates with extended\u2010spectrum beta\u2010lactamase (ESBL)\u2010 and AmpC\u2010mediated resistance identified in Canadian hospitals is largely unknown. The objective of the present study was to determine the demographics, risk factors and outcomes of patients with ESBL\u2010 or AmpC\u2010mediated resistant organisms in Canadian hospitals.<\/jats:p><jats:p>METHODS: Patients with clinical cultures of <jats:italic>Escherichia coli<\/jats:italic> or <jats:italic>Klebsiella<\/jats:italic> species were matched with patients with a similar organism but susceptible to third\u2010generation cephalosporins. Molecular identification of the AmpC or ESBL was determined using a combination of polymerase chain reaction and sequence analysis. Univariate and multivariate logistic regression analysis was performed to identify variables associated with becoming a case.<\/jats:p><jats:p>RESULTS: Eight Canadian hospitals identified 106 cases (ESBL\/AmpC) and 106 controls. All risk factors identified in the univariate analysis as a predictor of being an ESBL\/AmpC cases at the 0.20 P\u2010value were included in the multivariate analysis. No significant differences in outcomes were observed (unfavourable responses 17% versus 15% and mortality rates 13% versus 7%, P not significant). Multivariate logistic regression found an association of becoming an ESBL\/AmpC case with: previous admission to a nursing home (OR 8.28, P=0.01) or acute care facility (OR 1.96, P=0.03), length of stay before infection (OR 3.05, P=0.004), and previous use of first\u2010generation cephalosporins (OR 2.38, P=0.02) or third\u2010generation cephalosporins (OR 4.52, P=0.01). Appropriate antibiotics were more likely to be given to controls (27.0% versus 13.3%, P=0.05) and number of days to appropriate antibiotics was longer for cases (median 2.8 days versus 1.2 days, P=0.05).<\/jats:p><jats:p>CONCLUSION: The importance of patient medical history, present admission and antibiotic use should be considered for all <jats:italic>E coli<\/jats:italic> or <jats:italic>Klebsiella<\/jats:italic> species patients pending susceptibility testing results.<\/jats:p>","DOI":"10.1155\/2009\/725872","type":"journal-article","created":{"date-parts":[[2016,3,15]],"date-time":"2016-03-15T08:03:36Z","timestamp":1458029016000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Risk Factors for and Outcomes Associated with Clinical Isolates of <i>Escherichia coli<\/i> and <i>Klebsiella<\/i> Species Resistant to Extended\u2010Spectrum Cephalosporins among Patients Admitted to Canadian Hospitals"],"prefix":"10.1155","volume":"20","author":[{"given":"Marianna","family":"Ofner-Agostini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Simor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Mulvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"McGeer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahir","family":"Hirji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"McCracken","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Gravel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Bryce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,1]]},"container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjidmm\/2009\/725872.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2009\/725872","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T18:58:54Z","timestamp":1723057134000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2009\/725872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2009,1]]}},"alternative-id":["10.1155\/2009\/725872"],"URL":"https:\/\/doi.org\/10.1155\/2009\/725872","archive":["Portico"],"relation":{},"ISSN":["1712-9532","1918-1493"],"issn-type":[{"type":"print","value":"1712-9532"},{"type":"electronic","value":"1918-1493"}],"subject":[],"published":{"date-parts":[[2009,1]]},"assertion":[{"value":"2009-01-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}