{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:00:37Z","timestamp":1762866037082,"version":"3.40.4"},"reference-count":24,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Chemotherapy"],"published-print":{"date-parts":[[2012]]},"abstract":"<b><i>Aim:<\/i><\/b> To describe the risk factors and molecular epidemiology of nosocomial bloodstream infections caused by extended-spectrum \u03b2-lactamase (ESBL)-producing Enterobacteriaceae in a tertiary care hospital. <b><i>Methods:<\/i><\/b> Patients with enterobacteria-positive blood cultures were included. ESBL expression in the isolates was detected using the combination disk method. Antimicrobial susceptibility testing was performed using the disk diffusion method. <i>bla<\/i><sub>SHV<\/sub>, <i>bla<\/i><sub>TEM<\/sub>, and <i>bla<\/i><sub>CTX-M<\/sub> genes were identified in the isolated strains by PCR and sequencing. <i>Klebsiella pneumoniae<\/i> isolates were genotyped by PFGE. <b><i>Results:<\/i><\/b> Of the 90 isolates recovered, half were found to express ESBLs. Twenty-eight (62%) of these isolates were <i>K. pneumoniae,<\/i> 8 (18%) were <i>Escherichia coli,<\/i> 6 (13%) were <i>Enterobacter cloacae,<\/i> and 3 (7%) were <i>Serratia marcescens<\/i>. Multivariate logistic regression analysis showed that the only independent risk factor associated with infection by ESBL-producing strains was use of broad-spectrum cephalosporins. None of the isolates was resistant to imipenem. The<i> bla<\/i><sub>SHV5<\/sub> gene was detected in 84% of isolates, followed by <i>bla<\/i><sub>CTX-M15<\/sub> (27%), <i>bla<\/i><sub>SHV2<\/sub> (9%), and <i>bla<\/i><sub>SHV12<\/sub> (7%). PFGE identified six clones among the 28 ESBL-producing <i>K. pneumoniae <\/i>isolates. <b><i>Conclusions:<\/i><\/b> ESBL-producing <i>K. pneumoniae<\/i> clones were detected throughout the hospital. Use of broad-spectrum cephalosporins is the most important risk factor associated with the proliferation of ESBL-producing strains.<\/jats:p>","DOI":"10.1159\/000339483","type":"journal-article","created":{"date-parts":[[2012,7,19]],"date-time":"2012-07-19T12:41:52Z","timestamp":1342701712000},"page":"217-224","source":"Crossref","is-referenced-by-count":17,"title":["Risk Factors Associated with Extended-Spectrum \u03b2-Lactamase-Producing Enterobacteriaceae Nosocomial Bloodstream Infections in a Tertiary Care Hospital: A Clinical and Molecular Analysis"],"prefix":"10.1159","volume":"58","author":[{"given":"Sissy","family":"Muro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"Garza-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Camacho-Ortiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria Mar\u00eda","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Mart\u00edn","family":"Llaca-D\u00edaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Bosques","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"Rositas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2012,7,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1159%2F000321032"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038%2F35021206"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159%2F000329661"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159%2F000320943"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.ijid.2008.03.008"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1128%2FCMR.18.4.657-686.2005"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016%2FS1473-3099%2808%2970041-0"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1086%2F500662"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1093%2Finfdis%2F174.3.529"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1128%2FJCM.39.6.2206-2212.2001"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1053%2Fjhin.2002.1288"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1128%2FAAC.50.4.1257-1262.2006"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1086%2F420816"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1086%2F500936"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1086%2F508877"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1128%2FAAC.46.2.500-510.2002"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1128%2FAAC.00075-10"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016%2FS0924-8579%2899%2900131-4"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1128%2FAAC.48.12.4574-4581.2004"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1128%2FAAC.01509-06"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016%2FS1201-9712%2800%2990072-9"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1128%2FAAC.45.12.3355-3361.2001"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1128%2FJCM.40.12.4666-4669.2002"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3201%2Feid0805.010346"}],"container-title":["Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339483","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339483","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339483","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:29:31Z","timestamp":1745432971000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000339483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2012,8,1]]},"published-print":{"date-parts":[[2012,8,24]]}},"URL":"https:\/\/doi.org\/10.1159\/000339483","archive":["Portico"],"relation":{},"ISSN":["0009-3157","1421-9794"],"issn-type":[{"type":"print","value":"0009-3157"},{"type":"electronic","value":"1421-9794"}],"subject":[],"published":{"date-parts":[[2012]]}}}