{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:16:08Z","timestamp":1790788568511,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,2,14]],"date-time":"2006-02-14T00:00:00Z","timestamp":1139875200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The frequency of ESBL producing <jats:italic>Klebsiella pneumoniae<\/jats:italic> bloodstream infections (BSI) is high in Brazilian hospitals, however little is known regarding what role, if any, resistance plays in the expected outcome in hospitals with a high prevalence of these pathogens.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>From 1996 to 2001, hospital acquired <jats:italic>K. pneumoniae<\/jats:italic> BSI were evaluated retrospectively. Each patient was included only once at the time of BSI. ESBL producing strains were identified using the E-test method. The association of variables with the mortality related to bacteremia was included in a stepwise logistic regression model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>One hundred and eight hospital acquired <jats:italic>K. pneumoniae<\/jats:italic> BSI met criteria for inclusion. Fifty two percent were due to ESBL producing strains. The overall in-hospital mortality was 40.8%. Variables independently predicting death by multivariate analysis were the following: mechanical ventilation (<jats:bold>p = 0.001<\/jats:bold>), number of comorbidities (<jats:bold>p = 0.003<\/jats:bold>), antimicrobials prescribed before bacteremia (<jats:bold>p = 0.01<\/jats:bold>) and fatal underlying disease (<jats:bold>p = 0.025<\/jats:bold>).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Bacteremia due to ESBL producing <jats:italic>K. pneumoniae<\/jats:italic> strains was not an independent predictor for death in patients with BSI. An increased mortality in hospital-acquired BSI by <jats:italic>K. pneumoniae<\/jats:italic> was related to the requirement for mechanical ventilation, more than two comorbidities, the previous use of two or more antibiotics, and the presence of a rapidly fatal disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-6-24","type":"journal-article","created":{"date-parts":[[2006,2,17]],"date-time":"2006-02-17T07:45:25Z","timestamp":1140162325000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum \u03b2-lactamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence"],"prefix":"10.1186","volume":"6","author":[{"given":"Alexandre R","family":"Marra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9rgio B","family":"Wey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adauto","family":"Castelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina","family":"Gales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruy Guilherme R","family":"Cal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 R do Carmo","family":"Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B","family":"Edmond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Alberto P","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2006,2,14]]},"reference":[{"issue":"3","key":"288_CR1","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/0196-6553(88)90053-3","volume":"16","author":"JS Garner","year":"1988","unstructured":"Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM: CDC definitions for nosocomial infections, 1988. 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