{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T02:46:38Z","timestamp":1767408398313},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,3,16]],"date-time":"2006-03-16T00:00:00Z","timestamp":1142467200000},"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>Bloodstream infection (BSI) due to Pseudomonas aeruginosa (Pa) has relevant clinical impact especially in relation to drug resistance determinants. The PER-1 extended-spectrum beta-lactamase (ESBL) is a common enzyme conferring high-level resistance to anti-pseudomonal cephalosporins. Risk factors and treatment outcome of BSI episodes caused by PER-1-positive Pa (PER-1-Pa) strains were compared to those caused by ESBL-negative Pa isolates (ESBL-N-Pa).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Twenty-six BSI cases due to ceftazidime-resistant Pa strains have been investigated. MIC values of anti-pseudomonal drugs were determined by the Etest method (AB Biodisk, Solna, Sweden). The double-disk synergy test was used to detect ESBL production. PCR amplification and DNA sequencing were used to characterize ESBL types. Clinical records of BSI-patients were examined retrospectively. Demographic data, underlying diseases (McCabe-Jackson classification and Charlson weighted index), risk factors, antimicrobial therapy, and treatment outcome were evaluated in cases due to ESBL-positive and cases due to ESBL-N-Pa isolates. Unpaired Student's t-test, Mann-Whitney U-test, Fisher's exact test and the \u03c7<jats:sup>2<\/jats:sup> test were used for statistical analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Nine Pa isolates expressed the PER-1 ESBL; the remaining 17 isolates did not produce ESBLs. Severe sepsis (<jats:italic>P<\/jats:italic> = 0.03), bladder and intravascular catheters (both <jats:italic>P<\/jats:italic> = 0.01), immunosuppressive therapy (<jats:italic>P<\/jats:italic> = 0.04), and mechanical ventilation (<jats:italic>P<\/jats:italic> = 0.03) were significantly associated with BSI due to PER-1-Pa. Empirical treatment (<jats:italic>P<\/jats:italic> = 0.02) and treatment after ID\/AST (<jats:italic>P<\/jats:italic> &lt; 0.01) were rarely adequate in PER-1-Pa cases. With regard to treatment outcome, 77.8% BSI cases due to PER-1-Pa <jats:italic>vs<\/jats:italic>. 28.6% cases due to ESBL-N-Pa isolates failed to respond (<jats:italic>P<\/jats:italic> &lt; 0.03). All cases due to PER-1-Pa that were treated with carbapenems (alone or in combination with amikacin) failed to respond. In contrast, 7\/8 cases due to ESBL-N-Pa given carbapenems were responders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Therapeutic failure and increased hospital costs are associated with BSI episodes caused by PER-1-Pa strains. Thus, recognition and prompt reporting of ESBL-production appears a critical factor for the management of patients with serious <jats:italic>P. aeruginosa<\/jats:italic> infections.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-6-52","type":"journal-article","created":{"date-parts":[[2006,4,6]],"date-time":"2006-04-06T13:28:13Z","timestamp":1144330093000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Pseudomonas aeruginosa bloodstream infections: risk factors and treatment outcome related to expression of the PER-1 extended-spectrum beta-lactamase"],"prefix":"10.1186","volume":"6","author":[{"given":"Andrea","family":"Endimiani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Luzzaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Pini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco","family":"Amicosante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian","family":"Maria Rossolini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Q","family":"Toniolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2006,3,16]]},"reference":[{"key":"316_CR1","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1086\/432803","volume":"41","author":"R Gaynes","year":"2005","unstructured":"Gaynes R, Edwards JR, National Nosocomial Infections Surveillance System: Overview of nosocomial infections caused by Gram-negative bacilli. 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