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dc.creatorRodríguez-Baño, Jesúses
dc.creatorPicón, Encarnaciónes
dc.creatorGijón, Palomaes
dc.creatorHernández, José Ramónes
dc.creatorCisneros, José Migueles
dc.creatorPeña, Carmenes
dc.creatorAlmela, Manueles
dc.creatorAlmirante, Benitoes
dc.creatorGrill, Fabioes
dc.creatorColomina, Javieres
dc.creatorMolinos, Soniaes
dc.creatorOliver, Antonioes
dc.creatorFernández-Mazarrasa, Carloses
dc.creatorNavarro, Gemmaes
dc.creatorColoma, Anaes
dc.creatorLópez Cerero, Lorenaes
dc.creatorPascual Hernández, Álvaroes
dc.date.accessioned2016-05-05T18:01:03Z
dc.date.available2016-05-05T18:01:03Z
dc.date.issued2010-05
dc.identifier.issn0095-1137es
dc.identifier.urihttp://hdl.handle.net/11441/40829
dc.description.abstractExtended-spectrum-B-lactamase (ESBL)-producing Escherichia coli (ESBLEC) is an increasing cause of community and nosocomial infections worldwide. However, there is scarce clinical information about nosocomial bloodstream infections (BSIs) caused by these pathogens. We performed a study to investigate the risk factors for and prognosis of nosocomial BSIs due to ESBLEC in 13 Spanish hospitals. Risk factors were assessed by using a case-control-control study; 96 cases (2 to 16% of all nosocomial BSIs due to E. coli in the participating centers) were included; the most frequent ESBL was CTX-M-14 (48% of the isolates). We found CTX-M-15 in 10% of the isolates, which means that this enzyme is emerging as a cause of invasive infections in Spain. By repetitive extragenic palindromic sequence-PCR, most isolates were found to be clonally unrelated. By multivariate analysis, the risk factors for nosocomial BSIs due to ESBLEC were found to be organ transplant (odds ratio [OR] = 4.8; 95% confidence interval [CI] = 1.4 to 15.7), the previous use of oxyimino-B-lactams (OR = 6.0; 95% CI = 3.0 to 11.8), and unknown BSI source (protective; OR = 0.4; 95% CI = 0.2 to 0.9), and duration of hospital stay (OR = 1.02; 95% CI = 1.00 to 1.03). The variables independently associated with mortality were a Pitt score of >1 (OR = 3.9; 95% CI = 1.2 to 12.9), a high-risk source (OR = 5.5; 95% CI = 1.4 to 21.9), and resistance to more than three antibiotics, apart from penicillins and cephalosporins (OR = 6.5; 95% CI = 1.4 to 30.0). Inappropriate empirical therapy was not associated with mortality. We conclude that ESBLEC is an important cause of nosocomial BSIs. The previous use of oxyimino-B-lactams was the only modifiable risk factor found. Resistance to drugs other than penicillins and cephalosporins was associated with increased mortality.es
dc.formatapplication/pdfes
dc.language.isoenges
dc.publisherAmerican Society for Microbiologyes
dc.relation.ispartofJournal of clinical microbiology, 48(5), 1726-1731es
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.titleRisk Factors and Prognosis of Nosocomial Bloodstream Infections Caused by Extended-Spectrum-B-Lactamase-Producing Escherichia colies
dc.typeinfo:eu-repo/semantics/articlees
dcterms.identifierhttps://ror.org/03yxnpp24
dc.type.versioninfo:eu-repo/semantics/publishedVersiones
dc.rights.accessrightsinfo:eu-repo/semantics/openAccesses
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Medicinaes
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Microbiologíaes
dc.identifier.doihttp://dx.doi.org/10.1128/jcm.02353-09es
idus.format.extent6es
dc.identifier.idushttps://idus.us.es/xmlui/handle/11441/40829

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