ArticleAntimicrobial agents and chemotherapy2007
Predictors of mortality in patients with bloodstream infections caused by extended-spectrum-beta-lactamase-producing Enterobacteriaceae: importance of inadequate initial antimicrobial treatment.
Article in Antimicrobial agents and chemotherapy, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 197 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Risk-factors for Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) Bacteria Colonization Among Patients at High Risk of STIs
Evaluation of the Artificial Intelligence-based Prescription Support Software iAST® for the Choice of Empirical and Semi-targeted Antibiotic Treatment
Who cites it
197 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Female Sex and Mortality in Patients With Gram-Negative Bacteremia: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Prevalence of ESBL-Producing Enterobacteriaceae in Pediatric Bloodstream Infections: A Systematic Review and Meta-Analysis.PloS one · 2017Pooled it
- A randomized, controlled trial of prulifloxacin as conversion therapy after intravenous carbapenem in the treatment of acute pyelonephritis caused by third generation cephalosporin resistant pathogens: A pilot study.Clinical and translational science · 2023Trial
- Efficacy and safety of ceftazidime/avibactam in patients with infections caused by β-lactamase-producing Gram-negative pathogens: a pooled analysis from the Phase 3 clinical trial programme.The Journal of antimicrobial chemotherapy · 2023Trial
- A rapid, inexpensive diagnostic for bacterial pathogen and resistance detection in resource-limited settings.Science advances · 2026Article
- Phenotype-based appropriateness of IGM-enriched polyclonal immunoglobulin use in critical illness: report of an expert consensus.Journal of anesthesia, analgesia and critical care · 2026Review
- [Requirements for the rational use of antibiotics based on antibiotic stewardship].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- Characterization and targeting of deleterious mutations in Carbapenemase-producing Klebsiella pneumoniae: insights from variant calling, Computer-aided drug design, and DFT analysis.Archives of microbiology · 2026Article
- Effects of the Sequence of Empiric Beta-Lactam and Vancomycin Administration on Clinical Outcomes in Patients with Bloodstream Infection: A Systematic Review.Journal of clinical medicine · 2026Review
- Feasibility Study on Risk Stratification for Multidrug-Resistant Organism Infections Among ICU Patients in the United Arab Emirates.Risk management and healthcare policy · 2026Article
- Article
- Extended-spectrum-β-lactamase-producing Gram-negative bacteria are associated with high mortality in children with bloodstream infections in Dar es Salaam, Tanzania.BMC infectious diseases · 2025Article
- Proactive antimicrobial stewardship with real-time microbiological alerts improves management of bloodstream infections.JAC-antimicrobial resistance · 2025Article
- Clinical Outcome of Febrile Neutropenia and Associated Factors Among Adult Patients with Cancer Treated at Ethiopian Oncology Centers: A Retrospective Observational Study.Oncology and therapy · 2025Article
- Effect of Empirical Antimicrobial Therapy of Piperacillin-tazobactam Versus Carbapenems on Mortality for Patients with Sepsis from Nursing Homes.Internal medicine (Tokyo, Japan) · 2025Article
- Evaluation of Adjunctive Aminoglycoside Therapy Compared to β-Lactam Monotherapy in Critically Ill Patients with Gram-Negative Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2025Article
- Optimizing Antibiotic Treatment Duration for ESBL-Producing Enterobacteriaceae Bacteremia in ICU: A Multicentric Retrospective Cohort Study.Antibiotics (Basel, Switzerland) · 2025Article
- Direct detection of Gram-negative bacilli and extended-spectrum β-lactamase producers in positive blood culture specimens using MALDI-TOF MS.Frontiers in cellular and infection microbiology · 2025Article
- Fluoroquinolone resistance in ESKAPE pathogens: evolutionary pathways, one health transmission, and clinical surveillance.Frontiers in microbiology · 2025Review
- Is It Time to Start Worrying? A Comprehensive Report on the Three-Year Prevalence of ESBL-Producing Bacteria and Their Trends in Antibiotic Resistance from the Largest University Hospital in Slovakia.Pharmaceuticals (Basel, Switzerland) · 2024Article
137 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bloodstream infections (BSI) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms markedly increase the rates of treatment failure and death. We conducted a retrospective cohort analysis to identify risk factors for mortality in adult in-patients with BSI caused by ESBL-producing Enterobacteriaceae (ESBL-BSI). Particular attention was focused on defining the impact on the mortality of inadequate initial antimicrobial therapy (defined as the initiation of treatment with active antimicrobial agents >72 h after collection of the first positive blood culture). A total of 186 patients with ESBL-BSI caused by Escherichia coli (n = 104), Klebsiella pneumoniae (n = 58), or Proteus mirabilis (n = 24) were identified by our microbiology laboratory from 1 January 1999 through 31 December 2004. The overall 21-day mortality rate was 38.2% (71 of 186). In multivariate analysis, significant predictors of mortality were inadequate initial antimicrobial therapy (odds ratio [OR] = 6.28; 95% confidence interval [CI] = 3.18 to 12.42; P < 0.001) and unidentified primary infection site (OR = 2.69; 95% CI = 1.38 to 5.27; P = 0.004). The inadequately treated patients (89 of 186 [47.8%]) had a threefold increase in mortality compared to the adequately treated group (59.5% versus 18.5%; OR = 2.38; 95% CI = 1.76 to 3.22; P < 0.001). The regimens most commonly classified as inadequate were based on oxyimino cephalosporin or fluoroquinolone therapy. Prompt initiation of effective antimicrobial treatment is essential in patients with ESBL-BSI, and empirical decisions must be based on a sound knowledge of the local distribution of pathogens and their susceptibility patterns.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.