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Appropriateness of Empirical Treatment and Outcome in Bacteremia Caused by Extended-Spectrum-β-Lactamase-Producing Bacteria

Overview of attention for article published in Antimicrobial Agents and Chemotherapy, April 2013
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)
  • High Attention Score compared to outputs of the same age and source (87th percentile)

Mentioned by

blogs
1 blog
twitter
1 tweeter

Citations

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42 Dimensions

Readers on

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76 Mendeley
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Title
Appropriateness of Empirical Treatment and Outcome in Bacteremia Caused by Extended-Spectrum-β-Lactamase-Producing Bacteria
Published in
Antimicrobial Agents and Chemotherapy, April 2013
DOI 10.1128/aac.01523-12
Pubmed ID
Authors

Florine N. J. Frakking, Wouter C. Rottier, J. Wendelien Dorigo-Zetsma, Jarne M. van Hattem, Babette C. van Hees, Jan A. J. W. Kluytmans, Suzanne P. M. Lutgens, Jan M. Prins, Steven F. T. Thijsen, Annelies Verbon, Bart J. M. Vlaminckx, James W. Cohen Stuart, Maurine A. Leverstein-van Hall, Marc J. M. Bonten

Abstract

We studied clinical characteristics, appropriateness of initial antibiotic treatment, and other factors associated with day 30 mortality in patients with bacteremia caused by extended-spectrum-β-lactamase (ESBL)-producing bacteria in eight Dutch hospitals. Retrospectively, information was collected from 232 consecutive patients with ESBL bacteremia (due to Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae) between 2008 and 2010. In this cohort (median age of 65 years; 24 patients were <18 years of age), many had comorbidities, such as malignancy (34%) or recurrent urinary tract infection (UTI) (15%). One hundred forty episodes (60%) were nosocomial, 54 (23%) were otherwise health care associated, and 38 (16%) were community acquired. The most frequent sources of infection were UTI (42%) and intra-abdominal infection (28%). Appropriate therapy within 24 h after bacteremia onset was prescribed to 37% of all patients and to 54% of known ESBL carriers. The day 30 mortality rate was 20%. In a multivariable analysis, a Charlson comorbidity index of ≥ 3, an age of ≥ 75 years, intensive care unit (ICU) stay at bacteremia onset, a non-UTI bacteremia source, and presentation with severe sepsis, but not inappropriate therapy within <24 h (adjusted odds ratio [OR], 1.53; 95% confidence interval [CI], 0.68 to 3.45), were associated with day 30 mortality. Further assessment of confounding and a stratified analysis for patients with UTI and non-UTI origins of infection did not reveal a statistically significant effect of inappropriate therapy on day 30 mortality, and these results were insensitive to the possible misclassification of patients who had received β-lactam-β-lactamase inhibitor combinations or ceftazidime as initial treatment. In conclusion, ESBL bacteremia occurs mostly in patients with comorbidities requiring frequent hospitalization, and 84% of episodes were health care associated. Factors other than inappropriate therapy within <24 h determined day 30 mortality.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 76 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
India 1 1%
Turkey 1 1%
Unknown 74 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 17 22%
Student > Bachelor 11 14%
Researcher 10 13%
Student > Postgraduate 7 9%
Other 7 9%
Other 24 32%
Readers by discipline Count As %
Medicine and Dentistry 52 68%
Pharmacology, Toxicology and Pharmaceutical Science 6 8%
Unspecified 5 7%
Agricultural and Biological Sciences 4 5%
Immunology and Microbiology 3 4%
Other 6 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 September 2013.
All research outputs
#1,468,454
of 10,423,221 outputs
Outputs from Antimicrobial Agents and Chemotherapy
#1,952
of 8,515 outputs
Outputs of similar age
#19,669
of 131,349 outputs
Outputs of similar age from Antimicrobial Agents and Chemotherapy
#7
of 56 outputs
Altmetric has tracked 10,423,221 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,515 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.1. This one has done well, scoring higher than 77% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 131,349 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 56 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 87% of its contemporaries.