@article {5169,
	title = {Risk factors for coexistence of fluoroquinolone resistance and ESBL production among Enterobacteriaceae in a Greek university hospital.},
	journal = {J Chemother},
	volume = {20},
	year = {2008},
	month = {2008 Aug},
	pages = {452-7},
	abstract = {The purpose of this study was to identify risk factors for fluoroquinolone resistance (QR) among ESBL- producing Enterobacteriaceae causing nosocomial infections. The study was conducted in Laikon General Hospital in Athens, Greece, during the period January 2004 - January 2005. Epidemiological and clinical data were collected from the medical charts of the patients diagnosed with nosocomial infections due to an ESBL-producing Enterobacteriaceae. QR was 60\% among the 84 ESBL-producing Enterobacteriaceae isolates. Infection from QR-ESBL bacteria was associated with increased hospital stay (p=0.028); QRESBL bacteria were isolated later during hospitalization than fluoroquinolone susceptible (QS)-ESBL (p=0.089); factors associated with QR were immune-deficiency (p=0.047), previous use of carbapenems (p=0.08) and fluoroquinolones (p=0.067), and admission to the Transplantation Unit (p=0.047). In addition, QR-ESBL bacteria were more likely to be resistant to co-trimoxazole (p<0.001), gentamicin (p=0.054) and tobramycin (p=0.004). Logistic regression analysis indicated that admission to the transplantation unit was an independent risk factor for infection due to a QR-ESBL isolate. Results of this study question ciprofloxacin{\textquoteright}s usefulness as a valid alternative to carbapenems in our hospital for the treatment of infections due to ESBL-producing bacteria. In addition strategies for addressing the QR-ESBL situation should focus on limiting fluoroquinolone and carbapenem consumption and emphasize on barrier precautions in patients with longer hospitalization, immunosuppression, or admission to the transplantation unit.},
	keywords = {Anti-Bacterial Agents, beta-Lactamases, Cross Infection, Drug Resistance, Multiple, Bacterial, Enterobacteriaceae, Female, Fluoroquinolones, Greece, Hospitals, University, Humans, Logistic Models, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors},
	issn = {1973-9478},
	doi = {10.1179/joc.2008.20.4.452},
	author = {Katsandri, A and Avlamis, A and Vasilakopoulou, A and Mela, V and Kosmidis, C and J Papaparaskevas and Petrikkos, G L}
}
