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SUPPLEMENTAL DIGITAL MATERIAL

Resistance in aerobic Gram-negative bacilli (AGNB)

Except for Klebsiella, Enterobacter, most Enterobacteriaceae were susceptible to

antimicrobials (Supplemental Table 1). Antimicrobial susceptibility was determined by the disk diffusion method or MIC when performed. For the purpose of the study, reduced

susceptibility was considered resistant. For each species, there were no statistically significant differences in the rates of susceptibility to the antimicrobials studied between groups. The distribution of multi-drug resistant AGNB involved in AIs in both groups is shown in Supplemental Table 2.

Time to occurrence for ICU-acquired infection

The cumulative hazard of AIs in both groups is shown in Supplemental Figure 1

(Supplemental Digital Content 2, http://links.lww.com/CCM/A816).

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Supplemental Table 1. Antibiotic susceptibility of 150 aerobic Gram-negative isolates tested

Group A Group B

Tic Pip/taz Ctx Caz Cefe Imi Gen Tob Ami Cip Total Tic Pip/taz Ctx Caz Cefe Imi Gen Tob Ami Cip Total

Aerobic Gram-negative bacilli – no susceptible (%)

E. coli 7

(33)

11/15 (73)

17 (81)

17 (81)

11/14 (79)

21 (100)

17 (81)

14/18 (78)

19 (90)

14 (67)

21 8

(62)

11/11 (100)

13 (100)

13 (100)

13 (100)

13 (100)

11 (85)

11 (85)

13 (100)

11 (85)

13

Klebsiella 3/11

(27) 6 (50)

7 (58)

4/10 (40)

12 (100)

10 (83)

8 (67) 11 (92)

6 (50) 12 2 (40) 2 (40) 2 (40) 2 (40) 5

(100) 2 (40)

1 (20)

4 (80) 1 (20)

5

Enterobacter 8 (40)

8 (40) 8 (40)

8 (40)

18/18 (100)

20 (100)

18 (90)

12/14 (86)

20 (100)

15/16 (94)

20 1

(25)

1 (25) 1 (25) 1 (25) 3 (75) 4 (100)

2 (50)

2 (50)

3 (75) 3 (75)

4

Serratia 2

(33)

2 (33) 3 (50)

3 (50)

6 (100) 6 (100)

3 (50)

2 (33) 5 (83) 4 (67) 6 2 (50)

2 (50) 4 (100)

4 (100)

4 (100)

4 (100)

2 (50)

1 (25)

3 (75) 4 (100)

4

Citrobacter 0/2 0/2 0/2 0/2 2/2

(100)

1/2 0/2 0/2 0/2 4 0

Proteus 1

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4 (100) 4 (100)

4 (100)

4 (100) 4 (100)

4 (100)

2/2 (100)

4 (100)

4 (100)

4 0

Morganella 3

(100)

3 (100) 3 (100)

3 (100)

3 (100) 3 (100)

3 (100)

3 (100)

3 (100)

3 (100)

3 0

Pseudomonas aeruginosa

19 (70)

21 (78) 22

(81)

20 (74) 22 (81)

18 (67)

18 (67)

24 (89)

17 (63)

27 4/11

(36) 5/11 (45)

8 (62) 6/11 (55)

8 (62) 8 (62)

8 (62)

11 (85)

8 (62)

13

Acinetobacter 6 (100)

6 (100) 0 0 6

(100) 5 (83)

3 (50) 3 (50) 1 (17) 6 0

Stenotrophomonas maltophilia

0 1 (11) 0 1

(11)

0 6 (67) 4

(44)

1 (11) 3 (33) 8 (89) 9 0

Burkholderia cepacia 0/1 1/1

(100) 1/1 (100)

1/1 (100)

0 0/1 0 0 0 1

Note: Tic, ticarcillin; Pip/taz, piperacillin/tazobactam; Ctx, cefotaxime; Caz, ceftazidime; Cefe, cefepime; Imi, imipenem; Gen, gentamicin; Tob, tobramycin; ami, amikacin; Cip, ciprofloxacin.

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Supplemental Table 2. Distribution of multi-drug resistant aerobic Gram-negative bacilli recovered from acquired infections

Group A Group B

Microorganism species, no.

E coli 4 0

Klebsiella 1 3

Enterobacter 1 2

Serratia 3 0

Citrobacter 2 -

Stenotrophomonas maltophilia 9 -

Pseudomonas aeruginosa 7 3

Acinetobacter 4 -

Burkholderia - 1

Total 31 9

Note: Multi-drug resistance was defined by the resistance to ≥2 among the following antimicrobials: 3rd-generation cephalosporins

(cefotaxime/ceftazidime); imipenem; all three gentamicin, tobramycin and amikacin; ciprofloxacin.

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