Journal
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
Volume 66, Issue 4, Pages 402-406Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2009.11.012
Keywords
CTX-M-15 beta-lactamase; Escherichia coli infections; Long-term care facilities; Antimicrobial resistance
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Funding
- BMA Medical Foundation
- Beatrice Snyder Foundation
- NIH [GM008722-07]
- Office of Research and Development, Medical Research Service, Department of Veterans Affairs
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [T34GM008722] Funding Source: NIH RePORTER
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Bacteria harboring CTX-M extended-spectrum beta-lactamases (ESBLs) have been identified worldwide, with most reports coming from regions outside North America. We have identified CTX-M enzymes in 31% of ESBL-positive Escherichia coli isolates from our hospital and more than half (53%) of the isolates from associated long-term care facilities. Approximately 3/4 of all CTX-M bearing isolates were from urine specimens, with a predominance of CTX-M-15. A large proportion of such isolates were nonsusceptible to levofloxacin, trimethoprim/sulfamethoxazole, and all beta-lactam antimicrobials with the exception of the carbapenems, requiring carbapenem therapy for acute urinary tract infection or urinary tract-related sepsis. CTX-M beta-lactamases have emerged within our location, and detection of bacteria harboring these enzymes in the clinical microbiology laboratory remains problematic because molecular methods are needed for their identification. (C) 2010 Elsevier Inc. All rights reserved.
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