{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:10:52Z","timestamp":1790457052768,"version":"4.1.0"},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2016,9,28]],"date-time":"2016-09-28T00:00:00Z","timestamp":1475020800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec id=\"S0899823X16002257_abs1\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To evaluate risk factors for and molecular characteristics of community-onset extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) urinary tract infections (UTIs) in a US health system.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002257_abs2\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Case-control study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002257_abs3\" sec-type=\"general\"><jats:title>PARTICIPANTS<\/jats:title><jats:p>All patients presenting to the emergency department or outpatient practices with EB UTIs from December 21, 2010, through April 22, 2013, were included. Case patients had ESC-R EB UTIs. Control patients had ESC-susceptible EB UTIs and were matched 1:1 on study year.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002257_abs4\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Risk factors for ESC-R EB UTI were assessed using multivariable conditional logistic regression. A subset of case isolates was evaluated for extended-spectrum beta-lactamases.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002257_abs5\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>A total of 302 patients with community-onset EB UTI were included, of which 151 were cases. On multivariable analysis, risk factors for ESC-R EB UTI included trimethoprim-sulfamethoxazole use in the prior 6 months (odds ratio, 2.40 [95% CI, 1.22\u20134.70];<jats:italic>P<\/jats:italic>=.01), older age (1.03 [1.01\u20131.04];<jats:italic>P<\/jats:italic>&lt;.001), diabetes (2.91 [1.32\u20136.41];<jats:italic>P<\/jats:italic>=.008), and presentation to the emergency department ( 2.42 [1.31\u20134.46];<jats:italic>P<\/jats:italic>=.005). The prevalence of extended-spectrum beta-lactamases among 120 case isolates was 52% CTX-M, 29% TEM, 20% OXA, and 13% SHV. The prevalence of AmpC was 25%. Pulsed-field gel electrophoresis of the CTX-M<jats:italic>Escherichia coli<\/jats:italic>isolates showed no distinct clusters.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002257_abs6\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>Use of trimethoprim-sulfamethoxazole, older age, diabetes, and presentation to the emergency department were associated with community-onset ESC-R EB UTI. There was a high prevalence of CTX-M among our community isolates. Further studies are needed to determine strategies to limit emergence of these organisms in the community.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic>2016;1433\u20131439<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2016.225","type":"journal-article","created":{"date-parts":[[2016,9,28]],"date-time":"2016-09-28T07:30:33Z","timestamp":1475047833000},"page":"1433-1439","source":"Crossref","is-referenced-by-count":18,"title":["Clinical and Molecular Characterization of Community-Onset Urinary Tract Infections Due to Extended-Spectrum Cephalosporin-Resistant Enterobacteriaceae"],"prefix":"10.1017","volume":"37","author":[{"given":"Judith A.","family":"Anesi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irving","family":"Nachamkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Garrigan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B.","family":"Bilker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Wheeler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam","family":"Tolomeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,9,28]]},"reference":[{"key":"S0899823X16002257_ref15","doi-asserted-by":"publisher","DOI":"10.1086\/604713"},{"key":"S0899823X16002257_ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.02941.x"},{"key":"S0899823X16002257_ref18","doi-asserted-by":"publisher","DOI":"10.1179\/joc.2008.20.5.581"},{"key":"S0899823X16002257_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/592250"},{"key":"S0899823X16002257_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.17.1923"},{"key":"S0899823X16002257_ref36","doi-asserted-by":"publisher","DOI":"10.1086\/431587"},{"key":"S0899823X16002257_ref38","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkh397"},{"key":"S0899823X16002257_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2012.02991.x"},{"key":"S0899823X16002257_ref3","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.4.1257-1262.2006"},{"key":"S0899823X16002257_ref21","doi-asserted-by":"publisher","DOI":"10.1086\/671725"},{"key":"S0899823X16002257_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.09.034"},{"key":"S0899823X16002257_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-003-1084-2"},{"key":"S0899823X16002257_ref4","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.4.933-951.2001"},{"key":"S0899823X16002257_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.12.1583"},{"key":"S0899823X16002257_ref28","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00319-09"},{"key":"S0899823X16002257_ref22","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02052-13"},{"key":"S0899823X16002257_ref12","doi-asserted-by":"publisher","DOI":"10.1086\/588082"},{"key":"S0899823X16002257_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2010.04.005"},{"key":"S0899823X16002257_ref14","doi-asserted-by":"crossref","DOI":"10.2807\/ese.18.21.20484-en","article-title":"Temporal trends of extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates in in- and outpatients in Switzerland, 2004 to 2011","volume":"18","author":"Kronenberg","year":"2013","journal-title":"Euro Surveill"},{"key":"S0899823X16002257_ref31","doi-asserted-by":"publisher","DOI":"10.1086\/503046"},{"key":"S0899823X16002257_ref1","doi-asserted-by":"publisher","DOI":"10.1086\/321834"},{"key":"S0899823X16002257_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl035"},{"key":"S0899823X16002257_ref30","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02143-08"},{"key":"S0899823X16002257_ref34","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115101"},{"key":"S0899823X16002257_ref35","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.9.989"},{"key":"S0899823X16002257_ref26","unstructured":"Centers for Disease Control and Infection (CDC). 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