{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:58:07Z","timestamp":1791309487006,"version":"4.3.1"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X21004967_as1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The incidence of infections from extended-spectrum \u03b2-lactamase (ESBL)\u2013producing Enterobacterales (ESBL-E) is increasing in the United States. We describe the epidemiology of ESBL-E at 5 Emerging Infections Program (EIP) sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21004967_as2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      During October\u2013December 2017, we piloted active laboratory- and population-based (New York, New Mexico, Tennessee) or sentinel (Colorado, Georgia) ESBL-E surveillance. An incident case was the first isolation from normally sterile body sites or urine of\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      or\n                      <jats:italic>Klebsiella pneumoniae\/oxytoca<\/jats:italic>\n                      resistant to \u22651 extended-spectrum cephalosporin and nonresistant to all carbapenems tested at a clinical laboratory from a surveillance area resident in a 30-day period. Demographic and clinical data were obtained from medical records. The Centers for Disease Control and Prevention (CDC) performed reference antimicrobial susceptibility testing and whole-genome sequencing on a convenience sample of case isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21004967_as3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 884 incident cases. The estimated annual incidence in sites conducting population-based surveillance was 199.7 per 100,000 population. Overall, 800 isolates (96%) were from urine, and 790 (89%) were\n                      <jats:italic>E. coli<\/jats:italic>\n                      . Also, 393 cases (47%) were community-associated. Among 136 isolates (15%) tested at the CDC, 122 (90%) met the surveillance definition phenotype; 114 (93%) of 122 were shown to be ESBL producers by clavulanate testing. In total, 111 (97%) of confirmed ESBL producers harbored a\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>CTX-M<\/jats:sub>\n                      gene. Among ESBL-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates, 52 (54%) were ST131; 44% of these cases were community associated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X21004967_as4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The burden of ESBL-E was high across surveillance sites, with nearly half of cases acquired in the community. EIP has implemented ongoing ESBL-E surveillance to inform prevention efforts, particularly in the community and to watch for the emergence of new ESBL-E strains.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2021.496","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T06:04:26Z","timestamp":1644818666000},"page":"1586-1594","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":39,"title":["Epidemiology of extended-spectrum \u03b2-lactamase\u2013producing Enterobacterales in five US sites participating in the Emerging Infections Program, 2017"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2347-3690","authenticated-orcid":false,"given":"Nadezhda","family":"Duffy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2463-0598","authenticated-orcid":false,"given":"Maria","family":"Karlsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah E.","family":"Reses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davina","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Daniels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-7002","authenticated-orcid":false,"given":"Richard A.","family":"Stanton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Janelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Schutz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Bamberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9808-063X","authenticated-orcid":false,"given":"Paulina A.","family":"Rebolledo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Bower","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4016-3184","authenticated-orcid":false,"given":"Rebekah","family":"Blakney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse T.","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin C.","family":"Phipps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina G.","family":"Flores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-2841","authenticated-orcid":false,"given":"Ghinwa","family":"Dumyati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Kopin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Tsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion A.","family":"Kainer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Muleta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benji","family":"Byrd-Warner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian E.","family":"Grass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5723-8317","authenticated-orcid":false,"given":"Joseph D.","family":"Lutgring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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Antibiotic resistance threats in the United States, 2019. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/2019-ar-threats-report-508.pdf. Published November 13, 2019. Accessed January 3, 2020."},{"key":"S0899823X21004967_ref39","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06025-11"},{"key":"S0899823X21004967_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2017.156"},{"key":"S0899823X21004967_ref18","doi-asserted-by":"publisher","DOI":"10.1101\/gr.251678.119"},{"key":"S0899823X21004967_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30108-1"},{"key":"S0899823X21004967_ref36","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.336"},{"key":"S0899823X21004967_ref9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1914433"},{"key":"S0899823X21004967_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30676-5"},{"key":"S0899823X21004967_ref20","unstructured":"20. 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Management of multidrug-resistant organisms in healthcare settings, 2006. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/infectioncontrol\/pdf\/guidelines\/mdro-guidelines.pdf. Published February 15, 2017. 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