{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:50:16Z","timestamp":1791809416402,"version":"4.3.4"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26105169_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Compare characteristics of community-associated (CA) versus healthcare-associated (HCA) extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) urinary tract infection (UTI) cases and assess associations between ESBL-E UTI prevalence and census-tract social vulnerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105169_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105169_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Monroe County, NY, January 2020\u2013December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105169_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Population surveillance of first urinary ESBL-E isolate among county residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105169_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      ESBL-E, defined as resistance to \u22651 third-generation cephalosporin, was identified from inpatient and outpatient urinary specimens. Demographic, clinical, and healthcare exposure data were abstracted; cases were classified as CA or HCA using standardized definitions. Addresses were geocoded to census tracts and linked to CDC Social Vulnerability Index (SVI) scores. Characteristics were compared using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      and Wilcoxon tests. Generalized linear models assessed associations between SVI themes and ESBL-E prevalence by epidemiologic classification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105169_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 3,100 ESBL-E UTI cases, 1,621 (52.3%) were CA and 1,468 (47.4%) HCA. CA cases were younger (median 56 vs 71.5 years), more often female (89.5% vs 68.4%), and less medically complex than HCA cases. HCA prevalence increased with SVI score, while CA prevalence remained stable across SVI levels. The HCA association was mainly driven by SVI Theme 2 (household composition\/disability; P = .0011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105169_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>CA and HCA ESBL-E UTIs exhibit distinct epidemiology. No association was observed between SVI and CA ESBL-E UTI prevalence. HCA prevalence increased with social vulnerability, largely driven by SVI Theme 2, potentially reflecting healthcare exposure and medical complexity. Factors driving CA ESBL-E differ, and ESBL-E reduction efforts should consider broader structural and community factors beyond those captured by the SVI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10516","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T07:01:08Z","timestamp":1785999668000},"page":"1016-1022","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Distinct individual and community-level drivers of extended-spectrum beta-lactamase-producing Enterobacterales urinary tract infections"],"prefix":"10.1017","volume":"47","author":[{"given":"Julia","family":"Tellerman","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0197-1293","authenticated-orcid":false,"given":"Sanjukta","family":"Bandyopadhyay","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsioa Che","family":"Looi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Myers","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Dietz","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-2841","authenticated-orcid":false,"given":"Ghinwa","family":"Dumyati","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"},{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6051-0027","authenticated-orcid":false,"given":"Brenda L.","family":"Tesini","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"},{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"},{"id":[{"id":"https:\/\/ror.org\/00trqv719","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"S0899823X26105169_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa514"},{"key":"S0899823X26105169_ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-019-00206-4"},{"key":"S0899823X26105169_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2021.496"},{"key":"S0899823X26105169_ref2","unstructured":"2. Centers for Disease Control and Prevention. Emerging Infections Program, Healthcare-Associated Infections \u2013 Community Interface Surveillance Report, Multi-site Gram-negative Surveillance Initiative (MuGSI), Extended-spectrum \u03b2-lactamase-producing Enterobacterales Surveillance, 2021; 2023."},{"key":"S0899823X26105169_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-025-00869-9"},{"key":"S0899823X26105169_ref1","volume-title":"Antibiotic Resistance Threats in the United States, 2019","year":"2019"},{"key":"S0899823X26105169_ref16","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2013694117"},{"key":"S0899823X26105169_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.32679"},{"key":"S0899823X26105169_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0899823X26105169_ref29","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae171"},{"key":"S0899823X26105169_ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-019-0492-8"},{"key":"S0899823X26105169_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0880-5"},{"key":"S0899823X26105169_ref12","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2010.0939"},{"key":"S0899823X26105169_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy357"},{"key":"S0899823X26105169_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.64"},{"key":"S0899823X26105169_ref6","unstructured":"6. Centers for Disease Control and Prevention. 2025 Multi-site Gram-Negative Surveillance Initiative (MuGSI): Healthcare-Associated Infections Community Interface (HAIC) Case Report Form. 2025."},{"key":"S0899823X26105169_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.02.026"},{"key":"S0899823X26105169_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.01.013"},{"key":"S0899823X26105169_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.vetmic.2014.03.007"},{"key":"S0899823X26105169_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.09.034"},{"key":"S0899823X26105169_ref9","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00220-10"},{"key":"S0899823X26105169_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae313"},{"key":"S0899823X26105169_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2017.11.003"},{"key":"S0899823X26105169_ref5","unstructured":"5. United States Census Bureau, 2020 Census Demographic and Housing Characteristics File (DHC), Table P1: Total Population, Monroe County, New York. https:\/\/data.census.gov\/table?g=050XX00US36055."},{"key":"S0899823X26105169_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.116"},{"key":"S0899823X26105169_ref13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0074323"},{"key":"S0899823X26105169_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpa.2015.03.004"},{"key":"S0899823X26105169_ref4","unstructured":"4. Centers for Disease Control and Prevention (CDC)\/Agency for Toxic Substances and Disease Registry (ATSDR) Geospatial Research, Analysis, and Services Program. CDC\/ATSDR Social Vulnerability Index 2020 Database New York. https:\/\/www.atsdr.cdc.gov\/placeandhealth\/svi\/data_documentation_download.html. Accessed August 20, 2024."},{"key":"S0899823X26105169_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268822001637"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:37:16Z","timestamp":1791808636000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26105169\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":29,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S0899823X26105169"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10516","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}