{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:24:04Z","timestamp":1777922644673,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:p>\n                    According to the European Antimicrobial Resistance Surveillance System project results, Bulgaria has become one of the European countries with dramatically increasing rates of extended-spectrum beta-lactamase (ESBL) producers. The aim of this work was to investigate the epidemiology of ESBL-producing\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    clinical isolates in Bulgaria, collected from seven clinical centers in three towns, during two study periods: 2002\u20132003 and 2006\u20132009. For 193 ESBL-producing\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    isolates random amplified polymorphic DNA (RAPD) analyses, phylogenetic typing, and screening for O25b-ST131 isolates were carried out. Antimicrobial susceptibility, ESBL-type and transferability of resistance determinants were analyzed. Four different ESBL-types, namely TEM-139, SHV-12, CTX-M-3, and CTX-M-15 were found. CTX-M-15 dominated, being found in 88% of the isolates. RAPD-typing revealed 35 types, among which type A dominated, comprising 65% of the isolates. Sixty-eight percent of the 193 isolates belonged to the O25b-ST131 clone, to the phylogenetic group B2, mostly showed RAPD-type A (92%) and were found in all participating hospitals. O25b-ST131 isolates predominantly produced CTX-M-15 (96%), and less SHV-12 (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    =3) or TEM-139 (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    =2). In conclusion, this study demonstrated for the first time the country-wide dissemination of a highly resistant B2 O25b-ST131 CTX-M-15 producing\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    clone in Bulgaria.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2011.0186","type":"journal-article","created":{"date-parts":[[2012,2,21]],"date-time":"2012-02-21T15:08:41Z","timestamp":1329836921000},"page":"390-395","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["High Prevalence of CTX-M-15-Producing O25b-ST131\n                    <i>Escherichia coli<\/i>\n                    Clone in Bulgarian Hospitals"],"prefix":"10.1177","volume":"18","author":[{"given":"Rumyana","family":"Markovska","sequence":"first","affiliation":[{"name":"Medical University","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Schneider","sequence":"additional","affiliation":[{"name":"MICOER Institute","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dobrinka","family":"Ivanova","sequence":"additional","affiliation":[{"name":"Second Multiprofile Hospital","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Keuleyan","sequence":"additional","affiliation":[{"name":"Medical Institute","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Temenuga","family":"Stoeva","sequence":"additional","affiliation":[{"name":"Varna University Hospital","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariya","family":"Sredkova","sequence":"additional","affiliation":[{"name":"Pleven University Hospital","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyka","family":"Markova","sequence":"additional","affiliation":[{"name":"Alexandrovska University Hospital","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalina","family":"Bojkova","sequence":"additional","affiliation":[{"name":"Varna University Hospital","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raina","family":"Gergova","sequence":"additional","affiliation":[{"name":"Medical University","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adolf","family":"Bauernfeind","sequence":"additional","affiliation":[{"name":"MICOER Institute","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Mitov","sequence":"additional","affiliation":[{"name":"Medical University","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1128\/AAC.43.8.1924","article-title":"A novel type of AmpC Beta-Lactamase, ACC-1, produced by a Klebsiella pneumoniae causing nosocomial pneumonia","volume":"43","author":"Bauernfeind A.","year":"1999","unstructured":"Bauernfeind A., , Schneider I., , Jungwirth R., , Sahly H., , Ullmann U. 1999. A novel type of AmpC Beta-Lactamase, ACC-1, produced by a Klebsiella pneumoniae causing nosocomial pneumonia. Antimicrob. Agents Chemother., 43:1924\u20131931.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp122"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.1-14.2004"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.4.933-951.2001"},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/jac\/dkq491","article-title":"Spread of Escherichia coli O25b:H4-B2-ST131 producing CTX-M-15 and SHV-12 with high virulence gene content in Barcelona (Spain)","volume":"66","author":"Coelho A.","year":"2011","unstructured":"Coelho A., , Mora A., , Mamani R., , L\u00f3pez C., , Gonz\u00e1lez-L\u00f3pez J., , Larrosa M., , Quintero-Zarate J., , Dahbi G., , Herrera A., , Blanco J., , Blanco M. et al. 2011. Spread of Escherichia coli O25b:H4-B2-ST131 producing CTX-M-15 and SHV-12 with high virulence gene content in Barcelona (Spain) J. Antimicrob. Chemother., 66:517\u2013526.","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"4555","DOI":"10.1128\/AEM.66.10.4555-4558.2000","article-title":"Rapid and simple detection of the Escherichia coli phylogenetic group","volume":"66","author":"Clermont O.","year":"2000","unstructured":"Clermont O., , Bonacorsi S., , Bingen E. 2000. Rapid and simple detection of the Escherichia coli phylogenetic group. Appl. Environ. Microbiol., 66:4555\u20134558.","journal-title":"Appl. Environ. Microbiol."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp194"},{"key":"e_1_3_3_9_2","volume-title":"Sixteenth Informational Supplement. 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Infect."},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2008.0814"},{"key":"e_1_3_3_19_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1099\/00221287-88-1-169","article-title":"The use of analytical isoelectric focussing for detection and identification of beta-lactamases","volume":"88","author":"Matthew M.","year":"1975","unstructured":"Matthew M., , Harris A., , Marshall M., , Ross G. 1975. The use of analytical isoelectric focussing for detection and identification of beta-lactamases. J. Gen. Microbiol., 88:169\u2013178.","journal-title":"J. Gen. 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Molecular characteristics of extended-spectrum-beta-lactamase-producing Escherichia coli isolates causing bacteremia in the Calgary Health Region from 2000 to 2007: emergence of clone ST131 as a cause of community-acquired infections. Antimicrob. Agents Chemother., 53:2846\u20132851.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq415"},{"key":"e_1_3_3_27_2","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1128\/JCM.00045-11","article-title":"First characterization of CTX-M-15-producing Escherichia coli ST131 and ST405 clones causing community-onset infections in South America","volume":"49","author":"Ruiz S.","year":"2011","unstructured":"Ruiz S., , Montealegre M., , Ruiz-Garbajosa P., , Correa A., , Brice\u00f1o D., , Martinez E., , Villegas M. 2011. First characterization of CTX-M-15-producing Escherichia coli ST131 and ST405 clones causing community-onset infections in South America. J. Clin. 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