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Desirability of outcome ranking was determined at 30 days after infection onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This analysis included 282 patients with E. coli BSI; 43% (121\/282) were E. coli ST131 and 23% (66\/282) belonged to the C2\/H30Rx subclade. Resistance to ceftriaxone was present in 79% (96\/121) ST131, 86% (57\/66) E. coli ST131 C2\/H30Rx, and 27% (43\/161) E. coli non-ST131. Compared to patients with non-ST131 E. coli BSI, patients with ST131 BSI were older (median 70 years, [Q1 62, Q3 76] years vs 65 years, [51, 74]; P = .005) and more often admitted from long-term care facilities (21\/121 [17%] vs 7\/161 [4%], P &amp;lt; .001). Overall and empiric carbapenem use was more frequent in the treatment of patients with ST131 BSI compared with non-ST131 BSI (overall 89\/121 [74%] vs 50\/161 [31%]; empiric: 58\/121 [48%] vs 31\/161 [19%], P &amp;lt; .001). Desirability of outcome ranking outcomes were similar between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most ceftriaxone-resistant E. coli from US patients with E. coli BSI belong to ST131, particularly E. coli ST131 C2\/H30Rx, serving as an important driver of carbapenem use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag160","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:52:22Z","timestamp":1772628742000},"page":"e27-e37","source":"Crossref","is-referenced-by-count":1,"title":["<i>Escherichia coli<\/i>\n                    ST131 Drives Carbapenem Use for\n                    <i>E. coli<\/i>\n                    Bloodstream Infections"],"prefix":"10.1093","volume":"83","author":[{"given":"Natalie A","family":"Mackow","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine , Chapel Hill, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanying","family":"Shao","sequence":"additional","affiliation":[{"name":"Biostatistics Center, George Washington University , Rockville, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizhao","family":"Ge","sequence":"additional","affiliation":[{"name":"Biostatistics Center, George Washington University , Rockville, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Komarow","sequence":"additional","affiliation":[{"name":"Biostatistics Center, George Washington University , Rockville, Maryland 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