{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:18:45Z","timestamp":1759335525171},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,6,12]],"date-time":"2013-06-12T00:00:00Z","timestamp":1370995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:p>Acquired resistance to cephalosporins in Enterobacteriaceae is a global problem. After an outbreak at Uppsala University Hospital of extended\u2010spectrum \u03b2\u2010lactamase (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>)\u2010positive <jats:italic>Klebsiella pneumoniae<\/jats:italic> producing <jats:styled-content style=\"fixed-case\">CTX<\/jats:styled-content>\u2010M\u201015, there was a shift from AmpC to <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> production among <jats:italic>Escherichia coli<\/jats:italic> isolates. To explore the basis for this epidemiological shift, 46 <jats:italic><jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>. coli<\/jats:italic> isolates (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>s, n\u00a0=\u00a023; AmpC, n\u00a0=\u00a023) were characterized with regard to genetic relatedness, \u03b2\u2010lactamase, replicon and integron types, antibiotic resistance profiles, and genes encoding virulence factors. In addition, the survival in the environment and on hospital\u2010associated materials was analysed. <jats:styled-content style=\"fixed-case\">CTX<\/jats:styled-content>\u2010M\u201015 was the most frequent <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> (78%). Only three (13%) of the AmpC enzymes were harboured on plasmids (<jats:styled-content style=\"fixed-case\">CMY<\/jats:styled-content>\u20102, <jats:styled-content style=\"fixed-case\">DHA<\/jats:styled-content>\u20101). Independent of plasmid\u2010mediated beta\u2010lactamase, IncF plasmids predominated and only class I integrons were detected. The <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> producers carried more virulence genes (p\u00a0=\u00a00.04), exhibited a broader resistance phenotype (p\u00a0=\u00a00.01) and survived significantly longer (p\u00a0=\u00a00.03) on different materials than the AmpC\u2010producing isolates. In conclusion, <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing isolates had properties which are likely to augment their competitiveness. Apart from antibiotic resistance and virulence factors, extended survival in the environment could be a selective trait for successful <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing <jats:italic>E. coli<\/jats:italic> strains.<\/jats:p>","DOI":"10.1111\/apm.12102","type":"journal-article","created":{"date-parts":[[2013,6,12]],"date-time":"2013-06-12T05:29:25Z","timestamp":1371014965000},"page":"59-67","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Survival in the environment is a possible key factor for the expansion of <i>Escherichia coli<\/i> strains producing extended\u2010spectrum \u03b2\u2010lactamases"],"prefix":"10.1111","volume":"122","author":[{"given":"Gustaf","family":"Starlander","sequence":"first","affiliation":[{"name":"Department of Medical Sciences\/Section of Clinical Bacteriology Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences\/Section of Clinical Bacteriology Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Edquist","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences\/Section of Clinical Bacteriology Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c5sa","family":"Melhus","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences\/Section of Clinical Bacteriology Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01055-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2005.02.005"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/315217"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2009.11.003"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq415"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0691.2000.00107.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/290221a0"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.6.2153-2162.2002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(08)70041-0"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2006.08.011"},{"key":"e_1_2_7_12_1","unstructured":"European Centre for Disease Prevention and Control.Antimicrobial resistance surveillance in Europe 2010. 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