{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:32:11Z","timestamp":1790472731809,"version":"4.1.0"},"reference-count":45,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T00:00:00Z","timestamp":1501545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            sequence type 131 (ST131) predominates globally among multidrug-resistant (MDR)\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            strains. We used whole-genome sequencing (WGS) to investigate 63 MDR\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            isolates from 7 North Carolina community hospitals (2010 to 2015). Of these, 39 (62%) represented ST131, including 37 (95%) from the ST131-\n            <jats:italic>H<\/jats:italic>\n            30R subclone: 10 (27%) from its\n            <jats:italic>H<\/jats:italic>\n            30R1 subset and 27 (69%) from its\n            <jats:italic>H<\/jats:italic>\n            30Rx subset. ST131 core genomes differed by a median of 15 (range, 0 to 490) single-nucleotide variants (SNVs) overall versus only 7 within\n            <jats:italic>H<\/jats:italic>\n            30R1 (range, 3 to 12 SNVs) and 11 within\n            <jats:italic>H<\/jats:italic>\n            30Rx (range, 0 to 21). The four isolates with identical core genomes were all\n            <jats:italic>H<\/jats:italic>\n            30Rx. Epidemiological and clinical characteristics did not vary significantly by strain type, but many patients with MDR\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            or\n            <jats:italic>H<\/jats:italic>\n            30Rx infection were critically ill and had poor outcomes.\n            <jats:italic>H<\/jats:italic>\n            30Rx isolates characteristically exhibited fluoroquinolone resistance and CTX-M-15 production, had a high prevalence of trimethoprim-sulfamethoxazole resistance (89%),\n            <jats:italic>sul1<\/jats:italic>\n            (89%), and\n            <jats:italic>dfrA17<\/jats:italic>\n            (85%), and were enriched for specific virulence traits, and all qualified as extraintestinal pathogenic\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            . The high overall prevalence of CTX-M-15 appeared to be possibly attributable to its association with the ST131-\n            <jats:italic>H<\/jats:italic>\n            30Rx subclone and IncF[F2:A1:B\u2212] plasmids. Some phylogenetically clustered non-ST131 MDR\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            isolates also had distinctive serotypes\/\n            <jats:italic>fimH<\/jats:italic>\n            types, fluoroquinolone mutations, CTX-M variants, and IncF types. Thus, WGS analysis of our community hospital source MDR\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            isolates suggested ongoing circulation and differentiation of\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            ST131 subclones, with clonal segregation of CTX-M variants, other resistance genes, Inc-type plasmids, and virulence genes.\n          <\/jats:p>","DOI":"10.1128\/aac.00912-17","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T00:30:26Z","timestamp":1496709026000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":46,"title":["Genomic Analysis of Multidrug-Resistant Escherichia coli from North Carolina Community Hospitals: Ongoing Circulation of CTX-M-Producing ST131-\n            <i>H<\/i>\n            30Rx and ST131-\n            <i>H<\/i>\n            30R1 Strains"],"prefix":"10.1128","volume":"61","author":[{"given":"Hajime","family":"Kanamori","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian M.","family":"Parobek","sequence":"additional","affiliation":[{"name":"Curriculum in Genetics and Molecular Biology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Juliano","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Minnesota, Minneapolis, Minnesota, USA"},{"name":"Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Minnesota, Minneapolis, Minnesota, USA"},{"name":"Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Weber","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Rutala","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"},{"name":"Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deverick J.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA"},{"name":"Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, 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