{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:43:34Z","timestamp":1791517414743,"version":"4.3.4"},"reference-count":32,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2006,7,1]],"date-time":"2006-07-01T00:00:00Z","timestamp":1151712000000},"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":["J Clin Microbiol"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            A total of 151\n            <jats:italic>Escherichia coli<\/jats:italic>\n            strains resistant to cefotaxime and ceftazidime were isolated during a prospective surveillance study. These strains were characterized by clinical, microbiological, and molecular analyses and were distributed into four clusters of 103, 11, 6, and 5 isolates, along with 25 unrelated strains. The principal cluster was isolated from urine, wound, blood, and other samples in three hospitals, eight nursing homes, and a community healthcare center. This cluster was associated with both nosocomial (65%) and community-acquired (35%) infections. Most strains were resistant to ciprofloxacin, gentamicin, tobramycin, cefepime, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole but were susceptible to imipenem. All isolates from the four clusters expressed the extended-spectrum \u03b2-lactamase (ESBL) CTX-M-15. This enzyme was also present in 8 (30.8%) of the 26 unrelated isolates. The other ESBLs, CTX-M-14 and CTX-M-32, were detected in five and seven cases, respectively, but they were detected in individual\n            <jats:italic>E. coli<\/jats:italic>\n            isolates only. In three clusters,\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-15<\/jats:sub>\n            alleles were linked to an IS\n            <jats:italic>Ecp1<\/jats:italic>\n            -like element, while in eight strains of cluster II an IS\n            <jats:italic>26<\/jats:italic>\n            element preceded the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-15<\/jats:sub>\n            allele. An additional pool of resistance genes included\n            <jats:italic>tetA<\/jats:italic>\n            ,\n            <jats:italic>drfA14<\/jats:italic>\n            or\n            <jats:italic>dfrA17<\/jats:italic>\n            ,\n            <jats:italic>sul1<\/jats:italic>\n            or\n            <jats:italic>sul2<\/jats:italic>\n            ,\n            <jats:italic>aac(6\u2032)Ib<\/jats:italic>\n            , and\n            <jats:italic>aac(3)IIb<\/jats:italic>\n            . All except one of the 27 isolates tested for genetic virulence markers harbored the same three virulence genes:\n            <jats:italic>iutA<\/jats:italic>\n            and\n            <jats:italic>fyuA<\/jats:italic>\n            (siderophores), and\n            <jats:italic>traT<\/jats:italic>\n            (serum survival factor). Epidemic or occasional isolates of cefotaxime- and ceftazidime-resistant\n            <jats:italic>E. coli<\/jats:italic>\n            can spread between distinct health facilities including hospitals, community health centers, and long-term care centers.\n          <\/jats:p>","DOI":"10.1128\/jcm.00447-06","type":"journal-article","created":{"date-parts":[[2006,7,7]],"date-time":"2006-07-07T13:56:08Z","timestamp":1152280568000},"page":"2359-2366","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":138,"title":["Spread of\n            <i>Escherichia coli<\/i>\n            Strains with High-Level Cefotaxime and Ceftazidime Resistance between the Community, Long-Term Care Facilities, and Hospital Institutions"],"prefix":"10.1128","volume":"44","author":[{"given":"Jesu\u0301s","family":"Oteo","sequence":"first","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Navarro","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Cercenado","sequence":"additional","affiliation":[{"name":"Microbiology Department, Hospital Gregorio Maran\u0303o\u0301n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Delgado-Iribarren","sequence":"additional","affiliation":[{"name":"Microbiology Department, Fundacio\u0301n Hospital de Alcorco\u0301n, Alcorco\u0301n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Wilhelmi","sequence":"additional","affiliation":[{"name":"Microbiology Department, Hospital Severo Ochoa, Legane\u0301s, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Orden","sequence":"additional","affiliation":[{"name":"Microbiology Department, Centro de Especialidades Argu\u0308elles, Hospital Puerta de Hierro, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Garci\u0301a","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Miguelan\u0303ez","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u0301a","family":"Pe\u0301rez-Va\u0301zquez","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Garci\u0301a-Cobos","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bele\u0301n","family":"Aracil","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vero\u0301nica","family":"Bautista","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose\u0301","family":"Campos","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, Bacteriology Service, Centro Nacional de Microbiologi\u0301a, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain"},{"name":"Consejo Superior de Investigaciones Cienti\u0301ficas, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.1-14.2004"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.10.3758-3764.2004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.10.3156-3163.2002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.6.2308-2313.2004"},{"key":"e_1_3_2_6_2","unstructured":"Clinical and Laboratory Standards Institute. 2005. 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