{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:53:16Z","timestamp":1770295996940,"version":"3.49.0"},"reference-count":51,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2007,6,1]],"date-time":"2007-06-01T00:00:00Z","timestamp":1180656000000},"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":[[2007,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Of the 181 unduplicated\n            <jats:italic>Escherichia coli<\/jats:italic>\n            strains isolated in nine different hospitals in three Portuguese regions, 119 were extended-spectrum \u03b2-lactamase (ESBL)-CTX-M producers and were selected for phenotype and genotype characterization. CTX-M producer strains were prevalent among community-acquired infections (56%), urinary tract infections (76%), and patients \u226560 years old (76%). In MIC tests, all strains were resistant to cefotaxime, 92% were resistant to ceftazidime, 93% were resistant to quinolones, 89% were resistant to aminoglycoside, and 26% were resistant to trimethoprim-sulfamethoxazole; all strains were sensitive to carbapenems, and 92% of the strains had a multidrug resistance phenotype. Molecular methods identified 109 isolates harboring a\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-15<\/jats:sub>\n            gene, 1 harboring the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-32<\/jats:sub>\n            gene (first identification in the country), and 9 harboring the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-14<\/jats:sub>\n            gene. All isolates presented the IS\n            <jats:italic>Ecp1<\/jats:italic>\n            element upstream from the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M<\/jats:sub>\n            genes; one presented the IS\n            <jats:italic>903<\/jats:italic>\n            element (downstream of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-14<\/jats:sub>\n            gene), and none had the IS\n            <jats:italic>26<\/jats:italic>\n            element; 85% carried\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>TEM-1B<\/jats:sub>\n            , and 84% also carried a\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-30<\/jats:sub>\n            . Genetic relatedness analysis based on pulsed-field gel electrophoresis defined five clusters and indicated that 76% of all isolates (from cluster IV) corresponded to a single epidemic strain. Of the 47 strains from one hospital, 41 belonged to cluster IV and were disseminated in three main wards. CTX-M-producing\n            <jats:italic>E. coli<\/jats:italic>\n            strains are currently a problem in Portugal, with CTX-M-15 particularly common. This study suggests that the horizontal transfer of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M<\/jats:sub>\n            genes, mediated by plasmids and\/or mobile elements, contributes to the dissemination of CTX-M enzymes to community and hospital environments. The use of extended-spectrum cephalosporins, quinolones, and aminoglycosides is compromised, leaving carbapenems as the therapeutic option for severe infections caused by ESBL producers.\n          <\/jats:p>","DOI":"10.1128\/aac.01412-06","type":"journal-article","created":{"date-parts":[[2007,3,20]],"date-time":"2007-03-20T00:20:22Z","timestamp":1174350022000},"page":"1946-1955","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":126,"title":["Spread of Extended-Spectrum \u03b2-Lactamase CTX-M-Producing\n            <i>Escherichia coli<\/i>\n            Clinical Isolates in Community and Nosocomial Environments in Portugal"],"prefix":"10.1128","volume":"51","author":[{"given":"Nuno","family":"Mendonc\u0327a","sequence":"first","affiliation":[{"name":"Antibiotic Resistance Unit, Centre of Bacteriology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal"}]},{"given":"Joana","family":"Leita\u0303o","sequence":"additional","affiliation":[{"name":"Antibiotic Resistance Unit, Centre of Bacteriology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal"}]},{"given":"Vera","family":"Manageiro","sequence":"additional","affiliation":[{"name":"Antibiotic Resistance Unit, Centre of Bacteriology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal"}]},{"given":"Euge\u0301nia","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Antibiotic Resistance Unit, Centre of Bacteriology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal"}]},{"given":"Manuela","family":"Canic\u0327a","sequence":"additional","affiliation":[{"name":"Antibiotic Resistance Unit, Centre of Bacteriology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkf151"},{"key":"e_1_3_2_3_2","first-page":"75","volume":"120","year":"1994","unstructured":"Belaaouaj, A., C. Lapoumeroulie, M. M. Cani\u00e7a, G. Vedel, P. N\u00e9vot, R. Krishnamoorthy, and G. Paul. 1994. Nucleotide sequences of the genes coding for the TEM-like \u03b2-lactamases IRT-1 and IRT-2 (formerly called TRI-1 and TRI-2). FEMS Microbiol. Lett.120:75-80.","journal-title":"FEMS Microbiol. 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