{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:45:42Z","timestamp":1756460742408,"version":"3.37.3"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Pathogens"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Extended Spectrum<jats:italic>\u03b2<\/jats:italic>-Lactamases (ESBLs) confer resistance to third-generation cephalosporins and CTX-M types have emerged as the most prominent ESBLs worldwide. This study was designed to determine the prevalence of CTX-M positive ESBL-producing urinary<jats:italic>E. coli<\/jats:italic>isolates from HIV patients and to establish the association of multidrug resistance, phylogeny, and virulence profile with CTX-M production. A total of 57 ESBL producers identified among 76<jats:italic>E. coli<\/jats:italic>strains isolated from HIV patients from South India were screened for<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mrow><mml:msub><mml:mrow><mml:mi>b<\/mml:mi><mml:mi>l<\/mml:mi><mml:mi>a<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">C<\/mml:mi><mml:mi mathvariant=\"normal\">T<\/mml:mi><mml:mi mathvariant=\"normal\">X<\/mml:mi><mml:mtext>-<\/mml:mtext><mml:mi mathvariant=\"normal\">M<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>, AmpC production, multidrug resistance, and nine virulence associated genes (VAGs),<jats:italic>fimH<\/jats:italic>,<jats:italic>pap<\/jats:italic>,<jats:italic>afa\/dra<\/jats:italic>,<jats:italic>sfa\/foc<\/jats:italic>,<jats:italic>iutA<\/jats:italic>,<jats:italic>fyuA<\/jats:italic>,<jats:italic>iroN<\/jats:italic>,<jats:italic>usp,<\/jats:italic>and<jats:italic>kpsMII.<\/jats:italic>The majority (70.2%) of the ESBL producers harbored<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:msub><mml:mrow><mml:mi>b<\/mml:mi><mml:mi>l<\/mml:mi><mml:mi>a<\/mml:mi><\/mml:mrow><mml:mrow><mml:mi mathvariant=\"normal\">C<\/mml:mi><mml:mi mathvariant=\"normal\">T<\/mml:mi><mml:mi mathvariant=\"normal\">X<\/mml:mi><mml:mtext>-<\/mml:mtext><mml:mi mathvariant=\"normal\">M<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math>and were AmpC coproducers. Among the CTX-M producers, 47.5% were found to be UPEC, 10% harbored as many as 7 VAGs, and 45% possessed<jats:italic>kpsMII<\/jats:italic>. Multidrug resistance (CIP<jats:sup>R<\/jats:sup>SXT<jats:sup>R<\/jats:sup>GEN<jats:sup>R<\/jats:sup>) was significantly more common among the CTX-M producers compared to the nonproducers (70% versus 41.2%). However, 71.4% of the multidrug resistant CTX-M producers exhibited susceptibility to nitrofurantoin thereby making it an effective alternative to cephalosporins\/fluoroquinolones. The emergence of CTX-M-producing highly virulent, multidrug resistant uropathogenic<jats:italic>E. coli<\/jats:italic>is of significant public health concern in countries like India with a high burden of HIV\/AIDS.<\/jats:p>","DOI":"10.1155\/2016\/4152704","type":"journal-article","created":{"date-parts":[[2016,3,30]],"date-time":"2016-03-30T23:44:38Z","timestamp":1459381478000},"page":"1-6","source":"Crossref","is-referenced-by-count":7,"title":["Multidrug Resistant CTX-M-Producing<i>Escherichia coli<\/i>: A Growing Threat among HIV Patients in India"],"prefix":"10.1155","volume":"2016","author":[{"given":"Kesavaram","family":"Padmavathy","sequence":"first","affiliation":[{"name":"Department of Microbiology, Research Laboratory for Oral and Systemic Health, Sree Balaji Dental College and Hospital, BIHER, Bharath University, Chennai 600100, 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