title: Extended-spectrum β-lactamase-producing Escherichia coli strains in the feces of carriers contribute substantially to urinary tract infections in these patients.
abstract: BACKGROUND
  The current increase in the incidence of urinary tract infections (UTIs) worldwide caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli may be due to the high number of ESBL-producing Enterobacteriaceae carriers in the community. However, whether ESBL-producing bacteria can cause UTIs in carriers remains uncertain.
  
  
  METHODS
  In this study, 21 fecal carriers of ESBL-producing Enterobacteriaceae were assessed for UTIs caused by ESBL-producing E. coli. Bacterial isolates obtained from patients' urine and stool specimens were phenotypically and genotypically examined. Clonal similarities of isolates were assessed by multilocus sequence typing (MLST) and random amplified polymorphic DNA (RAPD) fingerprinting.
  
  
  RESULTS
  The study revealed that 9 of 21 carriers developed UTIs, and genetic analysis showed that 44% of the UTIs developed were caused by the same ESBL-producing E. coli as that found in the feces of the patients.
  
  
  CONCLUSIONS
  The ESBL-producing E. coli in carriers can cause UTIs.
authors.affiliation: Department of Bioinformatics, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Niki
authors.forename: I
authors.initials: I
authors.lastname: Hirai
authors.forename: A
authors.initials: A
authors.lastname: Yoshinaga
authors.forename: L
authors.initials: L
authors.lastname: Ulzii-Orshikh
authors.forename: A
authors.initials: A
authors.lastname: Nakata
authors.forename: A
authors.initials: A
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000378:metabolism* / Q000652:urine; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D016133:Polymerase Chain Reaction; D019105:Random Amplified Polymorphic DNA Technique; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000652:urine; D014556:Urine / Q000382:microbiology; D001618:beta-Lactamases / Q000378:metabolism* / Q000652:urine
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D001618:beta-Lactamases