title: Extended spectrum beta-lactamase-producing Enterobacteriaceae in international travelers and non-travelers in New York City.
abstract: BACKGROUND
  We performed this study 1) to determine the prevalence of community-associated extended spectrum beta-lactamase producing Enterobacteriaceae (ESBLPE) colonization and infection in New York City (NYC); 2) to determine the prevalence of newly-acquired ESBLPE during travel; 3) to look for similarities in contemporaneous hospital-associated bloodstream ESBLPE and travel-associated ESBLPE.
  
  
  METHODS
  Subjects were recruited from a travel medicine practice and consented to submit pre- and post-travel stools, which were assessed for the presence of ESBLPE. Pre-travel stools and stools submitted for culture were used to estimate the prevalence of community-associated ESBLPE. The prevalence of ESBLPE-associated urinary tract infections was calculated from available retrospective data. Hospital-associated ESBLPE were acquired from saved bloodstream isolates. All ESBLPE underwent multilocus sequence typing (MLST) and ESBL characterization.
  
  
  RESULTS
  One of 60 (1.7%) pre- or non-travel associated stool was colonized with ESBLPE. Among community-associated urine specimens, 1.3% of Escherichia coli and 1.4% of Klebsiella pneumoniae were identified as ESBLPE. Seven of 28 travelers (25.0%) acquired a new ESBLPE during travel. No similarities were found between travel-associated ESBLPE and hospital-associated ESBLPE. A range of imported ESBL genes were found, including CTX-M-14 and CTX-15.
  
  
  CONCLUSIONS
  ESBL colonization and infection were relatively low during the study period in NYC. A significant minority of travelers acquired new ESBLPE during travel.
authors.affiliation: Department of Medicine, Alta Bates Summit Medical Center, Oakland, California, USA.scottweisenberg@gmail.com
authors.forename: Scott A
authors.initials: SA
authors.lastname: Weisenberg
authors.forename: Jose R
authors.initials: JR
authors.lastname: Mediavilla
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Alexander
authors.forename: Kyu Y
authors.initials: KY
authors.lastname: Rhee
authors.forename: Barry N
authors.initials: BN
authors.lastname: Kreiswirth
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Jenkins
mesh_terms: D004755:Enterobacteriaceae / Q000201:enzymology*; D004926:Escherichia coli / Q000201:enzymology; D006801:Humans; D038622:Internationality; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics; D014195:Travel; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001618:beta-Lactamases