title: Prevalence and spread of multidrug-resistant Escherichia coli including ST131 in different patient populations in the Euroregion Meuse-Rhine.
abstract: OBJECTIVE
  To investigate the prevalence and genetic background of Escherichia coli collected from different patient populations in the Euroregion Meuse-Rhine.
  
  
  METHODS
  Susceptibility testing was performed on 1651 E. coli isolates with broth microdilution. Their genetic background was determined using pulsed-field gel electrophoresis and multilocus sequence typing.
  
  
  RESULTS
  The prevalence of resistance varied significantly between the populations. Approximately 10% of the E. coli isolates were multidrug-resistant and/or a β-lactamase producer. The most prevalent extended-spectrum β-lactamase type was CTX-M-15 and ST131 was the most prevalent multilocus sequence typing type. RESULTS from pulsed-field gel electrophoresis of the ST131 isolates indicate the spread of these isolates in the Euroregion.
  
  
  CONCLUSIONS
  E. coli ST131 was the most prevalent sequence type in our Euroregional study. It is essential to control the spread of these resistant strains (e.g., with infection-control policies, antibiotic stewardship programs and antibiotic resistance surveillance). In this way we could observe shifts in the prevalence of resistance of the E. coli population and act accordingly.
authors.affiliation: Maastricht University Medical Centre, Department of Medical Microbiology, P Debyelaan 25, 6229 HX Maastricht, The Netherlands.
authors.forename: Christina
authors.initials: C
authors.lastname: van der Donk
authors.forename: Jeroen
authors.initials: J
authors.lastname: van de Bovenkamp
authors.forename: Hans
authors.initials: H
authors.lastname: Bamelis
authors.forename: Christel
authors.initials: C
authors.lastname: Driessen
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Feldhoff
authors.forename: Wiltrud
authors.initials: W
authors.lastname: Kalka-Moll
authors.forename: Koen
authors.initials: K
authors.lastname: Magerman
authors.forename: Ellen
authors.initials: E
authors.lastname: Stobberingh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001530:Belgium / Q000453:epidemiology; D016172:DNA Fingerprinting; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases