title: [Analysis of community-associated bloodstream infections caused by Escherichia coli producing extended-spectrum β-lactamase].
abstract: OBJECTIVE
  To compare the risk factors and resistance characterizations between the Community-associated (CA) and Hospital-associated (HA) bloodstream infections (BSIs) caused by extended-spectrum β-lactamase-producing ESBLs) Escherichia coli. Infections control strategy must be made for the spread of CA E. Coli.
  
  
  METHODS
  Fifty-one samples of ESBLs-producing BSI E. Coli were collected in 3201 hospital affiliated of Xi'an jiaotong University School of Medicine from 2008 to 2013. Antimicrobial agents susceptibility test and ESBLs confirmation test were determined by K-B method. PFGE was used to investigate the clonality of clinical isolates. PCR amplification and sequencing were used to screen ESBLs genes. Plasmid conjugation assay was used by filter mating. An S1-PFGE assay on plasmid and southern blot were performed to determine the plasmid molecular size and resistance genes location.
  
  
  RESULTS
  There were 27 community-associated samples, while 24 hospital-associated samples in 51. And patients with community-acquired infections were increasing year by year. Also there was a significant difference between patients with urinary tract infection and cancer in CA and HA. Cases of urinary tract infection were mainly CA, reaching to 18. 40 of OR value, and from 2. 161 to 156. 7 of 95% confidence interval. While Cases of cancer gave priority to HA, OR value was 0. 147 7 with 0. 034 85 to 0. 626 30 of 95% confidence interval. PFGE results did not support the evidence of clone dissemination. Among 51 strains, 26 TEM genotype, including 12 CA strains, 12 SHV genotype, including 5 CA strains, 21 CTX-M-1 genotype, including 10 CA strains , and 25 CTX-M-9 genotype. including 13 CA strains. All ESBLs resistant genotypes were no significant differences in the two groups. Conclusions Urinary tract infection is risk factor for community-aassociated bloodstream infection caused by E. Coli relatively. Degree of drug resistance of ESBLs-producing E. Coli isolated from Community-Associated Bloodstream Infections is close to Hospital-Associated. So the public health control measures are needed to prevent the further spread of CA ESBLs-producing E. Coli. [Key words] Bloodstream infection; Risk factor; Resistance; Pulsed field gel electrophoresis; Plasmid
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Li
authors.forename: Minghui
authors.initials: M
authors.lastname: Deng
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Xuan
authors.initials: X
authors.lastname: Hou
authors.forename: Junqi
authors.initials: J
authors.lastname: Tao
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.forename: Mengrong
authors.initials: M
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Li
authors.forename: Yihai
authors.initials: Y
authors.lastname: Gu
mesh_terms: D016470:Bacteremia; D017714:Community-Acquired Infections; D016521:Electrophoresis, Gel, Pulsed-Field; D004927:Escherichia coli Infections; D006801:Humans; D010957:Plasmids; D016133:Polymerase Chain Reaction; D014552:Urinary Tract Infections; D001618:beta-Lactamases
chemical_list: C055184:beta-lactamase TEM-3; D001618:beta-Lactamases