<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-4157</journal-id>
<journal-title><![CDATA[Biomédica]]></journal-title>
<abbrev-journal-title><![CDATA[Biomédica]]></abbrev-journal-title>
<issn>0120-4157</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-41572019000500096</article-id>
<article-id pub-id-type="doi">10.7705/biomedica.v39i2.4030</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela]]></article-title>
<article-title xml:lang="es"><![CDATA[Multirresistencia a medicamentos y factores de riesgo asociados con infecciones urinarias por Escherichia coli adquiridas en la comunidad, Venezuela]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guzmán]]></surname>
<given-names><![CDATA[Militza]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salazar]]></surname>
<given-names><![CDATA[Elsa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cordero]]></surname>
<given-names><![CDATA[Vicmaris]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villanueva]]></surname>
<given-names><![CDATA[Andreína]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodulfo]]></surname>
<given-names><![CDATA[Hectorina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Donato]]></surname>
<given-names><![CDATA[Marcos De]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Oriente Departamento de Bioanálisis Laboratorio de Bacteriología Molecular]]></institution>
<addr-line><![CDATA[Cumaná ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Oriente Instituto de Investigaciones en Biomedicina y Ciencias Aplicadas Dra. Susan Tai (IIBCAUDO) Laboratorio de Genética Molecular]]></institution>
<addr-line><![CDATA[Cumaná ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Escuela de Ingeniería y Ciencias Tecnológico de Monterrey ]]></institution>
<addr-line><![CDATA[Querétaro ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>05</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>05</month>
<year>2019</year>
</pub-date>
<volume>39</volume>
<fpage>96</fpage>
<lpage>106</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-41572019000500096&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-41572019000500096&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-41572019000500096&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: The treatment of urinary tract infections has become more challenging due to the increasing frequency of multidrug-resistant Escherichia coli in human populations.  Objective: To characterize multidrug-resistant E. coli isolates causing community-acquired urinary tract infections in Cumaná, Venezuela, and associate possible risk factors for infection by extended-spectrum beta-lactamases (ESBL)-producing isolates.  Materials and methods: We included all the patients with urinary tract infections attending the urology outpatient consultation and emergency unit in the Hospital de Cumaná, Estado Sucre, Venezuela, from January through June, 2014. blaTEM, blaSHV and blaCTX-M genes detection was carried out by PCR.  Results: We found a high prevalence of multidrug-resistant E. coli (25.2%) with 20.4% of the isolates producing ESBL. The ESBL-producing isolates showed a high frequency (66.7%) of simultaneous resistance to trimethoprim-sulphamethoxazole, fluoroquinolones and aminoglycosides compared to non-producing isolates (2.4%). Of the resistant isolates, 65.4% carried the blaTEM gene, 34.6% the blaCTX-M and 23.1% the blaSHV. The blaCTX-M genes detected belonged to the CTX-M-1 and CTX-M-2 groups. Plasmid transfer was demonstrated by in vitro conjugation in 17 of the 26 ESBL-producing isolates. All three genes detected were transferred to the transconjugants. Age over 60 years, complicated urinary tract infections and previous use of a catheter predisposed patients to infection by ESBL-producing E. coli.  Conclusions: The high frequency of multidrug-resistant ESBL-producing isolates should alert the regional health authorities to take measures to reduce the risk of outbreaks caused by these types of bacteria in the community.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción. El tratamiento de las infecciones urinarias constituye un reto creciente por el aumento de Escherichia coli proveniente de la comunidad multirresistente a los medicamentos.  Objetivo. Caracterizar aislamientos de E. coli multirresistente causantes de infecciones urinarias adquiridas en la comunidad en Cumaná, Venezuela, y detectar los posibles riesgos de infección por aislamientos productores de betalactamasas de espectro extendido (BLEE).  Materiales y métodos. Se incluyeron todos los pacientes atendidos en la consulta externa de urología y en urgencias del Hospital de Cumaná entre enero y junio de 2014 y que evidenciaban infecciones urinarias. La detección de los genes blaTEM, blaSHV y blaCTX-M se hizo mediante la reacción en cadena de la polimerasa (PCR).  Resultados. Se encontró una alta prevalencia de E. coli multirresistente a los medicamentos (25,2 %), con 20,4 % de aislamientos productores de BLEE y una gran frecuencia de resistencia simultánea a trimetoprim-sulfametoxazol, fluoroquinolonas y aminoglucósidos (66,7 %) comparados con los no productores (2,4 %). En el 65,4 % de los aislamientos resistentes, se encontró el gen blaTEM; en 34,6 %, el blaCTX-M, y en 23,1 %, el blaSHV. Los genes blaCTX-M detectados pertenecían a los grupos CTX-M-1 y CTX-M-2. Se demostró la transferencia in vitro de plásmidos por conjugación en 17 de los 26 aislamientos productores de BLEE. Los tres tipos de genes detectados se transfirieron a los transconjugantes. La edad mayor de 60 años, las infecciones urinarias con complicaciones y el uso previo de catéter, predispusieron a la infección por cepas de E. coli productoras de BLEE.  Conclusiones. La gran frecuencia de aislamientos multirresistentes productores de BLEE debería alertar a las autoridades sanitarias para tomar medidas que reduzcan el riesgo de epidemias causadas por este tipo de bacterias en la comunidad.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Escherichia coli]]></kwd>
<kwd lng="en"><![CDATA[urologic diseases]]></kwd>
<kwd lng="en"><![CDATA[beta-lactamases]]></kwd>
<kwd lng="en"><![CDATA[rug resistance, bacterial]]></kwd>
<kwd lng="en"><![CDATA[community-acquired infections]]></kwd>
<kwd lng="es"><![CDATA[Escherichia coli]]></kwd>
<kwd lng="es"><![CDATA[enfermedades urológicas]]></kwd>
<kwd lng="es"><![CDATA[beta-lactamasas]]></kwd>
<kwd lng="es"><![CDATA[farmacorresistencia bacteriana]]></kwd>
<kwd lng="es"><![CDATA[infecciones comunitarias adquiridas]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Laupland]]></surname>
<given-names><![CDATA[KB]]></given-names>
</name>
<name>
<surname><![CDATA[Ross]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Pitout]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Church]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Gregson]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Community-onset urinary tract infections: A population-based assessment]]></article-title>
<source><![CDATA[Infection]]></source>
<year>2007</year>
<volume>35</volume>
<page-range>150</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peirano]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Pitout]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Molecular epidemiology of Escherichia coli producing CTX-M &#946;-lactamases: The worldwide emergence of clone ST131 O25: H4]]></article-title>
<source><![CDATA[Int J Antimicrob Agents]]></source>
<year>2010</year>
<volume>35</volume>
<page-range>316-21</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guzmán-Blanco]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Labarca]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Villegas]]></surname>
<given-names><![CDATA[MV]]></given-names>
</name>
<name>
<surname><![CDATA[Gotuzzo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Extended spectrum &#946;-lactamase producers among nosocomial Enterobacteriaceae in Latin America]]></article-title>
<source><![CDATA[Braz J Infect Dis]]></source>
<year>2014</year>
<volume>18</volume>
<page-range>421-33</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cantón]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[González-Alba]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Galán]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[CTX-M enzymes: Origin and diffusion]]></article-title>
<source><![CDATA[Front Microbiol]]></source>
<year>2012</year>
<volume>3</volume>
<page-range>110</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bonnet]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Growing group of extended-spectrum &#946;-lactamases: The CTX-M enzymes]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2004</year>
<volume>48</volume>
<page-range>1-4</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dhillon]]></surname>
<given-names><![CDATA[RH]]></given-names>
</name>
<name>
<surname><![CDATA[Clark]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ESBLs: A clear and present danger?]]></article-title>
<source><![CDATA[Crit Care Res Pract]]></source>
<year>2012</year>
<volume>2012</volume>
<page-range>625170</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Narváez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pedroza]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Alonso]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Lemoine]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Caracterización de plásmidos de resistencia a antibióticos en aislados nosocomiales del Hospital Universitario de Caracas]]></article-title>
<source><![CDATA[Rev Soc Ven Microbiol]]></source>
<year>2005</year>
<volume>25</volume>
<page-range>29-34</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guzmán]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Alonso]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Caracterización de ß-lactamasas de espectro extendido (BLEE) en cepas nosocomiales de K. pneumoniae. Sucre-Venezuela]]></article-title>
<source><![CDATA[Invest Clin]]></source>
<year>2009</year>
<volume>50</volume>
<page-range>419-31</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guevara]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Manrique]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Urinary infections acquired in community: Epidemiology, resistance to antibiotics and therapeutic options]]></article-title>
<source><![CDATA[Kasmera]]></source>
<year>2011</year>
<volume>39</volume>
<page-range>87-97</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Araque]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Millán]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Millán]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Vielma]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de &#946;-lactamasa CTX-M-15 en grupos filogenéticos de Escherichia coli uropatógena aisladas en pacientes de la comunidad en Mérida, Venezuela]]></article-title>
<source><![CDATA[Invest Clin]]></source>
<year>2014</year>
<volume>55</volume>
<page-range>32-43</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[de Cueto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La microbiología en el diagnóstico de la infección del tracto urinario]]></article-title>
<source><![CDATA[Pigrau C, editor. Infección del tracto urinario]]></source>
<year>2013</year>
<edition>Primera edición</edition>
<page-range>11-22</page-range><publisher-loc><![CDATA[Madrid ]]></publisher-loc>
<publisher-name><![CDATA[Salvat]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nicolle]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Bradley]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Colgan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rice]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Schaeffer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hooton]]></surname>
<given-names><![CDATA[TM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2005</year>
<volume>40</volume>
<page-range>643-54</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Friedman]]></surname>
<given-names><![CDATA[ND]]></given-names>
</name>
<name>
<surname><![CDATA[Kaye]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Stout]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[McGarry]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Trivette]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Briggs]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Health care-associated bloodstream infections in adults: A reason to change the accepted definition of community-acquired infections]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>2002</year>
<volume>137</volume>
<page-range>791-7</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<collab>Clinical and Laboratory Standards Institute</collab>
<source><![CDATA[Performance standards for antimicrobial susceptibility testing; twenty-four informational supplement, M100-S24]]></source>
<year>2014</year>
<page-range>226</page-range><publisher-loc><![CDATA[Wayne, PA ]]></publisher-loc>
<publisher-name><![CDATA[CLSI]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Magiorakos]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Srinivasan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carey]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Carmeli]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Falagas]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Giske]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance]]></article-title>
<source><![CDATA[Clin Microbiol Infect]]></source>
<year>2012</year>
<volume>18</volume>
<page-range>268-81</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eckert]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gautier]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Saladin-Allard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hidri]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Verdet]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ould-Hocine]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dissemination of CTX-M- type beta-lactamases among clinical isolates of Enterobacteriaceae in Paris, France]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2004</year>
<volume>48</volume>
<page-range>1249-55</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haeggman]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Löfdal]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Poauw]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Verhoef]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Brisse]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diversity and evolution of the class A chromosomal beta-lactamase gene in Klebsiella pneumoniae]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2004</year>
<volume>48</volume>
<page-range>2400-8</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eldestein]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pimkin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Palagin]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Eldestein]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Stratchounski]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence and molecular epidemiology of CTX-M extended spectrum &#946;-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Russian hospitals]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2003</year>
<volume>47</volume>
<page-range>3724- 32</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mahboobeh]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Forghanifard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Moshrefi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence and molecular characterization of plasmid-mediated extended-spectrum &#946;-lactamase genes (blaTEM, blaCTX and blaSHV) among urinary Escherichia coli clinical isolates in Mashhad, Iran]]></article-title>
<source><![CDATA[Iran J Basic Med Sci]]></source>
<year>2012</year>
<volume>15</volume>
<page-range>833-9</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[GV]]></given-names>
</name>
<name>
<surname><![CDATA[Baird]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Karlowsky]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Master]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
<name>
<surname><![CDATA[Bordon]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nitrofurantoin retains antimicrobial activity against multidrug-resistant urinary Escherichia coli from US outpatients]]></article-title>
<source><![CDATA[J Antimicrob Chemother]]></source>
<year>2014</year>
<volume>69</volume>
<page-range>3259-62</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alos]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiología y etiología de la infección urinaria comunitaria. Sensibilidad antimicrobiana de los principales patógenos y significado clínico de la resistencia]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2005</year>
<volume>23</volume>
<page-range>3-8</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spellberg]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Talbot]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Brass]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bradley]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Boucher]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Gilbert]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Position paper: Recommended design features of future clinical trials of antibacterial agents for community-acquired pneumonia]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2008</year>
<volume>47</volume>
<numero>^s3</numero>
<issue>^s3</issue>
<supplement>3</supplement>
<page-range>S249-65</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Winokur]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
<name>
<surname><![CDATA[Canton]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Casellas]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Legakis]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and characterization of isolates from Europe, the Americas, and the Western Pacific Region]]></article-title>
<source><![CDATA[Clin Inf Dis]]></source>
<year>2001</year>
<volume>32</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>S94-103</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Canton]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Coque]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The CTX-M beta-lactamase pandemic]]></article-title>
<source><![CDATA[Curr Opin Microbiol]]></source>
<year>2006</year>
<volume>9</volume>
<page-range>466-75</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hussain]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ewers]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Nandanwar]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Guenther]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Jadhav]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Wieler]]></surname>
<given-names><![CDATA[LH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multiresistant uropathogenic Escherichia coli from a region in India where urinary tract infections are endemic: Genotypic and phenotypic characteristics of sequence type 131 isolates of the CTX-M-15 extended-spectrum-beta-lactamase-producing lineage]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2012</year>
<volume>56</volume>
<page-range>6358</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ben-Ami]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez-Baño]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Arslan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Pitout]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Quentin]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Calbo]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing enterobacteriaceae in nonhospitalized patients]]></article-title>
<source><![CDATA[Clin Infect Dis]]></source>
<year>2009</year>
<volume>49</volume>
<page-range>682-90</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Alfadel]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Asghar]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Elhassan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of TEM, SHV and CTX-M genes in Escherichia coli and Klebsiella spp. urinary isolates from Sudan with confirmed ESBL phenotype]]></article-title>
<source><![CDATA[Life Sci J]]></source>
<year>2013</year>
<volume>10</volume>
<page-range>191-5</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Radice]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Power]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Di Conza]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gutkind]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Early dissemination of CTX-M-derived enzymes in South America]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2002</year>
<volume>46</volume>
<page-range>602-4</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Kelkar]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Quinn]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical isolates of Enterobacteriaceae producing extended-spectrum b-lactamases: Prevalence of CTX-M-3 at a hospital in China]]></article-title>
<source><![CDATA[Antimicrob Agents Chemother]]></source>
<year>2003</year>
<volume>47</volume>
<page-range>790-3</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yamasaki]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Komatsu]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Yamashita]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Shimakawa]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Ura]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Nishio]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Production of CTX-M-3 extended-spectrum beta-lactamase and IMP-1 metallo beta-lactamase by five Gramnegative bacilli: Survey of clinical isolates from seven laboratories collected in 1998 and 2000, in the Kinki region of Japan]]></article-title>
<source><![CDATA[J Antimicrob Chemother]]></source>
<year>2003</year>
<volume>51</volume>
<page-range>631-8</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kung]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Ku]]></surname>
<given-names><![CDATA[WW]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Fung]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Kuo]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology and risk factors of community-onset urinary tract infection caused by extended-spectrum &#946;-lactamase-producing Enterobacteriaceae in a medical center in Taiwan: A prospective cohort study]]></article-title>
<source><![CDATA[J Microbiol Immunol Infect]]></source>
<year>2015</year>
<volume>48</volume>
<page-range>168-74</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Araque]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Millán]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Salas]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[CTX-M-32 beta-lactamase-producing uropathogenic Escherichia coli isolated in Latin America]]></article-title>
<source><![CDATA[J Infect Dev Ctries]]></source>
<year>2013</year>
<volume>7</volume>
<page-range>432-5</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Coque]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Baquero]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Cantón]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Increasing prevalence of ESBL-producing enterobacteriaceae in Europe]]></article-title>
<source><![CDATA[Eurosurveillance]]></source>
<year>2008</year>
<volume>47</volume>
<page-range>19-29</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rossolini]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[D&#8217;Andrea]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mugnaioli]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Microbiol Infect]]></source>
<year>2008</year>
<volume>14</volume>
<page-range>33-41</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Banerjee]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Strahilevitz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Johnson]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Nagwekar]]></surname>
<given-names><![CDATA[PP]]></given-names>
</name>
<name>
<surname><![CDATA[Schora]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Shevrin]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictors and molecular epidemiology of community-onset extended-spectrum &#946;-lactamase-producing Escherichia coli infection in a Midwestern community]]></article-title>
<source><![CDATA[Infect Control Hosp Epidemiol]]></source>
<year>2013</year>
<volume>34</volume>
<page-range>947-53</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Blanco]]></surname>
<given-names><![CDATA[VM]]></given-names>
</name>
<name>
<surname><![CDATA[Maya]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Correa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Perenguez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Motoa]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2016</year>
<volume>34</volume>
<page-range>559-65</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kronenberg]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hilty]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Endimiani]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Muhlemann]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Temporal trends of extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates in in- and outpatients in Switzerland, 2004 to 2011]]></article-title>
<source><![CDATA[Euro Surveill]]></source>
<year>2013</year>
<volume>18</volume>
<page-range>20484</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Anesi]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Lautenbach]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Nachamkin]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Garrigan]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Bilker]]></surname>
<given-names><![CDATA[WB]]></given-names>
</name>
<name>
<surname><![CDATA[Wheeler]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical and molecular characterization of community-onset urinary tract infections due to extended-spectrum cephalosporin-resistant Enterobacteriaceae]]></article-title>
<source><![CDATA[Infect Control Hosp Epidemiol]]></source>
<year>2016</year>
<volume>37</volume>
<page-range>1433-9</page-range></nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bours]]></surname>
<given-names><![CDATA[PH]]></given-names>
</name>
<name>
<surname><![CDATA[Polak]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Hoepelman]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
<name>
<surname><![CDATA[Delgado]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Jarquin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Matute]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Increasing resistance in community-acquired urinary tract infections in Latin America, five years after the implementation of national therapeutic guidelines]]></article-title>
<source><![CDATA[Int J Infect Dis]]></source>
<year>2010</year>
<volume>14</volume>
<page-range>e770-4</page-range></nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Seija]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Fratchez]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Ventura]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Pintos]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores asociados al desarrollo de infección urinaria de origen comunitario causada por Escherichia coli resistente a fluoroquinolonas]]></article-title>
<source><![CDATA[Rev Chilena Infectol]]></source>
<year>2014</year>
<volume>31</volume>
<page-range>400-5</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
