To increase understanding of community-acquired resistance, stool samples from 477 nonhospitalized persons in Maryland and Michigan, from 2004 to 2008, were screened for ceftriaxone resistance. Seven (1.5%) yielded ceftriaxone-resistant Escherichia coli; one isolate was resistant to all eight antimicrobial classes routinely tested: aminoglycosides, β-lactam/β-lactamase inhibitor combinations, cephems, penicillins, folate pathway inhibitors, phenicols, quinolones, and tetracyclines. The extensively resistant isolate was from a 50-year-old woman who denied antimicrobial use, hospitalization, or international travel within 6 months. Meat (beef, chicken, and pork) and eggs were consumed within 1 month before stool collection. Further studies are warranted to understand potential sources, including the food supply, of resistant E. coli.
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References
1.
AkwarTH, PoppeC, WilsonJ, Reid-SmithRJ, DyckM, WaddingtonJ, ShangD, DassieN, McEwenSA. Risk factors for antimicrobial resistance among fecal Escherichia coli from residents on forty-three swine farms. Microb Drug Resist, 2007; 13:69–76.
2.
CarattoliA, BertiniA, VillaL, FalboV, HopkinsKL, ThrelfallEJ. Identification of plasmids by PCR-based replicon typing. J Microbiol Methods, 2005; 63:219–228.
3.
ChenS, ZhaoS, WhiteDG, SchroederCM, LuR, YangH, McDermottPF, AyersS, MengJ. Characterization of multiple-antimicrobial-resistant salmonella serovars isolated from retail meats. Appl Environ Microbiol, 2004; 70:1–7.
4.
[CLSI] Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated from Animals; Approved Standard—Third Edition. CLSI document M31-A3. Wayne, PA: CLSI, 2008.
5.
[CLSI] Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twentieth Informational Supplement. CLSI Document M100-S20. Wayne, PA: CLSI, 2010.
6.
Danish Integrated Antimicrobial Resistance Monitoring and Research Program. DANMAP 2008—Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Foods and Humans in Denmark. ISSN 1600–2032. Søborg, Denmark: National Food Institute Technical University of Denmark, 2008.
FolsterJP, PecicG, BolcenS, TheobaldL, HiseK, CarattoliA, ZhaoS, McDermottPF, WhichardJM. Characterization of extended-spectrum cephalosporin-resistant Salmonella enterica serovar Heidelberg isolated from humans in the United States. Foodborne Pathog Dis, 2009; 7:181–187.
9.
HillierS, RobertsZ, DunstanF, ButlerC, HowardA, PalmerS. Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. J Antimicrob Chemother, 2007; 60:92–99.
10.
JohnsonJR, KuskowskiMA, SmithK, O'BryanTT, TatiniS. Antimicrobial-resistant and extraintestinal pathogenic Escherichia coli in retail foods. J Infect Dis, 2005; 191:1040–1049.
11.
LevingsRS, LightfootD, PartridgeSR, HallRM, DjordjevicSP. The genomic island SGI1, containing the multiple antibiotic resistance region of Salmonella enterica serovar Typhimurium DT104 or variants of it, is widely distributed in other S. enterica serovars. J Bacteriol, 2005; 187:4401–4409.
12.
LindseyRL, Fedorka-CrayPJ, FryeJG, MeinersmannRJ. Inc A/C plasmids are prevalent in multidrug-resistant Salmonella enterica isolates. Appl Environ Microbiol, 2009; 75:1908–1915.
13.
MadsenL, AarestrupFM, OlsenJE. Characterisation of streptomycin resistance determinants in Danish isolates of Salmonella Typhimurium. Vet Microbiol, 2000; 75:73–82.
14.
MangesAR, SmithSP, LauBJ, NuvalCJ, EisenbergJN, DietrichPS, RileyLW. Retail meat consumption and the acquisition of antimicrobial resistant Escherichia coli causing urinary tract infections: a case-control study. Foodborne Pathog Dis, 2007; 4:419–431.
15.
NgLK, MulveyMR, MartinI, PetersGA, JohnsonW. Genetic characterization of antimicrobial resistance in Canadian isolates of Salmonella serovar Typhimurium DT104. Antimicrob Agents Chemother, 1999; 43:3018–3021.
16.
PriceLB, GrahamJP, LackeyLG, RoessA, VailesR, SilbergeldE. Elevated risk of carrying gentamicin-resistant Escherichia coli among U.S. poultry workers. Environ Health Perspect, 2007; 115:1738–1742.
17.
RussoTA, JohnsonJR. Medical and economic impact of extraintestinal infections due to Escherichia coli: focus on an increasingly important endemic problem. Microbes Infect, 2003; 5:449–456.
18.
SannesMR, BelongiaEA, KiekeB, SmithK, KiekeA, VandermauseM, BenderJ, ClabotsC, WinokurP, JohnsonJR. Predictors of antimicrobial-resistant Escherichia coli in the feces of vegetarians and newly hospitalized adults in Minnesota and Wisconsin. J Infect Dis, 2008; 197:430–434.
19.
Sjolund-KarlssonM, RickertR, MatarC, PecicG, HowieRL, JoyceK, MedallaF, BarzilayEJ, WhichardJM. Salmonella isolates with decreased susceptibility to extended-spectrum Cephalosporins in the United States. Foodborne Pathog Dis, 2010[Epub ahead of print].
20.
SottoA, De BoeverCM, Fabbro-PerayP, GoubyA, SirotD, JourdanJ. Risk factors for antibiotic-resistant Escherichia coli isolated from hospitalized patients with urinary tract infections: a prospective study. J Clin Microbiol, 2001; 39:438–444.
21.
van den BogaardAE, StobberinghEE. Epidemiology of resistance to antibiotics. Links between animals and humans. Int J Antimicrob Agents, 2000; 14:327–335.
22.
WinokurPL, VonsteinDL, HoffmanLJ, UhlenhoppEK, DoernGV. Evidence for transfer of CMY-2 AmpC beta-lactamase plasmids between Escherichia coli and Salmonella isolates from food animals and humans. Antimicrob Agents Chemother, 2001; 45:2716–2722.
