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This study aimed to investigate antimicrobial resistance and molecular epidemiology of extended-spectrum β-lactamase (ESBL)-producing  Escherichia coli  ( E. coli ) isolated from outpatients in town hospitals of Shandong province, China. Antimicrobial susceptibility of ESBL-producing  E. coli  was tested using the disk diffusion and resistance genes encoding for β-lactamases ( bla  TEM ,  bla  CTXM , and  bla  SHV ) were detected by polymerase chain reaction (PCR). Multilocus sequence typing (ST) of ESBL-producing  E. coli  was analyzed in this study. Our results showed that of 320  E. coli  isolates, 201 carried ESBL genes (201/320, 62.8%), and these isolates all carried  bla  CTX-M  genes, the most common being  bla  CTX-M-14  (116/201, 57.7%), followed by  bla  CTX-M-55  (47/201, 23.4%) and  bla  CTX-M-15  (31/201, 15.4%). ESBL-producing  E. coli  exhibited highly resistant to penicillin derivatives, fluoroquinolones, folate pathway inhibitors, and third-generation cephalosporins, but no carbapenem-resistant isolates were found in this study. Forty-two STs were found among the 201 ESBL-producing  E. coli , and the most common ST was ST131 (27/201, 13.4%), followed by ST405 (19/201, 9.5%) and ST69 (15/201, 7.5%). Taken together, a high isolation rate of ESBL-producing  E. coli  (62.8%) was found among outpatients in town hospitals.  bla  CTX-M  gene was most dominant and was composed of a variety of subtypes. No dominant ST was detected among ESBL-producing  E. coli , indicating that these ESBL-producing  E. coli  isolates derive from different clones.

frontiers in microbiology

Antimicrobial Resistance and Molecular Epidemiology of ESBL-Producing Escherichia coli Isolated from Outpatients in Town Hospitals of Shandong Province, China