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Clin Infect Dis. 2015 Feb 1;60(3):439-52. doi: 10.1093/cid/ciu785. Epub 2014 Oct 9.

Do human extraintestinal Escherichia coli infections resistant to expanded-spectrum cephalosporins originate from food-producing animals? A systematic review.

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The University of Queensland, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston.
Biosecurity Sciences Laboratory, Biosecurity Queensland, Department of Agriculture, Fisheries and Forestry, Coopers Plains, Queensland.
The University of Queensland, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston Monash Infectious Diseases, Monash Health, Clayton, Victoria, Australia.


To find out whether food-producing animals (FPAs) are a source of extraintestinal expanded-spectrum cephalosporin-resistant Escherichia coli (ESCR-EC) infections in humans, Medline, Embase, and the Cochrane Database of Systematic Reviews were systematically reviewed. Thirty-four original, peer-reviewed publications were identified for inclusion. Six molecular epidemiology studies supported the transfer of resistance via whole bacterium transmission (WBT), which was best characterized among poultry in the Netherlands. Thirteen molecular epidemiology studies supported transmission of resistance via mobile genetic elements, which demonstrated greater diversity of geography and host FPA. Seventeen molecular epidemiology studies did not support WBT and two did not support mobile genetic element-mediated transmission. Four observational epidemiology studies were consistent with zoonotic transmission. Overall, there is evidence that a proportion of human extraintestinal ESCR-EC infections originate from FPAs. Poultry, in particular, is probably a source, but the quantitative and geographical extent of the problem is unclear and requires further investigation.


E. coli; ESBL; ST131; poultry; urinary tract; zoonosis

[Indexed for MEDLINE]

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