Infections with multi-drug resistant E. coli, which is also known as ESBL (extended spectrum beta-lactamase), have been assumed to be a hospital phenomenon. A recent analysis presented at The Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) surveyed records from five hospitals across the USA (New York, Pennsylvania, Michigan, Texas, and Iowa) and identified 291 cases of ESBL E. coli infections over 12 months, but also found that 107 patients (37%) had acquired infections before they entered a hospital.
This indicates that multi-drug resistant E. coli is now spreading in the everyday world, in an undetected and untracked fashion. Most of the cases were due to the ST131 strain of E. coli, which emerged only a few decades ago and became a dominant strain. Over the decades, the organism has acquired additional resistance factors.
ESBL E. coli has even had a rapid emergence in the Netherlands, a country where antibiotics are strictly regulated. In a recent study, 8.5% of 1,713 Amsterdam residents had ESBL E. coli in their stool samples. It’s still puzzling how ESBL E. coli managed to find its way into the general population, one that hasn’t had much contact with hospitals, which are supposed to be the breeding grounds for these variants of E. coli.