Community-acquired Extended-Spectrum β-Lactamase Producers, United States

sTo the Editor: Extended-spectrum b-lactamase (ESBL)nproducing organisms have become a common problem for patients in hospitals and other healthcare facilities. Community-onset ESBL infections have recently been described in Spain, the United Kingdom, Israel, and Canada. Typically, the infections are urinary tract infections (UTIs) with CTX-Mnproducing Escherichia coli. These organisms may be resistant to most or all antimicrobial agents commonly used to treat UTIs, such as ciprofloxacin, trimethoprim-sulfamethoxazole, gentamicin, and ceftriaxone.Although CTX-Mnproducing E. coli have previously been found in the United States, clinical descriptions of community-acquired ESBL-producing E. coli infections have not been reported in this country. We describe 2 healthy young women in Pennsylvania in whom UTI with CTX-M-15nproducing E. coli developed...