Endemic occurrence of infections by multidrug-resistantEscherichia coliof four unique serotypes in the elderly population of Israel

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Abstract
During a period of four years, multidrug-resistant Escherichia coli of particular serotypes have been isolated from 255 elderly (>65 years) patients from four hospitals in central Israel. 83% of the isolates belonged to one of four predominant serotypes (O153:H31, O101:H-, O2:H42, and O102:H6). All isolates were producers of extended spectrum β-lactamases and resistant to ciprofloxacin. To our knowledge, the involved serotypes have hitherto not been reported as etiological agents of extraintestinal human infections (MEDLINE). Pulsed-field gel electrophoresis of isolates from one of the most frequent serotypes indicated a clonal relationship between them. Further investigation of these strains and analysis of their virulence factors may help to confine their spread.