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5% of urine isolates were ESBL-producing (Fig.?1). The number of K.?pneumoniae isolates with an ESBL phenotype also increased significantly (p?Selleck Paclitaxel isolates could not be recultured. Forty-three had originated from urine samples, 36 from pus and wounds, and two from blood cultures. One major PFGE type, AK, consisting of 60 (74%) isolates, was identified (Fig.?2). The isolates of this type were collected from 16 different wards; 59 were healthcare-associated, and only one was community-acquired. The combination of blaSHV-12 and blaTEM was the most prevalent gene combination (75%) in this PFGE type. The majority of the ESBL-producing E.?coli and K.?pneumoniae isolates included in this study were multidrug-resistant (MDR), i.e. resistant to more than three different antimicrobial drug classes. find more In particular, the prevalence of ciprofloxacin resistance was high (82%). All of the E.?coli isolates of PFGE type?AE and seven (88%) of PFGE type?BE were MDR (Fig.?2). Similarly, 56 (93%) of type?AKK.?pneumoniae isolates were MDR (Fig.?2). Only one carbapenem-resistant K.?pneumoniae isolate was detected. Although the frequency of carbapenem-resistant isolates has increased worldwide, owing to the emergence of KPC carbapenemases and metallo-��-lactamases, carbapenem-resistant K.?pneumoniae strains have remained rare in Finland. In Finland, the number of ESBL-producing E.?coli and K.?pneumoniae isolates had been very low until the end of the 1990s [10], but our results indicate that the situation has changed. We have shown that the number of new infections caused Fluconazole by ESBL-producing E.?coli strains increased dramatically (Fig.?1) within 4?years (2000�C2004) in the Helsinki city area. On the basis of data from 2005 onwards, this trend seems to be continuing (unpublished results). Of course, a similar change in the incidence of ESBL-producing E.?coli to that observed in this study has been observed in several other countries during the same time period [11�C13]. As in other countries, in the Helsinki region, the CTX-M-1-type ��-lactamases are predominant among ESBL-positive E.?coli isolates, regardless of clonal background.