Frazee BW, et al. - At a single Northern California emergency department (ED), urinary tract infections (UTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae were studied and characterized. Researchers also ascertained the proportion that occurred in patients without health care-associated risk factors and who received discordant initial antibiotic therapy. Microbiology staff prospectively reviewed ED urine culture results weekly for 1 year and presumptively identified ESBL-producing isolates by ceftriaxone plus ceftazidime resistance. Findings revealed that ESBL-producing Enterobacteriaceae was related to greater than 5% of culture-proven UTI, and in nearly half of cases there was no identifiable health care-associated risk factor. They noted that it was common to find levofloxacin co-resistance and discordant antibiotic therapy.