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diverse setting. Additionally, although we completed a thorough review of inpatient and outpatient records from several healthcare facilities in Maryland, data may have been missing. However, this factor is expected to have been similar for both cases and controls. As the incidence of ESBLs increases and they contribute to considerable morbidity and mortality, it is imperative to develop systems to identify children who are most at risk of infections caused by ESBL-producing organisms. Our findings suggest that in addition to reviewing prior culture histories to identify children with previous ESBL colonization or infection, targeted screening of children who received medical care abroad in high-risk countries, who recently received chemotherapy, or who recently underwent hematopoietic stem cell transplantations may be another strategy to help identify those most at risk for ESBL colonization.

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