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Seven E. coli isolates expressing resistance to 3rd generation cephalosporins were recovered from blood (n=2), kidney and lung tissue (n=1), and urinary tract (n=4) samples from seven patients hospitalised or recently discharged from the Divisions of Geriatrics and Pulmonary Medicine, Central Hospital of Rogaland, between July and September 2004. All isolates expressed a typical ESBL‐cefotaximase profile (cefotaxime MIC>ceftazidime MIC) with clavulanic acid synergy. A blaCTX‐M‐15 genotype was confirmed in six strains that were coresistant to gentamicin, nitrofurantoin, trimethoprim‐sulfamethoxazole and ciprofloxacin. A blaCTX‐M‐3 genotype was detected in the last strain. XbaI‐PFGE patterns of the six blaCTX‐M‐15 isolates revealed a clonal relationship. BlaCTX‐M‐15 strains were also positive for the ISEcp1‐like insertion sequences that have been shown to be involved in the mobilization of blaCTX‐M. Further analyses revealed two blaCTX‐M‐15‐positive E. coli urinary isolates clonally related to the outbreak strain from two different patients at the same divisions in January and February 2004. These patients were later re‐hospitalised and one had E. coli with an ESBL‐cefotaximase profile in sputum and nasopharyngeal specimen during the outbreak period. Clinical evaluation suggests that the CTX‐M‐producing E. coli strains contributed to death in three patients due to delayed efficient antimicrobial therapy. The outbreak emphasises the epidemic potential of multiple‐antibiotic‐resistant CTX‐M‐15‐producing E. coli also in a country with low antibiotic usage and low prevalence of antimicrobial resistance.