Hasan Badrul, Laurell Karl, Rakib Mufti Mahmud, Ahlstedt Erik, Hernandez Jorge, Caceres Mercedes, Järhult Josef D
1 Section for Infectious Diseases, Department of Medical Sciences, Uppsala University , Uppsala, Sweden .
2 Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University , Uppsala, Sweden .
Microb Drug Resist. 2016 Dec;22(8):682-687. doi: 10.1089/mdr.2015.0323. Epub 2016 Mar 23.
Antibiotic-resistant bacteria are a major concern in the healthcare of today, especially the increasing number of gram-negative bacteria producing β-lactamases such as extended-spectrum β-lactamases (ESBLs). However, little is known about the relationship of ESBL producers in humans and domestic and wild birds, especially in a low-income setting. Therefore, we studied the fecal carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae in healthy humans, poultry, and wild birds in the vicinity of León, Nicaragua. Three hundred fecal samples were collected during December 2012 from humans (n = 100), poultry (n = 100) and wild birds (n = 100). The samples were examined for ESBL-producing E. coli and K. pneumoniae, revealing the prevalence of 27% in humans, 13% in poultry, and 8% in wild birds. Further characterization of the ESBL-producing isolates was performed through polymerase chain reaction (PCR) (NDM, CTX-M), epidemiological typing (ERIC2-PCR), multilocus sequence typing, and sequencing. ESBL producers harbored bla, bla, bla, and bla genotypes. The bla constituted the absolute majority of ESBL genes among all samples. ERIC-PCR demonstrated highly related E. coli clones among humans, poultry, and wild birds. Clinically relevant E. coli clone ST648 was found in humans and poultry. There is a shared pool of bla genes between humans and domesticated and wild birds in Nicaragua, and the results suggest shared clones of ESBL-producing E. coli. The study adds to the notion that wild birds and poultry can pick up antibiotic-resistant bacteria of human origin and function as a melting pot of resistance. Structured surveillance programs of antimicrobial resistance and a more regulated prescription of antibiotics are warranted in Nicaragua.
抗生素耐药细菌是当今医疗保健领域的一个主要问题，尤其是产生β-内酰胺酶（如超广谱β-内酰胺酶[ESBLs]）的革兰氏阴性菌数量不断增加。然而，对于人类以及家养和野生鸟类中ESBL产生菌之间的关系，人们了解甚少，特别是在低收入环境中。因此，我们研究了尼加拉瓜莱昂附近健康人类、家禽和野生鸟类中产ESBL大肠杆菌和肺炎克雷伯菌的粪便携带情况。2012年12月期间，我们收集了300份粪便样本，其中人类样本100份、家禽样本100份和野生鸟类样本100份。对样本进行了产ESBL大肠杆菌和肺炎克雷伯菌检测，结果显示人类中的患病率为27%，家禽中为13%，野生鸟类中为8%。通过聚合酶链反应（PCR）（检测NDM、CTX-M）、流行病学分型（ERIC2-PCR）、多位点序列分型和测序，对产ESBL分离株进行了进一步鉴定。产ESBL菌株携带bla、bla、bla和bla基因型。bla在所有样本的ESBL基因中占绝对多数。ERIC-PCR显示人类、家禽和野生鸟类中的大肠杆菌克隆高度相关。在人类和家禽中发现了临床相关的大肠杆菌克隆ST648。在尼加拉瓜，人类与家养和野生鸟类之间存在一个共享的bla基因库，结果表明产ESBL大肠杆菌存在共享克隆。该研究进一步证明，野生鸟类和家禽可以携带人类来源的抗生素耐药细菌，并成为耐药性的汇聚地。尼加拉瓜有必要开展抗菌药物耐药性的结构化监测计划，并对抗生素处方进行更严格的管理。
