Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso.
BMC Microbiol. 2023 Nov 17;23(1):351. doi: 10.1186/s12866-023-03108-0.
Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae have spread into the environment worldwide posing a potential public health threat. However, the prevalence data for low- and middle-income countries are still scarce. The aim of this study was to evaluate the presence of ESBL, AmpC-β-lactamase and carbapenemase-producing and multidrug-resistant E. coli and K. pneumoniae in wastewaters from healthcare centers in Burkina Faso.
Eighty-four (84) wastewater samples were collected from five healthcare centers and plated on selective ESBL ChromAgar. E. coli and Klebsiella pneumoniae isolates were identified using API20E. ESBL-producing bacteria were detected in 97.6% of the samples and their average concentration per hospital ranged from 1.10 × 10 to 5.23 × 10 CFU/mL. Out of 170 putative ESBL-producing isolates (64% of them were E. coli) and 51 putative AmpC-β-lactamase-producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, of which 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, moreover, all of them were resistant to all tested β-lactams. Resistance to ESBL inhibitors was also common, up to 66% in E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics to which the least resistance was detected.
This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including carbapenemase producers. Untreated healthcare wastewater entering the environment exposes people and animals to infections caused by these multi-resistant bacteria, which are difficult to treat, especially in the resource-poor settings.
超广谱β-内酰胺酶（ESBL）、质粒介导的AmpC-β-内酰胺酶和碳青霉烯酶产生的大肠杆菌和肺炎克雷伯菌已在全球范围内传播到环境中，对公共健康构成潜在威胁。然而，中低收入国家的流行数据仍然很少。本研究旨在评估布基纳法索五个医疗中心废水中产 ESBL、AmpC-β-内酰胺酶和碳青霉烯酶的以及多药耐药的大肠杆菌和肺炎克雷伯菌的存在情况。
从五个医疗中心收集了 84 个废水样本，并在选择性 ESBL ChromAgar 平板上进行了平板培养。使用 API20E 鉴定出大肠杆菌和肺炎克雷伯菌分离株。97.6%的样本中检测到产 ESBL 菌，每个医院的平均浓度范围为 1.10×10 至 5.23×10 CFU/mL。在 170 个疑似产 ESBL 分离株（其中 64%为大肠杆菌）和 51 个疑似 AmpC-β-内酰胺酶产生分离株中，分别有 95%和 45%得到了确认。在 10 个分离株中检测到碳青霉烯酶的产生，其中 6 个为 NDM 产生菌，3 个为 OXA-48 产生菌，1 个为 NDM 和 OXA-48 产生菌。所有分离株均为多药耐药菌，此外，所有分离株均对所有测试的β-内酰胺类药物均耐药。对 ESBL 抑制剂的耐药性也很常见，在大肠杆菌中高达 66%，在肺炎克雷伯菌中高达 62%。阿米卡星、磷霉素和呋喃妥因是检测到的耐药性最低的抗生素。
本研究表明，医疗中心的废水构成了布基纳法索多药耐药菌的储库，包括碳青霉烯酶产生菌。未经处理的医疗废水进入环境会使人和动物暴露于这些多耐药菌引起的感染，这些感染难以治疗，特别是在资源匮乏的环境中。
