Yamamoto Yoshimasa, Hoang Hoa Thi Thanh, Le Yen Hai, Appiah-Kwarteng Cornelia, Khong Diep Thi, Nguyen Thang Nam, Calvopina Manuel, Bastidas-Caldes Carlos, Tetsuka Nobuyuki, Anraku Masaki, Yamamoto Mayumi
The United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu, Japan.
School of Veterinary Medicine, University of Ghana, Accra, Ghana.
Microbiol Spectr. 2025 Jun 3;13(6):e0292024. doi: 10.1128/spectrum.02920-24. Epub 2025 Apr 30.
The spread of antimicrobial-resistant bacteria, especially in developing countries, is a critical healthcare issue. Among these, extended-spectrum beta-lactamase (ESBL)-producing bacteria are particularly concerning due to their resistance to third- and fourth-generation cephalosporins. Traditional methods for assessing bacterial resistance involve culturing bacteria on selective media from fecal samples, which may lead to selection bias. Alternatively, real-time PCR allows for detecting resistance genes directly from fecal DNA, providing a broader view of resistant bacteria. In this study, we evaluated the utility of a real-time PCR assay targeting ESBL-producing genes as a comprehensive detection method for ESBL-producing resistant bacteria in fecal samples. Additionally, we conducted a multinational comparative analysis of the colonization status of residents using this approach. The study analyzed ESBL genes in fecal samples from 161 residents in four countries: Ecuador, Ghana, Vietnam, and Japan. Samples from Ecuador, Ghana, and Vietnam, where ESBL carriage was notably high, revealed gene variations by country, with TEM genes being most common except in Ghana, where SHV genes predominated. These variations suggest that different bacterial hosts carry ESBL genes across countries. Quantitative PCR results further highlight that TEM is the most abundant ESBL gene. Although gene presence does not confirm antibiotic resistance, these findings underline significant ESBL carriage in low- and middle-income countries. The study emphasizes that gene detection in fecal samples is valuable for understanding resistant bacteria spread in communities.IMPORTANCEThe rise of antimicrobial-resistant bacteria, particularly extended-spectrum beta-lactamase (ESBL)-producing strains, poses a serious threat to healthcare in developing countries. This study utilized real-time PCR to detect ESBL genes directly from fecal DNA of 161 participants across four countries, offering a comprehensive analysis without the biases of traditional culture-based methods. High ESBL gene carriage rates were found in Ecuador, Ghana, and Vietnam, with regional differences in gene prevalence: TEM dominated in most countries, while SHV was most frequent in Ghana. These results highlight the widespread community-level dissemination of ESBL genes in low- and middle-income countries, underscoring the importance of using gene detection as a tool for assessing the spread of resistant bacteria.
耐抗菌药物细菌的传播，尤其是在发展中国家，是一个关键的医疗保健问题。其中，产超广谱β-内酰胺酶（ESBL）的细菌因其对第三代和第四代头孢菌素具有耐药性而尤为令人担忧。传统的评估细菌耐药性的方法是在粪便样本的选择性培养基上培养细菌，这可能会导致选择偏倚。另外，实时聚合酶链反应（PCR）可以直接从粪便DNA中检测耐药基因，从而更全面地了解耐药细菌的情况。在本研究中，我们评估了一种针对产ESBL基因的实时PCR检测方法作为粪便样本中产ESBL耐药细菌的综合检测方法的实用性。此外，我们使用这种方法对多个国家居民的定植状况进行了比较分析。该研究分析了来自四个国家（厄瓜多尔、加纳、越南和日本）的161名居民粪便样本中的ESBL基因。来自ESBL携带率明显较高的厄瓜多尔、加纳和越南的样本显示，不同国家的基因存在差异，除了加纳以SHV基因占主导外，TEM基因最为常见。这些差异表明不同国家的不同细菌宿主携带ESBL基因。定量PCR结果进一步突出显示TEM是最丰富的ESBL基因。虽然基因的存在并不确定是否存在抗生素耐药性，但这些发现强调了低收入和中等收入国家中ESBL的显著携带情况。该研究强调，粪便样本中的基因检测对于了解耐药细菌在社区中的传播具有重要价值。重要性耐抗菌药物细菌的出现，尤其是产超广谱β-内酰胺酶（ESBL）的菌株，对发展中国家的医疗保健构成了严重威胁。本研究利用实时PCR直接从四个国家的161名参与者的粪便DNA中检测ESBL基因，提供了一种全面的分析方法，避免了传统基于培养方法的偏倚。在厄瓜多尔、加纳和越南发现了较高的ESBL基因携带率，基因流行情况存在地区差异：在大多数国家TEM占主导，而在加纳SHV最为常见。这些结果突出了ESBL基因在低收入和中等收入国家社区层面的广泛传播，强调了使用基因检测作为评估耐药细菌传播工具的重要性。
