The spreading of carbapenemase-producing gram-negative bacilli (GNB) must be considered as an “urgent” threat. The aim of this study was to determine the prevalence of extended spectrum β-lactamase (ESBL), plasmid-mediated quinolone resistance (PMQR), and carbapenemase-producing GNB and to characterize the supporting genes in GNB specimens isolated from patients and healthy volunteers in Burkina Faso. From April to June 2016, carbapenemase-producing GNB screening was performed in 1,230 consecutive clinical specimens, and 158 fecal samples from inpatients and healthy volunteers without digestive pathology at Souro Sanou University Hospital, Bobo Dioulasso. Strains were identified by matrix-assisted laser desorption ionization–time of flight and antimicrobial susceptibility was tested with the disk diffusion method on Müller–Hinton agar. The presence of carbapenemase, ESBL, and PMQR genes was assessed by multiplex PCR. The molecular epidemiological study was performed using multilocus sequence typing analysis. From the 1,230 clinical samples, 443 GNB strains were isolated among which 4 (0.9%) were carbapenemase-producing isolates (Escherichia coli, n = 1; Acinetobacter baumannii, n = 3). Among the 158 fecal samples tested for carbapenemase-producing Enterobacteriaceae carriage, 13 (8.2%) were carbapenemase-producing isolates (E. coli, n = 4; Klebsiella pneumoniae, n = 6; A. baumannii, n = 2; Acinetobacter nosocomialis, n = 1; Acinetobacter bereziniae, n = 1). The strains from the two groups were resistant to broad-spectrum cephalosporins (100% for both), gentamicin (100% and 64.3%), levofloxacin (100% and 85.7%), and to amikacin (0% and 7.1%). The carbapenemase-encoding genes bla_NDM-1, bla_Oxa-58, bla_Oxa-181, and bla_VIM-2 were detected in clinical and in fecal samples. The majority (10/11) of the enterobacterial strains carried also bla_CTX-M-15. The majority of the strains belonged to ST692 for E. coli, to ST147 for K. pneumoniae and to ST2 for A. baumannii. This study confirms the presence of carbapenemase-producing GNB in samples from patients and healthy volunteers. More effective active surveillance activities are needed.

中文翻译：

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布基纳法索超广谱 β-内酰胺酶、质粒介导的喹诺酮耐药性和产碳青霉烯酶革兰氏阴性杆菌的流行率和分子特征。

产碳青霉烯酶革兰氏阴性杆菌 (GNB) 的传播必须被视为“紧急”威胁。本研究的目的是确定超广谱 β-内酰胺酶 (ESBL)、质粒介导的喹诺酮耐药性 (PMQR) 和产生碳青霉烯酶的 GNB 的流行情况，并表征从患者和健康志愿者中分离的 GNB 标本中的支持基因。布基纳法索。2016 年 4 月至 6 月，在 Bobo Dioulasso 的 Souro Sanou 大学医院对 1,230 个连续的临床标本和 158 个无消化系统病理学的住院患者和健康志愿者的粪便样本进行了产碳青霉烯酶 GNB 筛查。通过基质辅助激光解吸电离鉴定菌株 - 飞行时间和抗菌敏感性在 Müller-Hinton 琼脂上用圆盘扩散法测试。通过多重 PCR 评估碳青霉烯酶、ESBL 和 PMQR 基因的存在。使用多位点序列分型分析进行分子流行病学研究。从 1,230 份临床样本中，分离出 443 株 GNB，其中 4 株（0.9%）为产碳青霉烯酶株（大肠杆菌，n  = 1；鲍曼不动杆菌，n  = 3)。在检测产碳青霉烯酶肠杆菌科细菌的 158 个粪便样本中，13 个（8.2%）是产碳青霉烯酶分离株（大肠杆菌，n  = 4；肺炎克雷伯菌，n  = 6；鲍曼不动杆菌，n  = 2；医院不动杆菌， n  = 1；Bereziniae 不动杆菌，n  = 1)。来自两组的菌株对广谱头孢菌素（两者均为 100%）、庆大霉素（100% 和 64.3%）、左氧氟沙星（100% 和 85.7%）和阿米卡星（0% 和 7.1%）耐药。碳青霉烯酶编码基因bla _NDM-1，BLA_氧杂58，BLA_氧杂181，和BLA _{-VIM 2}在临床和粪便样品中检测到。大多数 (10/11) 肠杆菌菌株也携带bla _CTX-M-15。大多数菌株属于大肠杆菌的ST692，肺炎克雷伯菌的ST147和鲍曼不动杆菌的ST2 。该研究证实了患者和健康志愿者的样本中存在产生碳青霉烯酶的 GNB。需要更有效的主动监测活动。