This study investigated the bacterial colonization in patients admitted for treatment of drug-resistant tuberculosis in a specialized TB hospital. Identification and antimicrobial susceptibility testing of bacterial isolates (n = 62) from nasal, groin, and rectal swabs [patient cohort (n = 37)] were determined by the VITEK-MS system. Resistance gene analysis was by PCR and DNA sequencing. Molecular typing of Klebsiella pneumoniae isolates was by Multilocus Sequencing Typing (MLST). Patients (n = 13/37; 35%) were colonized by multidrug-resistant (MDR) bacteria (ESBL and MRSA) on admission. Of the 24 patients who were not colonized by MDR bacteria on admission, 46% (17/37) became colonized by MDR bacteria within 1 month of admission, mostly with ESBL-producing Enterobacteriales and resistance to aminoglycosides and fluoroquinolones. ESBL Escherichia coli (41/62; 66%) and K. pneumoniae (14/62; 23%) predominated. Genes encoding for ESBLs (bla_CTX-M-14, bla_CTX-M-15, bla_SHV-28, bla_OXA-1, and bla_OXY-2) and plasmid-mediated quinolone resistant genes (qnrB1, qnrB4, and qnrB10) were detected. MLST revealed genetic diversity among the K. pneumoniae isolates from hospitalized patients. This study provides insight into bacterial pathogen colonization in hospitalized TB patients with the first occurrence of the qnrB4 and qnrB10 genes and co-expression of genes: qnrB4+aac(6′)-lb-cr, qnrB10+aac(6′)-lb-cr, qnrB4+qnrS1, and qnrB10+qnrS1 in fluoroquinolone-resistant E. coli isolates within South Africa. However, the source and colonization routes of these isolates could not be determined.

中文翻译：

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耐多药结核病住院患者的细菌定植谱

本研究调查了在结核病专科医院接受治疗的耐药结核病患者的细菌定植情况。 通过 VITEK-MS 系统确定 来自鼻腔、腹股沟和直肠拭子 [患者队列 ( n = 37)]的细菌分离株 ( n = 62) 的鉴定和抗菌药物敏感性测试。抗性基因分析是通过PCR和DNA测序。肺炎克雷伯菌分离株的分子分型是通过多位点测序分型 (MLST)。患者 ( n = 13/37；35%) 在入院时被耐多药 (MDR) 细菌（ESBL 和 MRSA）定植。在入院时未定植 MDR 细菌的 24 名患者中，46% (17/37) 在入院后 1 个月内被 MDR 细菌定植，主要是产 ESBL 的肠杆菌和对氨基糖苷类和氟喹诺酮类药物的耐药性。ESBL大肠杆菌（41/62；66%）和肺炎克雷伯菌（14/62；23%）占优势。编码 ESBL 的基因（bla _CTX-M-14、bla _CTX-M-15、bla _SHV-28、bla _OXA-1和bla _OXY-2）和质粒介导的喹诺酮抗性基因（qnrB1、qnrB4和qnrB10 ) 被检测到。MLST 揭示了来自住院患者的肺炎克雷伯菌分离株的遗传多样性。本研究提供了对首次出现qnrB4和qnrB10基因以及基因共表达的住院结核病患者细菌病原体定植的深入了解：qnrB4+aac(6′)-lb-cr、qnrB10+aac(6′)-lb -cr、qnrB4+qnrS1和qnrB10+qnrS1在南非境内耐氟喹诺酮类大肠杆菌分离株中。然而，无法确定这些分离株的来源和定植途径。