This study aimed to assess the molecular dissemination of Bacillus species in public hospitals in South Africa. The study conducted over 3 months during 2017 involved representative samples obtained from three wards (general ward, intensive care unit, and pediatric unit) from four public hospitals denoted as A (Central), B (Tertiary), C (Regional), and D (District). Swabs collected from 11 distinct hospital surfaces were screened using selective media, biochemical testing, and molecular methods. Overall, 17% (135/777) isolates were identified with a prevalence of 24% (32/135) for central, 33% (45/135) for tertiary, 27% (36/135) for regional, and 16% (22/135) for district hospital. Bacillus species were further confirmed to belong to Bacillus cereus (129/135; 96%) and Bacillus subtilis (6/135; 4%). Prevalence was similar across the wards, averaging 33.3% (45/135). The highest prevalence of Bacillus isolates was found on the drip stands (11.8%), sink (11.8%), ward phone (11.5%), and nurses' tables (10.3%). Minimum inhibitory concentration analyses revealed high resistance to β-lactams, fluoroquinolones, and tetracyclines. The most common resistance genes detected were ermB (56%) and tetM (5%). Enterotoxin virulence genes hblA (77%) and hblD (88%) associated with the diarrheal syndrome were most detected; however, no ces genes (cereulide toxin) for emetic syndrome was found. The enterobacterial repetitive intergenic consensus PCR revealed considerable diversity at the different levels of health care, although the clonal spread of strains between the sites/wards within each specific hospital was revealed. The study highlighted the dissemination of drug-resistant Bacillus spp. in public hospital environments and calls for the design of optimal strategies to curb their spread.

中文翻译：

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芽孢杆菌属的发生、抗生素耐药性、毒力因素和遗传多样性。来自南非公立医院环境

本研究旨在评估南非公立医院中芽孢杆菌属的分子传播情况。该研究在 2017 年进行了超过 3 个月，涉及从四家公立医院的三个病房（普通病房、重症监护病房和儿科病房）获得的代表性样本，分别表示为 A（中央）、B（三级）、C（区域）和 D （区）。使用选择性培养基、生化测试和分子方法筛选从 11 个不同医院表面收集的拭子。总体而言，鉴定出 17% (135/777) 的分离株，其中中部的流行率为 24% (32/135)，三级的流行率为 33% (45/135)，区域性的流行率为 27% (36/135)，地区流行率为 16%。 22/135) 用于地区医院。进一步证实芽孢杆菌属蜡样芽孢杆菌(129/135; 96%) 和枯草芽孢杆菌(6/135; 4%)。病房的患病率相似，平均为 33.3% (45/135)。在滴水台 (11.8%)、水槽 (11.8%)、病房电话 (11.5%) 和护士桌 (10.3%) 上发现芽孢杆菌分离物的最高流行率。最低抑菌浓度分析显示对 β-内酰胺类、氟喹诺酮类和四环素类具有高耐药性。检测到的最常见的抗性基因是ermB (56%) 和 t etM (5%)。与腹泻综合征相关的肠毒素毒力基因hblA (77%) 和hblD (88%) 被检测到最多；但是，没有ces发现了催吐综合征的基因（cereulide toxin）。尽管揭示了每个特定医院内站点/病房之间菌株的克隆传播，但肠杆菌重复基因间共识 PCR 揭示了不同医疗保健水平的相当大的多样性。该研究强调了耐药芽孢杆菌的传播。在公立医院环境中，并呼吁设计最佳策略来遏制其传播。