Molecular Detection of Extended-Spectrum Beta Lactamase and Carbapenemase Genes in Escherichia coli and Salmonella spp. Isolated from Chickens Consumed Outdoors in Ouagadougou, Burkina Faso

This study was carried out to assess the prevalence of resistance genes in strains of Escherichia coli and Salmonella spp. isolated from free-range chickens in Ouagadougou, where resistant bacteria can be transmitted to humans via faeces or contaminated meat. A total of 280 strains of Escherichia coli and 129 strains of Salmonella spp. resistant to at least one beta-lactam or carbapenem antibiotic were used in this study. PCR analyses revealed the presence of ESBL (extended spectrum beta lactamase) resistance genes in Escherichia coli isolates, with 3.21% (9/280) possessing the CTX-M (Cefotaximase) gene, 15.35% (43/280) had the SHV (Sulfhydril Variable) gene, and 11.42% (32/280) had carbapenemase resistance genes, more specifically IMP (Imipenemase metallo-beta-lactamase). As regards Salmonella spp. strains, only the presence of the SHV (Sulfhydril Variable) gene was identified in 2.32% (3/129) of isolates belonging to the ESBL family, while 26.35% (34/129) and 13.95% (18/129) of isolates respectively possessed the IMP (Imipenemase metallo-beta-lactamase) and NDM (New Delhi metallo-β-lactamase) genes, both of the carbapenemase type. The significant prevalence of resistance genes in bacterial strains isolated from chickens sold outdoors in Ouagadougou raises major public health concerns, due to the possible transmission of these resistant strains to humans through the consumption of contaminated meat, thus complicating the treatment of bacterial infections.

Extended-spectrum β-lactamase controversies

G.A.Jacoby 教授毕业于美国哈佛医学院,为国际知名的传染病学、微生物学和免疫学专家,曾长期担任美国麻省总医院传染病科医师,现任麻省 Lahey 医学中心传染病实验室主任,中国感染与化疗杂志特邀编委。长期以来 Jacoby 教授对细菌耐药机制有深入研究,尤其对细菌(肺炎克雷伯菌、大肠埃希菌等)产生质粒介导的超广谱β内酰胺酶(ESBL)以及喹诺酮类的耐药机制研究。曾发表多篇有关上述专题的权威性论著。此次本刊特邀 Jacoby 教授撰写有关 ESBL 的新进展,文中阐述目前 ESBLs 除通常所指质粒介导β内酰胺酶中扩大了酶水解的底物谱导致细菌对头孢噻肟、头孢他啶、氨曲南等抗生素耐药外,还包括许多具有不同特点的β内酰胺酶,其中某些酶产自共生菌。除 ESBL 外,AmpC 酶和各种碳青霉烯β内酰胺酶也可导致细菌对上述抗生素耐药,因此临床微生物实验室准确检出和鉴别各种β内酰胺酶,对于临床选用适宜的抗茵药十分重要。美国 CLSI(过去称为 NCCLS)推荐采用两步法(筛选及确证)检测细菌产 ESBL;但有的学者认为测定抗茵药物对细菌的 MIC,如用药后 T>MIC 在50%以上即可达到满意疗效,无需检测细菌是否产 ESBL。目前认为碳青霉烯类抗生素治疗产 ESBL 菌感染的疗效最为满意,但由此可能引起细菌对该类药物耐药,值得关注。采用大剂量头孢吡肟或哌拉西林-三唑巴坦治疗产ESBL 菌感染是否有效尚有争论,临床上对β内酰胺类最为耐药的菌株往往对几乎所有现用抗菌药耐药。黏菌素(或多黏菌素 B)曾成功的用于治疗此种多重耐药菌感染。此外替莫西林(temocillin,一种对β内酰胺酶稳定的青霉素类)与替加环素(tigecvcline,为米诺环素衍生物)体外对产 ESBL 菌有抗菌作用,但尚无临床研究资料。