ABSTRACT High ESBL prevalence in MDR E. coli and Klebsiella from clinical and wastewater samples, with concerning AmpC and carbapenemase occurrence and frequent co-resistance. Multidrug-resistant (MDR) gram-negative bacteria pose a global health threat, with MDR-Escherichia coli and MDR-Klebsiella pneumoniae as the primary contributors among Enterobacterales. This study explored the prevalence of extended-spectrum beta-lactamase (ESBL), AmpC-β-lactamase and carbapenemase-encoding genes among ESBL-producing E. coli and Klebsiella spp. isolated from clinical and hospital wastewater samples in Burkina Faso. We analyzed 292 ESBL-producing E. coli and Klebsiella spp. isolates from clinical specimens (n = 218) and hospital wastewaters (n = 74) across five Burkinabe hospitals. Using the conventional PCR multiplex technique, we screened for 10 key resistance genes, covering ESBL (blaCTX-M, blaSHV and blaTEM), AmpC-β-lactamase (blaDHA and blaFOX) or carbapenemases (blaOXA-48, blaNDM, blaVIM, blaKPC and blaIMP). Resistance genes were present in both clinical and wastewater samples across all levels of healthcare facilities. ESBL-encoding genes were detected in 95.5% of the isolates, AmpC-β-lactamase genes in 11.0% and carbapenemase-encoding genes in 17.1%. Many isolates from both clinical and hospital wastewater samples harbored multiple resistance genes, spanning all three gene categories. The findings from this study underscore the urgent need for a comprehensive hospital-based AMR surveillance system and stringent antibiotic stewardship measures to limit the spread of resistant bacteria in the environment to protect public health.
Garba et al. (Fri,) studied this question.