Carriage Rate of Enterobacterales Resistant to Extended-Spectrum Cephalosporins in the Tunisian Population

• Published in: Pathogens (Basel) Vol. 13; no. 8; p. 624
• Main Authors: Mahjoub Khachroub, Ahlem, Souguir, Meriem, Châtre, Pierre, Elhouda Bouhlel, Nour, Jaidane, Nadia, Drapeau, Antoine, El Kantaoui, Marah, Azaiez, Sana, Madec, Jean-Yves, Mansour, Wejdene, Haenni, Marisa
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26.07.2024; MDPI
• Subjects: Acids; Antibiotics; Antimicrobial resistance; Bacteria; Bacteriology; Cephalosporins; Drug resistance; E coli; Enterobacterales; Epidemics; ESBL; F-:A-:B53; Feces; Gene sequencing; Genes; Intestinal microflora; Klebsiella; Life Sciences; Microbiology and Parasitology; Microbiota; Pathogens; Phenotypes; Phylogenetics; plasmid; Population genetics; Quality control; ST349; Tunisia; Whole genome sequencing; France; Tunisia; F-:A-:B53; ESBL; plasmid; Tunisia; ST349
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens13080624

Enterobacterales resistant to extended-spectrum cephalosporins (ESC) are a marker of the antimicrobial resistance (AMR) burden. They are infecting humans, but the intestinal microbiota can also be transiently colonized without developing symptoms. Healthy carriage can promote silent dissemination of resistant bacteria, and data on this colonization are often lacking. Between 2021 and 2023, a sampling of healthy Tunisian people was carried out. Fecal samples (n = 256) were plated on selective agar, and all collected isolates were characterized by phenotypic (antibiograms) and genomic (whole-genome sequencing) methods. A total of 26 (26/256, 10.2%) isolates were collected, including 24 and 2 . In total, 17 isolates (15 and 2 ) presented an ESBL phenotype conferred by the gene, and 9 isolates presented an AmpC phenotype conferred by the gene. belonged to ST1564 and ST313, while belonged to diverse STs including the pandemic ST131 clone. Clonally related ST349 isolates carrying the gene were found in nine individuals. In parallel, four -positive isolates carried this ESC-resistance gene on an epidemic plasmid IncF/F-:A-:B53 previously identified in Tunisian pigeons and fish. These findings highlight the spread of genetically diverse ESC-resistant Enterobacterales as well as an epidemic plasmid in Tunisia, emphasizing the need for antimicrobial stewardship to limit the transmission of these resistances in the Tunisian population.