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 ( = 62) from nasal, groin, and rectal swabs [patient cohort ( = 37)] were determined by the VITEK-MS system. Resistance gene analysis was by PCR and DNA sequencing. Molecular typing of isolates was by Multilocus Sequencing Typing (MLST). Patients ( = 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 (41/62; 66%) and (14/62; 23%) predominated. Genes encoding for ESBLs (, , , , and ) and plasmid-mediated quinolone resistant genes (, , and ) were detected. MLST revealed genetic diversity among the isolates from hospitalized patients. This study provides insight into bacterial pathogen colonization in hospitalized TB patients with the first occurrence of the and genes and co-expression of genes: , , and in fluoroquinolone-resistant isolates within South Africa. However, the source and colonization routes of these isolates could not be determined.
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