Occurrence, Antibiotic Resistance, Virulence Factors, and Genetic Diversity of spp. from Public Hospital Environments in South Africa.

This study aimed to assess the molecular dissemination of 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. species were further confirmed to belong to (129/135; 96%) and (6/135; 4%). Prevalence was similar across the wards, averaging 33.3% (45/135). The highest prevalence of 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 (56%) and t (5%). Enterotoxin virulence genes (77%) and (88%) associated with the diarrheal syndrome were most detected; however, no 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 spp. in public hospital environments and calls for the design of optimal strategies to curb their spread.