Search

In Burkina Faso, the implementation of the quality management system remains weak in diagnostic laboratories. Integrating mentoring into the life of clinical diagnostic laboratories, a qualified mentor is essential for quality system control. The objective of this study was to evaluate the impact of the mentoring process on quality improvement. Mentoring process was implemented at nine laboratories. The process consisted of a one-week mentor stay in the laboratory as one visit, with four in total. The SLIPTA checklist was used as a measurement tool. Two audits were performed (before and after the implementation of the mentoring process. The audit data were analyzed to estimate the effect of mentoring on quality improvement. A score difference of 24.55% was found significant between the two audits (paired Student's t-test p-value = 0.0002). The variables non-conformities, corrective/preventive actions, and facilities/safety have factored more than eight points between the two audits. However, the management/customer service and information one have only slightly increased (2.27 and 0.63, respectively). Mentoring has improved the quality management system in laboratories. However, some points of the process need to be improved to bring these laboratories toward international accreditation.

Contains fulltext : 293869.pdf (Publisher’s version ) (Open Access) Antimicrobial resistance (AMR) has been exacerbated by the inappropriate use of diagnostics, leading to excessive prescription of antimicrobials, and is an imminent threat to global health. Diagnostic stewardship (DS) is an auxiliary to antimicrobial stewardship (AMS) and comprises ordering the right tests, for the right patient, at the right time. It also promotes the judicious use of rapid and novel molecular diagnostic tools to enable the initiation of proper antibiotic therapy, while avoiding excessive use of broad-spectrum antibiotics. Proper interpretation of test results is crucial to avoid overdiagnosis and excessive healthcare costs. Although many rapid diagnostic tools have been developed with a high diagnostic yield, they are often limited by accessibility, cost, and lack of knowledge regarding their use. Careful consideration of clinical signs and symptoms with knowledge of the local epidemiology are essential for DS. This enables appropriate interpretation of microbiological results. Multidisciplinary teams that include well trained professionals should cooperate to promote DS. Challenges and barriers to the implementation of DS are mostly caused by scarcity of resources and lack of trained personnel and, most importantly, lack of knowledge. The lack of resources is often due to absence of awareness of the impact that good medical microbiology diagnostic facilities and expertise can have on the proper use of antibiotics. 01 juli 2023

Background There is no gold standard for tuberculosis diagnosis in children. Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children were proposed by international experts in 2012 and updated in 2015. We aimed to compare the 2012 and 2015 Clinical Case Definitions in HIV-infected children with suspected tuberculosis. Methods We enrolled HIV-infected children with suspected tuberculosis in Burkina Faso, Cambodia, Cameroon, and Vietnam (ANRS [Agence Nationale de Recherches sur le SIDA et les hépatites virales] 12229 PAANTHER [Pediatric Asian African Network for Tuberculosis and HIV Research] 01 Study). We classified children using the 2012 and 2015 Case Definitions considering as tuberculosis cases those with confirmed tuberculosis and those with probable and unconfirmed tuberculosis in the 2012 and the 2015 classifications, respectively. We assessed agreement between both classifications. Results Of 438 children enrolled, 197 (45.0%) children were classified as tuberculosis (45 confirmed, 152 probable) using the 2012 Case Definition and 251 (57.3%) were classified as tuberculosis (55 confirmed, 196 unconfirmed) using the 2015 classification. Inter-classification agreement for tuberculosis diagnosis was 364/438, 83.1%, with a kappa statistic of 0.667 (95% confidence interval 0.598-0.736). Of 152 children with probable tuberculosis (2012), 142 (93.4%) were considered as tuberculosis by the 2015 version and 10 (6.6%) as unlikely tuberculosis including 9 with spontaneous clinical improvement. Of 132 possible tuberculosis (2012), 58 (43.9%) were reclassified as tuberculosis (2015). Conclusions Agreement between the 2 versions of the Case Definition was substantial but more children were considered as tuberculosis using the 2015 version. Spontaneous symptom resolution reinforces both confidence in the “unlikely” category as being children without tuberculosis and the importance of the clinician’s treatment decision in the study.

Background: Extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) are a serious challenge to patients’ treatment. The aim of this study is to determine the prevalence of ESBL-PE, investigate the associated resistance, and analyze the associated risk factors for acquisition of ESBL-PE.Methodology: A cross-sectional study was conducted on healthy volunteers and inpatients. After obtaining informed consent, rectal swabs were collected from each participant for isolation of Enterobacteriaceae on Hektoen enteric agar containing 4µg/L cefotaxime. The Enterobacteriaceae isolates were identified using biochemical tests and ESBL production was confirmed by the double-disc synergy test of amoxicillin and clavulanic acid. Antibiotic susceptibility test of each isolate was done by the disc diffusion method and interpreted using the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints version 5.0.Results: During the study period, prevalence of faecal ESBL-PE among the study participants was 54.5% (103/189); 53.5% among healthy volunteers and 55.7% among inpatients (p=0.87). The major ESBL-PE isolates was Escherichia coli (71%) followed by Klebsiella pneumoniae (16%). The isolates in hospitalized patients were resistant to norfloxacin (84.2%), cotrimoxazole (89.5%), and gentamicin (7.0%). The isolates from healthy volunteers were resistant to norfloxacin (86.2%), cotrimoxazole (82.8%), and gentamicin (1.7%).Gender, age, and previous antibiotic use were not significantly associated with carriage of ESBL-PE (p=0.51).Conclusion: The high prevalence of ESBL-PE in this study is worrying. There is an urgent need to develop measures to monitor and limit the spread of these multidrug-resistant organisms in healthcare facilities and the community in Burkina Faso. Keywords: faecal carriage, ESBL-PE, healthy volunteers, inpatients, Burkina Faso

The spreading of carbapenemase-producing gram-negative bacilli (GNB) must be considered as an "urgent" threat. The aim of this study was to determine the prevalence of extended spectrum β-lactamase (ESBL), plasmid-mediated quinolone resistance (PMQR), and carbapenemase-producing GNB and to characterize the supporting genes in GNB specimens isolated from patients and healthy volunteers in Burkina Faso. From April to June 2016, carbapenemase-producing GNB screening was performed in 1,230 consecutive clinical specimens, and 158 fecal samples from inpatients and healthy volunteers without digestive pathology at Souro Sanou University Hospital, Bobo Dioulasso. Strains were identified by matrix-assisted laser desorption ionization-time of flight and antimicrobial susceptibility was tested with the disk diffusion method on Müller-Hinton agar. The presence of carbapenemase, ESBL, and PMQR genes was assessed by multiplex PCR. The molecular epidemiological study was performed using multilocus sequence typing analysis. From the 1,230 clinical samples, 443 GNB strains were isolated among which 4 (0.9%) were carbapenemase-producing isolates (

Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) represent a threat for failure of empirical antibiotic therapy and are associated with high mortality, morbidity and expenses. The aims of this study was to determine the prevalence of ESBL-PE and multidrug resistant enterobacteria (MDR), enterobacteria profil, investigate the associated resistance in wastewater and salads. After wastewater and salad sampling, enterobacteria was isoled on (EMB + 4μg / L cefotaxim). The stains of Enterobacteriaceae were identified by using biochemical methods and confirmed as ESBL by double-disc synergy test (amoxicillin/clavulanic acid with cefotaxime 30 μg, ceftazidime 30 μg and ceftriaxone 30 μg). Finally, the associated resistance was investigated by testing the susceptibility of the strains by the disc diffusion method. Global prevalence of ESBL-PE was 53.92% (95% CI: 48,2-59,5) (153/293), 61.11% from wastewater and 42.47% from salads. Major ESBL-E was Escherichia coli (73.44%), followed by Klebsiella pneumoniae (21.88%). Resistance to the aminoglycoside , fluroquinolonones and sulfonamides classes were dominant, observed in 53,83%, 93,86% and 98,95% of the isolates, respectively. The frequence of MDR was hight to channel1 (32,40%) and channel2 (26,26%). This study reports very worrying results. There is an urgent need to develop measures to monitor the spread of these multidrug-resistant strains.Keywords: Wastewater, ESBL-PE, Salads, Ouagadougou.

Data collection and monitoring of carbapenemase-producing (CP) Gram-negative bacteria (GNB) are often limited. This study determined CP-GNB prevalence in Gabon and the genetic origins of the resistance genes. From January 2016 to March 2018, 869 clinically significant GNB isolates from inpatients and outpatients, and 19 fecal samples (inpatients) were analyzed in the main hospitals of Gabon. Fecal samples were screened using ChromID® CARBA SMART selective chromogenic medium biplates. Species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar, and resistance genes were assessed by multiplex polymerase chain reaction and sequencing. Overall, 1.61% of clinical isolates (14 of 869) and 5.26% of fecal samples (1 of 19) were CP-GNB. The CP-GNB rate was higher among inpatients (2.98%) than outpatients (0.33%), in intensive care units (28.57%, 4 of 14), and in urine samples (35.71%, 5 of 14). The most common CP-GNB were Klebsiella pneumoniae (53.33%) and Acinetobacter baumannii (26.67%). blaOXA-48 was the predominant carbapenemase-encoding gene (40%), followed by blaNDM-5 (33.33%). The A. baumannii multilocus sequence types ST2 and ST78, Enterobacter cloacae ST78, Escherichia coli ST2, and K. pneumonia ST48 and ST147 were found. These data indicate that CP bacteria are present in clinical and carriage samples. Preventive measures are needed to avoid the spread of resistance genes.

Rabies is a deadly viral disease that affects humans and animals. It is transmitted by rabid animals, through bite, scratch or licking. Almost 99% of human cases are caused by dogs. In Burkina Faso, nearly 5,000 bites cases are recorded annually. This cross-sectional investigation was conducted with the objective of assessing the knowledge, attitudes and practices of people regarding rabies and preventive measures in five health districts, Burkina Faso. Using a structured questionnaire, the survey was conducted in households to capture data on participants’ knowledge, attitudes and practices of rabies control. Through a house-to-house approach, the questionnaire was administrated to 320 household members. The results indicated that 36.9% of the participants had high level knowledge of rabies, 80% perceived it as a fatal disease, 76.4% of participant’s reported attitudes were negative and 58.9% of them reported uncorrect practices. The knowledge level of rabies was significantly associated with health district, area of household location, participant’s age, their level of education, previous history with rabies and information channels used by household (p

Introduction: Clinical syndromes of digestive expression or various origins, infectious diarrhea is a major public health problem in children in tropical countries. Methodology: This was a descriptive retrospective study aimed at analyzing the epidemiological and microbiological aspects of the stool cultures carried out in children aged 0-5 years hospitalized at CHUP-CDG from January 2010 to December 2015. Results: Out of 2329 stool cultures performed, we found a positivity rate of 4.12% with a predominance of requests in the infant service. With regard to the bacteria isolated, enteropathogenic Escherichia coli came first with 19 cases, then Salmonella spp with 10 cases and Shigella spp with 2 cases. Candida albicans were isolated in 30 cases and Candida spp in 33 cases. The frequency of parasites was 7.17% and that of Rotavirus / Adenovirus 44.12% (out of 68 virus search requests). 452 patients were on probabilistic antibiotic therapy out of 465 patients (97.20%) with a predominance of the combination ceftriaxone + gentamycin (87.6%). Also there were no suitable isolation media for germs such as as Yersinia, Campylobacter, and Clostridium. Conclusion: In view of all the above, there is a need to review the indications and the practical conditions for carrying out this technique in tropical environments with limited resources.

Our study aimed to assess the statistical relationship between the use of chloroquine phosphate or hydroxychloroquine plus azithromycin (CQ/HCQ + AZ) and virological recovery, disease worsening, and death among out- and inpatients with COVID-19 in Burkina Faso.This was a retrospective observational study that compared outcomes in terms of time to recovery, worsening, and death in patients who received CQ/HCQ + AZ and those who did not using a multivariable Cox or Poisson model before and after propensity matching.Of the 863 patients included in the study, about 50% (432/863) were home-based follow-up patients and 50% were inpatients. Of these, 83.3% (746/863) received at least 1 dose of CQ/HCQ + AZ and 13.7% (118/863) did not. There were no significant differences in associated time to recovery for patients receiving any CQ/HCQ + AZ (adjusted HR 1.44; 95% CI 0.76-2.71). Similarly, there was no significant association between CQ/HCQ + AZ use and worsening (adjusted IRR 0.80; 95% CI 0.50-1.50). However, compared with the untreated group, the treated group had a lower risk of death (adjusted HR 0.20; 95% CI 0.10-0.44).The study provided valuable additional information on the use of CQ/HCQ in patients with COVID-19 and did not show any harmful outcomes of CQ/HCQ + AZ treatment.

The realization of the antibiotic susceptibility test in agar is the routine bacteriological examination for the determination and monitoring of bacterial susceptibility to antibiotics. In this study, we report the comparative results between pencil leads for criterium, as an alternative to platinum rods in the realization of the antibiotic susceptibility test. Methodology Experimental study evaluating the comparability of the results between Criterium and Inoclic mines (by counting bacterial cells on agar after 5 successive dilutions of reason 10 from a bacterial suspension obtained after piercing through a colony; by measuring the inhibition diameters of 4 ATCC reference bacterial strains on an antibiogram in an agar medium) and evaluating the sterility of the criterium mines by culturing them on enriched broth (heart - brain type). Results 42 bacterial strains were used for bacterial cell counting. The results were of the same order of magnitude (107 CFU/mL) between Inoclic and criterium mines, for all strains and at all dilutions. The antibiotic susceptibility tests performed for the 4 reference strains by the Inoclics and criterium mines all complied (100%) with the expected limits for determining their sensitivity profile to the antibiotics tested. Compared to the bacterial growth inhibition diameters on antibiotic susceptibility tests, no intra-operator variability was observed, while significant inter-operator variability (both with Inoclic and 0.5 mm criterium mines) was observed with some strains and for inhibition diameters greater than 10 mm. The enriched broth cultures (BCC) and their subculture carried out on 10 criterium mines from 5 different batches were negative. Conclusion Criterium mines seem to be a serious and less expensive alternative to Inoclic for the realization of antibiotic susceptibility testing in our resource-limited countries.

Objectif : Rapporter les caracteristiques epidemiologiques et bacteriologiques des infections du site operatoire (ISO) dans les services de chirurgie de l'hopital national de Zinder, Niger. Patients et methodes : Il s’agissait d’une etude transversale qui s’est deroulee sur une periode de 5 mois (Mai a Aout 2016) aux services de chirurgie et de laboratoire de l’Hopital National de Zinder (HNZ) au Niger incluant tous les patients operes et ayant developpe une ISO. Resultats : Durant l’etude, 485 patients avaient ete operes et 38 cas d’ISO etaient enregistres soit une incidence de 7,83 %. L’âge median etait de 31,5 ans (8-78 ans). Le sexe masculin etait majoritaire avec un sexratio de 6,6 (33/5). Les urgences chirurgicales representaient 57,9% des cas (n=22). Selon la classification d’Alte Meier, 13 cas (34,2%) etaient consideres comme une chirurgie contaminee et 21 cas (55,3%) une chirurgie sale. Les ISO etaient superficielles dans 36,8% (n=14), profondes dans 42,1% (n=16). Sur les 38 prelevements analyses, 33 cultures etaient positives soit 86,8%. Les enterobacteries representaient 69,7% (n=23), les Cocci a Gram positif 24,2% (n=8). Escherichia coli etait l’espece predominante avec 45,5% (n=15), suivie de Staphylococcus aureus avec 18,2% (n=6). La majeure partie des cultures positives provenait du service de chirurgie viscerale 15 cas (45,5%) puis de l’urologie et de traumatologie-orthopedie avec respectivement 10 cas (30,3%) et 8 cas (24,2%). La quasi-totalite des enterobacteries etait resistante aux antibiotiques usuels (amoxicilline, amoxicilline-acide clavulanique) et plus de 84% etaient resistantes a la ceftriaxone. En general les bacilles Gram negatifs etaient sensibles a l’imipeneme (100%), la colistine (93,8%), l’aztreonam (68,7%) et le chloramphenicol (47,8%). Les cocci-Gram positifs etaient sensibles a la vancomycine, au chloramphenicol et a l’erythromycine dans respectivement 100% ; 62,5% et 57,1%. Conclusion : Les infections du site operatoires representent un probleme majeur. La frequence des ISO rend indispensable la mise en place d'une equipe multidisciplinaire pour la surveillance de celles-ci. Le fort taux de resistance aux antibiotiques usuels doit susciter des actions preventives et systematiser l’examen bacteriologique en cas de suppurations postoperatoires. Objective: To report the epidemiological and bacteriological characteristics of surgical site infections (SSI) in the surgical departments of Zinder National Hospital. Patients and methods: This was a cross-sectional study that took place over a period of 5 months (May to August 2016) at the Zinder National Hospital (HNZ) Surgical and Laboratory Services in Niger including all patients operated on and having developed an SSI. Results: During the study, 485 patients had been operated on and 38 cases of ISO were recorded with an incidence of 7.83%. The median age was 31.5 years (8-78 years). The male sex was in the majoritywith a sex ratio of 6.6 (33/5). Surgical emergencies accounted for 57.9% of cases (n = 22). According to Altemeier's classification, 13 cases (34.2%) were considered as contaminated surgery and 21 cases (55.3%) were dirty surgery. Surgical site infections were superficial in 36.8% (n = 14), deep in 42.1% (n = 16). Of the 38 samplings analyzed, 33 cultures were positive, i.e. 86.8%. The enterobacteria accounted for 69.7% (n = 23), Gram-positive Cocci 24.2% (n = 8). Escherichia coli was the predominant species with 45.5% (n = 15), followed by Staphylococcus aureus with 18.2% (n = 6). The majority of positive cultures came from the visceral surgery department 15 cases (45.5%) followed by urology and orthopedic trauma with respectively 10 cases (30.3%) and 8 cases (24.2%). Virtually all enterobacteria were resistant to the usual antibiotics (amoxicillin, amoxicillinclavulanic acid) and more than 84% were resistant to ceftriaxone. In general Gram-negative bacilli were sensitive to imipenem (100%), colistin (93.8%), aztreonam (68.7%) and chloramphenicol (47.8%). Gram-positive cocci were sensitive to vancomycin, chloramphenicol and erythromycin in 100%, respectively; 62.5% and 57.1%. Conclusion: Surgical site infections represent a major problem. The frequency of SSI makes it essential to set up a multidisciplinary team to monitor them. The high rate of resistance to the usual antibiotics must provoke preventive actions and systematize the bacteriological examination in case of postoperative suppuration.

BACKGROUND Suboptimal use of antibiotics is a driver of antimicrobial resistance (AMR). Clinical decision support systems (CDSS) can assist prescribers with rapid access to up-to-date information. In low- and middle-income countries (LMIC), the introduction of CDSS for antibiotic prescribing could have a measurable impact. However, interventions to implement them are challenging because of cultural and structural constraints, and their adoption and sustainability in routine clinical care are often limited. Preimplementation research is needed to ensure relevant adaptation and fit within the context of primary care in West Africa. OBJECTIVE This study examined the requirements for a CDSS adapted to the context of primary care in West Africa, to analyze the barriers and facilitators of its implementation and adaptation, and to ensure co-designed solutions for its adaptation and sustainable use. METHODS We organized a workshop in Burkina Faso in June 2019 with 47 health care professionals representing 9 West African countries and 6 medical specialties. The workshop began with a presentation of Antibioclic, a publicly funded CDSS for antibiotic prescribing in primary care that provides personalized antibiotic recommendations for 37 infectious diseases. Antibioclic is freely available on the web and as a smartphone app (iOS, Android). The presentation was followed by a roundtable discussion and completion of a questionnaire with open-ended questions by participants. Qualitative data were analyzed using thematic analysis. RESULTS Most of the participants had access to a smartphone during their clinical consultations (35/47, 74%), but only 49% (23/47) had access to a computer and none used CDSS for antibiotic prescribing. The participants considered that CDSS could have a number of benefits including updating the knowledge of practitioners on antibiotic prescribing, improving clinical care and reducing AMR, encouraging the establishment of national guidelines, and developing surveillance capabilities in primary care. The most frequently mentioned contextual barrier to implementing a CDSS was the potential risk of increasing self-medication in West Africa, where antibiotics can be bought without a prescription. The need for the CDSS to be tailored to the local epidemiology of infectious diseases and AMR was highlighted along with the availability of diagnostic tests and antibiotics using national guidelines where available. Participants endorsed co-design involving all stakeholders, including nurses, midwives, and pharmacists, as central to any introduction of CDSS. A phased approach was suggested by initiating and evaluating CDSS at a pilot site, followed by dissemination using professional networks and social media. The lack of widespread internet access and computers could be circumvented by a mobile app with an offline mode. CONCLUSIONS Our study provides valuable information for the development and implementation of a CDSS for antibiotic prescribing among primary care prescribers in LMICs and may, in turn, contribute to improving antibiotic use, clinical outcomes and decreasing AMR.

Leprosy is caused by Mycobacterium leprae , and it remains underdiagnosed in Burkina Faso. We investigated the use of fluorescent in situ hybridization (FISH) for detecting M. leprae in 27 skin samples (skin biopsy samples, slit skin samples, and skin lesion swabs) collected from 21 patients from Burkina Faso and three from Côte d’Ivoire who were suspected of having cutaneous leprosy. In all seven Ziehl-Neelsen-positive skin samples (four skin biopsy samples and three skin swabs collected from the same patient), FISH specifically identified M. leprae , including one FISH-positive skin biopsy sample that remained negative after testing with PCR targeting the rpoB gene and with the GenoType LepraeDR assay.

Bacterial resistance to antibiotics is a serious concern in developing countries due to precarious hygiene conditions, inappropriate prescription as well as self-medication and free sale of antibiotics. This study was aimed to assess the prevalence of strains producing extended-spectrum beta- lactamase in the Gram negative bacteria isolated in the laboratory. The study was conducted in the Charles De Gaulle Paediatric University Hospital (Ouagadougou) and the Arnaud de Villeneuve Regional University Hospital (Montpellier). Out of the 889 pathological substances (pus, urine and blood) analysed, 175 germs were isolated among which 110 were Gram negative bacteria (62.8%). 48.2% of the Gram negative bacteria were positive to extended-spectrum beta-lactamase. Among the 110 Gram negative bacteria isolated, 101 were Enterobacteria and 9 other Gram negative bacteria. No extended-spectrum beta-lactamase was found in the other Gram negative bacteria and 52.5% of Enterobacteria were extended-spectrum beta-lactamase positive. As for the extended-spectrum beta-lactamase phenotype, 60.4% were Escherichia coli and 32% were Klebsiella pneumoniae. 50.9% of extended-spectrum beta-lactamase came from pus and 41.5% from urine. In addition, 64.6% of hospitalised patients had an extended-spectrum beta-lactamase phenotype compared to 24.5% for out-patients. The results show the importance of the phenomenon and should help to better take care of this scourge because antibiotics despite everything, always save millions of lives. Key words: Extended-spectrum beta-lactamase (ESBL), enterobacteria, gram-negative bacilli, inpatients, out-patients.

Background Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) remains poorly documented in Africa. The objective of this study was to determine the prevalence of ESBL-PE fecal carriage in Chad. Methods In total, 200 fresh stool samples were collected from 100 healthy community volunteers and 100 hospitalized patients from January to March 2017. After screening using ESBL-selective agar plates and species identification by MALDI-TOF mass spectrometry, antibiotic susceptibility was tested using the disk diffusion method, and ESBL production confirmed with the double-disc synergy test. The different ESBL genes in potential ESBL-producing isolates were detected by PCR and double stranded DNA sequencing. Escherichia coli phylogenetic groups were determined using a PCR-based method. Results ESBL-PE fecal carriage prevalence was 44.5% (51% among hospitalized patients vs 38% among healthy volunteers; p Escherichia coli (64/89) and Klebsiella pneumoniae (16/89). PCR and sequencing showed that 98.8% (87/89) of ESBL-PE harbored blaCTX-M genes: blaCTX-M-15 in 94.25% (82/87) and blaCTX-M-14 in 5.75% (5/87). Phylogroup determination by quadruplex PCR indicated that ESBL-producing E. coli isolates belonged to group A (n = 17; 27%), C (n = 17; 27%), B2 (n = 9; 14%), B1 (n = 8; 13%), D (n = 8; 13%), E (n = 1; 1.6%), and F (n = 1; 1.6%). The ST131 clone was identified in 100% (9/9) of E. coli B2 strains. Conclusions The high fecal carriage rate of ESBL-PE associated with CTX-M-15 in hospital and community settings of Chad highlights the risk for resistance transmission between non-pathogenic and pathogenic bacteria.

Summary Background Antimicrobial resistance genes can be found in all ecosystems even in those where antibiotic selection pressure is less exerted. Extended spectrum 𝛽-lactamases (ESBL) determinants have been detected in clinical isolates and commensal bacteria from humans and animals. Here we investigated, for the first time, the ESBL-producing Enterobacteriaceae in stool from intensive and extensive breeding animals (cattle, pigs and poultry) in Burkina Faso. Results from March to June 2017 in the Bobo Dioulasso area, we investigated stool samples collected from healthy animals (cattle = 251; pigs = 250 and poultry = 397) in one (1) slaughterhouse, five (5) livestock farms and one (1) poultry market. The frequency of ESBL genes carriage was 41.03% among cattle, 69.60% among pigs, 0.8% among intensive farming and 19.1% among extensive poultry farming. Only all the poultry were fed with antibiotics. The bacterial strains carrying the ESBL were E. coli (278/315) and K. pneumoniae (36/315). The ESBL genes carried were CTX-M 15, TEM and Oxa-1-like. These three β- lactamase genes were associated in some bacterial strains. The E. coli strains belonged most commonly to the phylogroup A. Conclusion This study showed the high resistance of Enterobacteriaceae to antibiotics in livestock in Burkina Faso by production of ESBL. This high level of resistance was observed in animals that did not receive antibiotics. This situation could suggest an environmental contamination of the livestock with ESBL-producing bacteria.

International audience; BACKGROUND:The diagnosis of tuberculosis in human immunodeficiency virus (HIV)-infected children is challenging. We assessed the performance of alternative specimen collection methods for tuberculosis diagnosis in HIV-infected children using Xpert MTB/RIF (Xpert).METHODS:HIV-infected children aged ≤13 years with suspected intrathoracic tuberculosis were enrolled in 8 hospitals in Burkina Faso, Cambodia, Cameroon, and Vietnam. Gastric aspirates were taken for children aged

Viral hepatitis B is a public health issue. We establish the children serological profile of hepatitis B in Bobo-Dioulasso, six years after the introduction of hepatitis B vaccine into the Expanded Program on Immunization. This was a descriptive study of prospective data collection carried out in the Department of Pediatrics and the laboratory of virology of the Centre MURAZ of Bobo-Dioulasso between March 2013 and May 2013. Blood samples were made in search of the following hepatitis B serological markers: anti-HBcAb total, HBsAg, Ac anti-HBs, HBeAg, AcHBs, IgM anti-HBc total. The ELISA method with the Monolisa BIORAD reagents was used. A total of 2015 children were included, 1026 (50, 9%) boys and 989 (49.1%) girls, at an average age of 58±48 months. Out of these 2015 children, 53 (2.6%) were positive to HBsAg including 19 vaccinated cases, one child has received 3 doses plus 1 booster dose of hepatitis B vaccine. We found no statistically significant difference in the carriage of serologic markers of hepatitis B between the unvaccinated group and the vaccinated group. Large-scale studies should be carried out in Burkina Faso to see the real impact of vaccination on the health of our populations.

The impact of HIV-1 DNA coamplification during HIV-1 RNA quantification on dried blood spots (DBS) was explored. False-positive HIV RNA detection (22/62, 35%) was associated with high HIV-1 DNA levels. Specificity of HIV-1 RNA assays on DBS should be evaluated following manufacturer protocols on samples with HIV-1 DNA levels of ≥1,000 copies/10 6 peripheral blood mononuclear cells.

The aim of this study was to analyze ten (10) years of epidemiological surveillance data of meningitis in Burkina Faso for high risk germs patterns identification in order to contribute to the strengthening of prevention strategies. A retrospective study of the past decade (2005- 2014) of cases of acute bacterial meningitis occurred in the thirteen health regions, collected through epidemiological surveillance data meningitis in Burkina Faso. From a total of 88 057 suspected cases of acute bacterial meningitis, we recorded 9134 deaths. From the laboratory confirmed cases, the identified germs were as follows: 56.79% of Neisseria meningitidis , 41.09% of Streptococcus pneumoniae and 2.13% of Haemophilus influenzae . Among the meningococcus isolated, we observed the following distribution: 23.11% of NmA, 58.84% of NmW and 18% of NmX. Mortality associated with acute bacterial meningitis remains still high in Burkina Faso despite the complete disappearance of NmA since 2012, after the conjugate vaccine A (MenAfriVac) has been introduced in this country. However the emergence of NmX, the reemergence of NmW and the persistence of high prevalence of Streptococcus pneumoniae are a major concern in the fight against meningitis in Burkina Faso. So, it is necessary, in addition to the strengthening of surveillance, diagnosis and case management to develop and make available and accessible a conjugate trivalent vaccine against NmA the NmX and NmW serogroups. Keywords: meningococcal meningitis, W and X serogroups, Streptococcus pneumoniae, MenAfriVac

Background The conjugate vaccine against serogroup A Neisseria meningitidis (NmA), MenAfriVac, was first introduced in mass vaccination campaigns of 1-29-year-olds in Burkina Faso in 2010. It is not known whether MenAfriVac has an impact on NmA carriage. Methods We conducted a repeated cross-sectional meningococcal carriage study in a representative portion of the 1-29-year-old population in 3 districts in Burkina Faso before and up to 13 months after vaccination. One district was vaccinated in September 2010, and the other 2 were vaccinated in December 2010. We analyzed 25 521 oropharyngeal samples, of which 22 093 were obtained after vaccination. Results In October-November 2010, NmA carriage prevalence in the unvaccinated districts was comparable to the baseline established in 2009, but absent in the vaccinated district. Serogroup X N. meningitidis (NmX) dominated in both vaccinated and unvaccinated districts. With 4 additional sampling campaigns performed throughout 2011 in the 3 districts, overall postvaccination meningococcal carriage prevalence was 6.95%, with NmX dominating but declining for each campaign (from 8.66% to 1.97%). Compared with a baseline NmA carriage prevalence of 0.39%, no NmA was identified after vaccination. Overall vaccination coverage in the population sampled was 89.7%, declining over time in 1-year-olds (from 87.1% to 26.5%), as unvaccinated infants reached 1 year of age. NmA carriage was eliminated in both the vaccinated and unvaccinated population from 3 weeks up to 13 months after mass vaccination (P = .003). Conclusions The disappearance of NmA carriage among both vaccinated and unvaccinated populations is consistent with a vaccine-induced herd immunity effect.

We describe here a non-O1/non-O139 Vibrio cholerae isolate producing both VIM-1 and VIM-4 carbapenemases. It was isolated from a yellow-legged gull in southern France. The bla VIM genes were part of a class 1 integron structure located in an IncA/C plasmid. This study emphasizes the presence of carbapenemase genes in wildlife microbiota.