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Aims: Pneumonia is a leading cause of morbidity and a significant cause of mortality worldwide. Although information is available on pneumonia in children, the incidence in adults in many parts of Africa including Côte d'Ivoire is unknown. Knowledge of local etiologic agents of pneumonia is critical for making reasonable decisions about treatment as differences in etiology may result in poor response to therapy chosen to cover common pathogenic microbes in studies done in high countries of income. The objective of this study was to identify the viral etiology of pneumonia in adult patients with pneumonia in Abidjan, Côte d 'Ivoire. Study Design: This is a prospective experimental study conducted on the basis of the successive recruitment of patients admitted to hospital for severe pulmonary interstitial pneumonitis confirmed by radio or CT scan of the thorax. Place and Duration of Study: Pneumophtisiology department (PPH) of the University Hospital Center of Cocody (Côte d'Ivoire) and laboratory of Bacteriology- Virology of Pasteur Institut of Côte d’Ivoire, between February 2016 and October 2017. Methodology: Among all admitted patients in the unit of pneumophtisiology (PPH) of the hospital University, 90 patients aged at least 18 years were pre-included. A total of 33 bronchoalveolar lavage fluid (BAL) samples from adults suspected of pneumonia were analyzed. The viruses were identified by the real-time multiplex reverse polymerase chain reaction (RT-PCR). Results: Of the 33 BAL samples tested, 18.2% (6/33) viral agents were detected. Parainfluenza-3 PV-3 was the most prevalent virus (57.1%, 4/7), followed by coronavirus OC43 (14.3%, 1/7), coronavirus HKUI (14.3%, 1/7). ) and human rhinovirus (14.3%, 1/7). A virus and virus association was detected, which was PV-3 associated with coronavirus HKUI (14.3%, 1/7). Conclusion: The viral etiology of pneumonia is not very frequent in Côte d’Ivoire.

Staphylococcus aureus, which causes various infections, particularly suppurations, expresses many virulence factors. The resistance of S. aureus to methicillin (MRSA) which can spread to vancomycin constitutes a major challenge in infectiology. The search for virulence and resistance factors is therefore of interest to better understand the mechanisms of this pathogenicity. The objectives of this study were to determine the frequency of phenotypic and genotypic (mecA, vanB) resistances, the frequency of virulence genes (eta, etb, and lukS) and to investigate the resistant strains for the presence of virulence genes. On thirty-one strains isolated from infections at the Pasteur Institute of Côte d'Ivoire, the study of susceptibility to methicillin and vancomycin was carried out by phenotypic and molecular methods. We observed phenotypic and genotypic resistance to methicillin of 41.9% and 32.3% respectively. Despite a suspicion of very high vancomycin susceptibility reduced, 25.8% by phenotypic method, the vanB gene was only found in 3.2% of strains. The prevalence of virulence genes was high with the eta gene, 96.8%, and the lukS gene 45.2%. The mecA gene was present with an eta gene in 32.3% of strains and in 9.7% with the lukS gene, however the vanB gene was not present in any strain carrying virulence factors. These results should lead to the screening of other van genes for resistance to vancomycin.

OBJECTIVES To describe the emergence of Neisseria meningitidis (Nm) W135 in Cote d'Ivoire and its characteristics compared to NmA. METHODS Data on Nm samples isolated at the National Reference Center for meningitis in Cote d'Ivoire between 2007 and 2012 were analyzed. Socio-demographic data and biological information on the samples were extracted from the database. Categorical variables, such as sex and the serotype of the bacteria, were compared using the Fisher exact test, while the distribution of continuous variables, such as age, was compared using the Wilcoxon test. RESULTS Among the 175 Nm samples, 57 were NmA, 4 were NmB, 13 were NmC, and 99 were NmW135. The geographical distribution of NmA and NmW135 did not show a significant difference according to age or sex. NmW135 was more common than NmA in the northern health districts of Cote d'Ivoire (85.9 vs. 45.5%; p

Objectif : Le defaut de filiere de traitement des eaux usees a conduit a la realisation de ce travail avec pour objectif d’Etudier la qualite bacteriologique des eaux usees dans les retenues de l’Indenie contigues aux grands collecteurs du bassin du gourou. Methodologie et Resultats : Les echantillons ont ete preleves dans des bouteilles en verres et analysees suivant les methodes de microbiologies classiques. Dans la retenue A, la concentration moyenne de coliformes totaux etait de 2,74.10 7 UFC/100mL. Celles des coliformes thermotolerants, E. coli et les streptocoques fecaux, ont ete respectivement de 1,49.10 7 UFC/100mL, 1,22.10 7 UFC/100mL et de 9,19.10 6 UFC/100mL. Dans la retenue B, la concentration moyenne de Coliformes totaux etait de 2,98.10 7 UFC/100mL. Considerant les Coliformes thermotolerants, E. coli et les streptocoques fecaux, les charges moyennes ont ete respectivement de 2,19.10 7 UFC/100mL, 1,72.10 7 UFC/100mL et de 1,32.10 7 UFC/100mL. Conclusion et application des resultats : Les eaux des deux retenues etudiees presentent une mauvaise qualite bacteriologique eue egard aux concentrations des germes indicateurs de pollution fecale. En effet les concentrations en E. coli, Streptocoques fecaux et coliformes totaux etaient largement superieurs aux normes OMS pour les eaux usees destinees a etre rejetee dans l’environnement sans risque sanitaire. Il apparait alors plus que necessaire de creer des filieres de traitement de ces eaux usees avant leur rejet dans le milieu naturel. Ce qui pourrait reduire les risques de pollution environnementale d’une part et sanitaire d’autre part. Les resultats de ce travail posent aussi le probleme du mode d’utilisation des collecteurs et des retenus d’eaux usees qui passent pour etre de vrais depotoirs. Mots clefs : Eaux Usees, pollution, risque sanitaire, indicateurs

Background Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). Methods/ Principal findings During June 2011–December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d’Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0–40% of suspected cases were aged under five years and from 0.3–86% had rice water stools. Within surveillance zones, 0–37% of suspected cases had confirmed cholera compared to 27–38% during outbreaks. Annual confirmed incidence per 10,000 population was, Author Summary Cholera burden in Africa remains unknown, often because of weak national surveillance systems. Reporting is non-exhaustive for various reasons, such as individual and community fears of stigmatization and economic loss. Furthermore, only 3% to 5% of all cases are laboratory confirmed. A variety of case definitions are used across countries, which could lead to cholera over or under-reporting. Our study presents the first data from prospective multi-country cholera surveillance in Africa, and the only such data based on culture confirmation and that includes a description of clinical presentation. We show how confirmed cholera cases varied over time by setting, and identified three epidemiological patterns that can guide decision-making processes. We documented that reliance on suspected cases–as is usually done in national surveillance–rather than confirmed cases can over-estimate substantially cholera incidence. Finally, our surveillance strategy of using case-based reporting and a standard comprehensive case reporting form provided more information on at-risk populations and geographical hot spots than is currently available in the literature; this is turn should facilitate development of efficient preventive strategies.

The aim of the study was to show the emergence of the qnr genes in extended spectrum beta-lactamases producing enterobacteria in Abidjan between 2005 and 2006. The whole of 151 strains of extended spectrum beta-lactamases producing enterobacteria were studied: 64 Escherichia coli, 66 Klebsiella pneumoniae, seven Klebsiella oxytoca and 14 Enterobacter spp. isolated from various biological products and from in- and out-patients. The techniques of disks diffusion, double-disk synergy, E-test were respectively used for the antimicrobial susceptibility test, the detection of extended spectrum beta-lactamases and the minimal inhibiting concentration. The bla genes(SHV, TEM, CTXM groups 1, 2, 8, 9), and AmpC were determined by PCR and characterized by sequencing. A global prevalence of 27,2 % (41/151) and rates of 9,9, 14,6, 2,7 % for the qnr genes A, B, A and S were observed. The distribution was 42,9 % for Enterobacter spp, 31,2 % for Escherichia coli, 20,5 % for Klebsiella; 30 strains expressed at least two bla genes; four strains were associated with AmpC. The strains were resistant to the cotrimoxazole (97,6 %), to the cefepime (73,2 %), to the cefoxitine (56,1 %), to the imipeneme (0 %) and 43,9 % to all the aminosides. This high qnr gene prevalence associated with several types of bla genes in epidemic matter, the high level of resistance to antibiotics make fear a high risk of the transmission of multi-resistants bacteria and challenge the authorities for a resistance monitoring policy.

To the Editor: A multinational outbreak of infection with Neisseria meningitidis serogroup W135 belonging to the sequence type (ST) 11 clonal complex started in the year 2000 among pilgrims to Mecca, Saudi Arabia, and their contacts and continued in 2001 in countries of sub-Saharan Africa (primarily Burkina Faso) (1). Thereafter, infection caused by these isolates decreased (2), but quadrivalent meningococcal vaccine (against serogroups A, C, Y, and W135) was recommended for pilgrims and travelers to countries in the meningitis belt of Africa, which spans sub-Saharan Africa from Ethiopia to Senegal. After 2001, infections caused by serogroup A predominated in the meningitis belt, but isolates of serogroup X also emerged (3); isolates of serogroup W135/ST11 increased again in Niger in 2010 (4). During January 1–March 11, 2012, >4,000 suspected cases of meningococcal disease caused mainly by serogroup W135 were reported in countries of the African meningitis belt, including Benin, Burkina Faso, Mali, and Cote d’Ivoire (5). We present extensive bacteriologic and molecular characterization of N. meningitidis W135 isolates from 6 patients with meningococcal disease reported in France since January 2012; we also present typing data from 8 cases of meningitis in Cote d’Ivoire. None of the patients had received meningococcal vaccine. The cases in France were neither epidemiologically nor geographically linked; 4 were in residents of the Paris region. All cases were linked to recent travel to sub-Saharan Africa by the patient or patient contacts; 4 patients reported recent travel to Benin, Senegal, or Mali (Table). The 2 other cases were in a 4-month-old infant whose father had returned from Senegal 2 weeks before the onset of the disease and in a 5-year-old child who had several family members who visited Mali regularly, although no recent travel was documented. The delay between the return to France and the onset of the disease was

Resume Objectif. – Cette etude transversale avait pour objectif de determiner la seroprevalence de Borrelia burgdorferi en Cote-d’Ivoire. Patients. – Cent soixante-huit sujets etaient repartis dans 3 groupes de population. Le groupe A (n = 60) etait constitue d’eleveurs de bovins, qui par leur profession sont exposes aux piqures de tiques vivant sur le betail. Le groupe B (n = 48) etait constitue de patients, hospitalises dans les services de neurologie et de rhumatologie du centre hospitalier universitaire de Cocody (Abidjan), qui avaient une symptomatologie clinique evocatrice de maladie de Lyme. Le groupe C (n = 60) etait compose de donneurs de sang asymptomatiques. Methode et resultats. – La seroprevalence anti-Borrelia (de type IgG) globale apres confirmation par western blot etait de 33 %. La seroprevalence selon les groupes A, B, et C etait respectivement de 21, 83 et 20 %. L’analyse des profils electrophoretiques des proteines de B. burgdorferi B31 a montre que la flagelline et l’Osp B etaient respectivement retrouvees chez 43 et 80 % des serums testes. En revanche, dans 87 a 90 % des cas, l’Osp C etait absente. Conclusion. – Il s’avere necessaire de poursuivre les travaux en Cote-d’Ivoire pour confirmer la realite de la Borreliose de Lyme.

The emergence of Neisseria meningitidis serogroup X (NmX) in the African meningitis belt has urged the development of diagnostic tools and vaccines for this serogroup, especially following the introduction of a conjugate vaccine against N. meningitidis serogroup A (NmA). We have developed and evaluated a new rapid diagnostic test (RDT) for detecting the capsular polysaccharide (cps) antigen of this emerging serogroup. Whole inactivated NmX bacteria were used to immunize rabbits. Following purification by affinity chromatography, the cpsX-specific IgG antibodies were utilized to develop an NmX-specific immunochromatography dipstick RDT. The test was validated against purified cpsX and meningococcal strains of different serogroups. Its performance was evaluated against that of PCR on a collection of 369 cerebrospinal fluid (CSF) samples obtained from patients living in countries within the meningitis belt (Cameroon, Côte d'Ivoire, and Niger) or in France. The RDT was highly specific for NmX strains. Cutoffs of 10 5 CFU/ml and 1 ng/ml were observed for the reference NmX strain and purified cpsX, respectively. Sensitivity and specificity were 100% and 94%, respectively. A high agreement between PCR and RDT (Kappa coefficient, 0.98) was observed. The RDT gave a high positive likelihood ratio and a low negative likelihood (0.07), indicating almost 100% probability of declaring disease or not when the test is positive or negative, respectively. This unique NmX-specific test could be added to the available set of RDT for the detection of meningococcal meningitis in Africa as a major tool to reinforce epidemiological surveillance after the introduction of the NmA conjugate vaccine.

The increasing prevalence of antibiotic-resistant Streptococcus pneumoniae is of growing public health concern. The aim of this study was to assess resistance rates of S. pneumoniae to penicillin and other antimicrobial agents. Between November 1997 and February 1998 in a community health centre in Marcory, an Abidjan suburb, 138 S. pneumoniae strains were isolated from the nasopharynxes of 218 apparently healthy children aged 3-60 months. The sensitivity of the isolates was tested using the Kirby-Bauer method. In isolates with a possibly abnormal sensitivity to the Kirby-Bauer test, minimum inhibitory concentrations (MIC) were estimated using the E-test. Antimicrobials tested included penicillin G, amoxycillin, cefotaxime, cotrimoxazole, tetracycline, chloramphenicol, erythromycin, rifampicin and vancomycin. Twelve of 108 isolates (8.7%) had reduced sensitivity to penicillin G, and in three of them the MIC for penicillin reached at least 2 micrograms/ml. Resistance to amoxycillin and cefotaxime was lower than to penicillin (2.2%). With regard to cotrimoxazole, 37% were moderately resistant and 15.2% highly resistant. The lowest resistance rate observed was to rifampicin (2.2%) and the highest was to tetracycline (57.2%). Rates of resistance to erythromycin and chloramphenicol were 11.6% and 2.9%. All strains were sensitive to vancomycin. Multidrug resistance (MDR) was detected in 9.4% of S. pneumoniae isolates. In children, epidemiological surveillance of resistance can be monitored by bacteriological surveys, as shown in this study.

Tuberculosis (TB) is responsible for a high mortality rate (2.5%) worldwide, mainly in developing countries with a high prevalence of human immunodeficiency virus (HIV). The emergence of multiresistant strains of TB poses an extreme risk for TB outbreaks and highlights the need for global TB control strategies. Among Western African countries, Côte d’Ivoire (CI) represents a specific example of a country with great potential to prevent TB. Specifically, CI has a promising healthcare system for monitoring diseases, including vaccination programs. However, military and political conflict in CI favors the spread of infectious diseases, TB being among the most devastating. Compilation of the studies identifying common causes of TB would be extremely beneficial for the development of treatment and prevention strategies. Therefore, the purpose of this comprehensive review is to evaluate the epidemiology of TB in CI, describe the factors involved in pathogenesis, and suggest simple and applicable prevention strategies.

Tuberculosis (TB) is responsible for a high mortality rate (2.5%) worldwide, mainly in developing countries with a high prevalence of human immunodeficiency virus (HIV). The emergence of multiresistant strains of TB poses an extreme risk for TB outbreaks and highlights the need for global TB control strategies. Among Western African countries, Côte d’Ivoire (CI) represents a specific example of a country with great potential to prevent TB. Specifically, CI has a promising healthcare system for monitoring diseases, including vaccination programs. However, military and political conflict in CI favors the spread of infectious diseases, TB being among the most devastating. Compilation of the studies identifying common causes of TB would be extremely beneficial for the development of treatment and prevention strategies. Therefore, the purpose of this comprehensive review is to evaluate the epidemiology of TB in CI, describe the factors involved in pathogenesis, and suggest simple and applicable prevention strategies.

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Twenty crude extracts from 17 species out of 11 families were assessed for their antibacterial activity against Streptococcus pneumoniae (Pneumococcus). The selected plants are used in Northern Côte d'Ivoire to treat various infections including respiratory track diseases. From all the tested extracts, only 7 from 6 plants showed a promising in vitro bactericidal activity against Pneumococcus, including strains resistant to penicillin. The most active extracts were from Erythrina senegalensis (Fabaceae), Piliostigma thonningii (Caesalpiniaceae), Waltheria indica (Sterculiaceae), Andira inermis (Fabaceae), Uapaca togoensis (Euphorbiaceae), Keetia hispida (Rubiaceae) and Combretum molle (Combretaceae). This is the first time that the antipneumococcal activity of the tested plants is reported. The results of this preliminary investigation support the traditional use of these plants in the treatment of pneumococcal infections. The most active of them could be candidates for isolation of compounds which could serve as lead structures for the development of new drugs against Streptococcus pneumoniae.

Various diagnostic methods have been described to detect Neisseria gonorrhoeae. Collection of first void urine is advantageous because it is non-invasive, reproducible, and painless; and provides specimens that have already been used for detection of N. gonorrhoeae by molecular tools. The purpose of this study was to assess the usefulness of first void urine for detection of N. gonorrhoeae using conventional bacteriologic techniques in patients with low-grade symptoms. Investigation was focused on first void urine and urethral secretion specimens collected from 87 male patients who were undergoing diagnotic workup for suspicion of sexually transmitted infection. Direct microscopic examination of smears stained using the Gram technique and cultures on modified Thayer-Martin medium and on cooked blood agar were performed on each specimen. The prevalence of urethritis was 58.0%. Gonorrhoea was diagnosed in 7.5% of cases. The sensitivity and specificity of microscopic examination of first void urine for detection of Gram-negative diplococci were 85.7% and 97.5% respectively. First void urine was less productive than urethral secretion for detection of urethritis: sensitivity, 44.4% and specificity, 100%, and urethral flora: sensitivity, 59% and specificity of 96.9%. The good performance of first void urine specimens for detection of Gram-negative diplococci by microscopy may justify their use for identification of N. gonorrhoeae in level 1 laboratories. First void urine could also be useful for epidemiological studies and large-scale screening surveys.

Neonatal infection is frequent with rate of lethality between 20 to 70% in the developing countries. Among these neonatal infections, urinary infection is serious .The diagnosis of urinary infection is based on cytobacteriological exam. But it is rarely done for economic reasons. Principal objective of this survey was to identify the germs responsible for the urinary infections at the newborn in order to propose an adequate therapeutic algorithm.From July to December 2004, 720 newborns hospitalized in neonatalogy for neonatal infection were enrolled. Specimens of urines were collected in view of cytobacteriological exam. Culture was positive for 136 samples (18,9%). About etiology of urinary infections, enterobacteria were predominant with 77,5% against 26,5% for cocci Gram positive. The frequency of isolation of the enterobacteria was following: Escherichia coli, Klebsiella pneumoniae, Enterobacter and Levinea with respectively 32%, 28%, 28% and 12%. The rates of global resistance of the enterobacteria to the usual antibiotics varied from 66,7% to 85,7% for the amoxicilline associated to the clavulanic acid; of 25% to 66,7% for the ceftriaxone; and of 0 to 33,3% for the amikacine.

Twenty crude extracts from 17 species out of 11 families were assessed for their antibacterial activity against Streptococcus pneumoniae (Pneumococcus). The selected plants are used in Northern Cote d'Ivoire to treat various infections including respiratory track diseases. From all the tested extracts, only 7 from 6 plants showed a promising in vitro bactericidal activity against Pneumococcus, including strains resistant to penicillin. The most active extracts were from Erythrina senegalensis (Fabaceae), Piliostigma thonningii (Caesalpiniaceae), Waltheria indica (Sterculiaceae), Andira inermis (Fabaceae), Uapaca togoensis (Euphorbiaceae), Keetia hispida (Rubiaceae) and Combretum molle (Combretaceae). This is the first time that the antipneumococcal activity of the tested plants is reported. The results of this preliminary investigation support the traditional use of these plants in the treatment of pneumococcal infections. The most active of them could be candidates for isolation of compounds which could serve as lead structures for the development of new drugs against Streptococcus pneumoniae.

The emerging antibiotic resistance and worldwide diffusion of Streptococcus pneumoniae strains is an important public health problem.The aims of this study were to study the evolution of S. pneumoniae resistance rates to penicillin G and other antimicrobials from nasopharyngeal carriage.Four hundred and eighty-two nasopharyngeal samples of S. pneumoniae were studied from 1997 to 2001. The Kirby-Bauer technique was used to screen the susceptibility of samples and completed with the determination of penicillin G minimal inhibitory concentration using the E-test.Resistance to penicillin increased from 1997 to 2001: 8.5% in 1997, 20.7% in 1998, 16% in 1999, and 23.5% in 2001. However, the resistance to other beta-lactam antibiotics was low. The rate of resistance to cotrimoxazole increased from 52.2% in 1997 to 84.3% in 2001, with a higher degree of resistance in 2001. The resistance of S. pneumoniae to tetracycline increased. In contrast, the prevalence of erythromycin-resistant pneumococcal samples decreased from 11.6% in 1997 to 8% in 2001. The resistance to three or more antibiotics (multi-drug resistant) was also increased from 9.4% in 1997 to 23.5% in 2001.This data shows that carriage of antibiotic-resistant pneumococci is increasing in Abidjan. It will be interesting to assess the current bacterial resistance patterns by a national epidemiological observatory.

Mycobacterium ulcerans skin ulceration is a major issue of public health in Côte d'Ivoire. The diagnosis of M. ulcerans infection is hampered by the slow growth of the bacterium in culture, implying a delay of several weeks before a specific diagnosis can be obtained. In Côte d'Ivoire the diagnosis of Buruli ulcer is almost based on clinical features. During the last decade, many studies have demonstrated the extremely high capacity of PCR for rapidly and specifically detecting bacteria and genes of interest. That ability has revealed PCR as a powerful tool in clinical microbiology studies. In this study we evaluated the M. ulcerans detection in specimens of exudates and biopsies collected from patients clinically suspected of Buruli ulcer and treated in "Raoul Follereau" centre of Manikro in the North-central region of Côte d'Ivoire. The microscopic research of BAAR in 185 swabs loaded with skin lesions collected from these patients showed a positive rate of 14.6%. The PCR detection in 48 h or 72 h of the M. ulcerans IS2404 and IS2606 in the swabs and in the 26 biopsies, from these patients, showed positive rates of 15.7% and 84.6% respectively and in the same samples. These results obtained with PCR detection of M. ulcerans insertions sequences suggest that this technique performed with exudates and biopsy can be used to confirm a routine specific diagnosis of M. ulcerans and early screening of Buruli ulcer in Côte d'Ivoire.

To assess prevalence and trends of community acquired bacterial meningitis in childhood in a tertiary-care hospital before introduction of the HIB conjugate vaccine.Laboratory based data were recorded from January 1995 to December 2000 on two hundred and eighty seven children with bacterial meningitis. Identification of bacterial agents was performed with conventional methods. Information including age, gender, bacterial aetiology of meningitis, month and annual prevalence of agents was examined.The age of infected children ranges from 1 to 10 years with an average and median age of 34.2 months and 12 months respectively. Fifty five percent of children were male. The overall prevalence of agents were respectively 47.8% for Streptococcus pneumoniae followed by Haemophilus influenzae 39% and Neisseria meningitidis 13.2% with predominance of serogroup C. Stratification by age group shows that Haemophilus influenzae was the most common agent among children1 year of age following by S. pneumoniae and N. meningitidis. After 5 years, the number of cases of S. pneumoniae and N. meningitidis was prevalent. After 10 years, N. meningitidis was the first aetiology of bacterial meningitis. The six years data recorded highlighted the high and stable prevalence of H. influenzae B and S. pneumoniae and the low prevalence of N. meningitidis and high incidence of invasive meningococcal, pneumococcal and Haemophilus influenzae during the six years between September and February.Conjugated HIB vaccine is needed in our country to lower incidence of H. influenzae meningitis as already seen in developed countries. Continuous surveillance is necessary to monitor the disease trends, serotype distribution and antimicrobial susceptibility in order to implement appropriate public health interventions against community acquired bacterial meningitis.

To determine the prevalence of méticillino-résistant Staphylococcus aureus (MRSA) among health care personnel in Abidjan teaching hospitals as well as their resistance profile against other antibiotics, 592 health care personnel from various surgical and medical services: the intensive care unit, gynaecology and obstetrics and third-degree burns services of the Cocody, Treichville and Yopougon Teaching Hospitals were included. The previous nasal pits of each subject included were swabbed. The isolation of S. aureus strains was run in a Chapman medium followed by Identification based on morphological and biochemical characteristics. The resistance profile of the strains to antibiotics was determined by standard Kirby-Bauer disk diffusion method and a 1 microg disc of oxacillin was used for the detection of meticillin-resistance S. aureus strains according to NCCLS (National Committee for Clinical Laboratory Standards) guidelines. 269 members of the studied personnel were carriers of S. aureus, either a rate of portage of 45.4%. Among the 269 S. aureus isolates, 38.7% were MRSA strains and the carriage rate of MRSA in the population was 17.8%. The health care personnel working in surgery was the more colonized (36.7%) follow-up of those of the medical services (31.4%) and of the the intensive care unit (12.4%). A variable proportion of strains of MRSA also expressed resistances to the other families of antibiotics: 27% to aminosids of which 13.5% of phénotype kanamycine, tobramycine, gentamycine (KTG), 58.7% to macrolids and related (MLS), 37.5% to fluoroquinolons, 14.4% to cyclines and 40% to the cotrimoxazole. This confirms their multi-resistant character. The prevalence of MRSA carriage among health care personnel is high; this personnel constitutes an infectious risk for the hospitalized patients who are so exposed to nosocomial infections caused by MRSA.

The authors report the results of a seroepidemiological study of rubella in pregnancy. Rubella antibodies were present in 82% of the pregnant women and 18% were seronegative. Most of seronegative women were less than twenty years old, nulliparous, on first period of gestation and in low socioeconomical conditions.