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Garba Z, Kaboré B, Bonkoungou IJO, Natama MH, Rouamba T, Haukka K, Kirveskari JP, Tinto H, Sangaré L, Barro N, Kantele A. Phenotypic Detection of Carbapenemase and AmpC-β-Lactamase Production among Extended Spectrum β-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella spp. Isolated from Clinical Specimens. Antibiotics (Basel) 2023; 13:31. [PMID: 38247589 PMCID: PMC10812623 DOI: 10.3390/antibiotics13010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction: Data on antimicrobial resistance (AMR) are sparse across numerous African countries, as microbiological analyses are not routinely conducted and surveillance data are not collected. Accordingly, clinical samples are not routinely tested for carbapenem-resistant bacteria and, therefore, the general understanding of their prevalence in the region remains limited. Methods: Between January 2020 and June 2022, we collected extended spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-PE) isolates from five hospitals in Burkina Faso. After an initial culture on ESBL-selective media, the species were identified using API20E and isolates were tested against 13 antimicrobial agents using the disc diffusion method on Mueller-Hinton (MH) agar. ESBL production was confirmed via a double-disc synergy test. Production of carbapenemases and AmpC-β-lactamases and phenotypic co-resistance were determined. Results: Among the 473 ESBL-PE, 356 were ESBL-E. coli (ESBL-Ec) and 117 were Klebsiella spp. (ESBL-K). Of these isolates, 5.3% were carbapenemase and 5.3% were AmpC-β-lactamase-positive. Three types of carbapenemases were identified: 19 NDM, 3 OXA-48-like and 1 VIM. Two isolates produced both NDM and OXA-48-like carbapenemases. Carbapenemase producers were detected at all levels of healthcare. Co-resistance rates were up to 85% for aminoglycosides, 90% for sulfonamides, 95% for fluoroquinolones and 25% for chloramphenicol. Fosfomycin resistance was 6% for ESBL-Ec and 49% for ESBL-K (49%). Conclusions: Some of the ESBL-Ec and ESBL-K co-produced carbapenemases and/or AmpC-β-lactamases at all healthcare levels and in various sample types with high co-resistance rates to non-betalactams. Carbapenem resistance is no longer rare, calling for testing in routine diagnostics, a comprehensive resistance surveillance system and infection control within healthcare.
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Affiliation(s)
- Zakaria Garba
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou 03 BP 7021, Burkina Faso; (I.J.O.B.); (N.B.)
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Ouagadougou 11 BP 218, Burkina Faso; (B.K.); (M.H.N.); (T.R.); (H.T.)
| | - Bérenger Kaboré
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Ouagadougou 11 BP 218, Burkina Faso; (B.K.); (M.H.N.); (T.R.); (H.T.)
| | - Isidore J. O. Bonkoungou
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou 03 BP 7021, Burkina Faso; (I.J.O.B.); (N.B.)
| | - Magloire H. Natama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Ouagadougou 11 BP 218, Burkina Faso; (B.K.); (M.H.N.); (T.R.); (H.T.)
| | - Toussaint Rouamba
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Ouagadougou 11 BP 218, Burkina Faso; (B.K.); (M.H.N.); (T.R.); (H.T.)
| | - Kaisa Haukka
- Department of Microbiology, University of Helsinki, 00014 Helsinki, Finland;
- Human Microbiome Research Program, Medical Faculty, University of Helsinki, 00014 Helsinki, Finland
| | - Juha P. Kirveskari
- Helsinki Innovation Services Ltd., University of Helsinki, 00014 Helsinki, Finland;
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Ouagadougou 11 BP 218, Burkina Faso; (B.K.); (M.H.N.); (T.R.); (H.T.)
| | - Lassana Sangaré
- Department of Health Sciences, Université Joseph KI-ZERBO, Ouagadougou 03 BP 7021, Burkina Faso;
| | - Nicolas Barro
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou 03 BP 7021, Burkina Faso; (I.J.O.B.); (N.B.)
| | - Anu Kantele
- Human Microbiome Research Program, Medical Faculty, University of Helsinki, 00014 Helsinki, Finland
- Meilahti Infectious Diseases and Vaccine Research Center MeiVac, Helsinki University Hospital, 00029 Helsinki, Finland
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Garba Z, Bonkoungou IOJ, Millogo NO, Natama HM, Vokouma PAP, Bonko MDA, Karama I, Tiendrebeogo LAW, Haukka K, Tinto H, Sangaré L, Barro N. Wastewater from healthcare centers in Burkina Faso is a source of ESBL, AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae. BMC Microbiol 2023; 23:351. [PMID: 37978428 PMCID: PMC10655474 DOI: 10.1186/s12866-023-03108-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae have spread into the environment worldwide posing a potential public health threat. However, the prevalence data for low- and middle-income countries are still scarce. The aim of this study was to evaluate the presence of ESBL, AmpC-β-lactamase and carbapenemase-producing and multidrug-resistant E. coli and K. pneumoniae in wastewaters from healthcare centers in Burkina Faso. RESULTS Eighty-four (84) wastewater samples were collected from five healthcare centers and plated on selective ESBL ChromAgar. E. coli and Klebsiella pneumoniae isolates were identified using API20E. ESBL-producing bacteria were detected in 97.6% of the samples and their average concentration per hospital ranged from 1.10 × 105 to 5.23 × 106 CFU/mL. Out of 170 putative ESBL-producing isolates (64% of them were E. coli) and 51 putative AmpC-β-lactamase-producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, of which 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, moreover, all of them were resistant to all tested β-lactams. Resistance to ESBL inhibitors was also common, up to 66% in E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics to which the least resistance was detected. CONCLUSIONS This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including carbapenemase producers. Untreated healthcare wastewater entering the environment exposes people and animals to infections caused by these multi-resistant bacteria, which are difficult to treat, especially in the resource-poor settings.
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Affiliation(s)
- Zakaria Garba
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso.
| | - Isidore O J Bonkoungou
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Nadège O Millogo
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - H Magloire Natama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Pingdwendé A P Vokouma
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Massa Dit A Bonko
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Ibrahima Karama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | | | - Kaisa Haukka
- Department of Microbiology and Human Microbiome Research Program, University of Helsinki, Helsinki, Finland
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Lassana Sangaré
- Department of Health Sciences, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Nicolas Barro
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
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Roca A, Camara B, Bognini JD, Nakakana UN, Somé AM, Beloum N, Rouamba T, Sillah F, Danso M, Jones JC, Graves S, Jagne I, Getanda P, Darboe S, Tahita MC, Ndure E, Franck HS, Edmond SY, Dondeh BL, Nassa WGJ, Garba Z, Bojang A, Njie Y, Bottomley C, Tinto H, D’Alessandro U. Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial. JAMA 2023; 329:716-724. [PMID: 36881034 PMCID: PMC9993186 DOI: 10.1001/jama.2022.24388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
Importance Neonatal sepsis is a leading cause of neonatal mortality. New interventions are needed to decrease neonatal sepsis and mortality in regions with highest burden. Objective To evaluate the efficacy of intrapartum azithromycin to reduce neonatal sepsis or mortality, as well as neonatal and maternal infections. Design, Setting, and Participants This double-blind, placebo-controlled, randomized clinical trial enrolled and followed up birthing parents and their infants at 10 health facilities in The Gambia and Burkina Faso, West Africa, between October 2017 and May 2021. Interventions Participants were assigned at random to receive oral azithromycin (2 g) or placebo (ratio 1:1) during labor. Main Outcomes and Measures The primary outcome was a composite of neonatal sepsis or mortality, with the former defined based on microbiologic or clinical criteria. Secondary outcomes were neonatal infections (skin, umbilical, eye and ear infections), malaria, and fever; postpartum infections (puerperal sepsis, mastitis), fever, and malaria; and use of antibiotics during 4-week follow-up. Results The trial randomized 11 983 persons in labor (median age, 29.9 years). Overall, 225 newborns (1.9% of 11 783 live births) met the primary end point. The incidence of neonatal mortality or sepsis was similar in the azithromycin and placebo groups (2.0% [115/5889] vs 1.9% [110/5894]; risk difference [RD], 0.09 [95% CI, -0.39 to 0.57]), as was the incidence of neonatal mortality (0.8% vs 0.8%; RD, 0.04 [95% CI, -0.27 to 0.35]) and neonatal sepsis (1.3% vs 1.3%; RD, 0.02 [95% CI, -0.38 to 0.43]). Newborns in the azithromycin group compared with the placebo group had lower incidence of skin infections (0.8% vs 1.7%; RD, -0.90 [95% CI, -1.30 to -0.49]) and need for antibiotics (6.2% vs 7.8%; RD, -1.58 [95% CI, -2.49 to -0.67]). Postpartum parents in the azithromycin group had lower incidence of mastitis (0.3% vs 0.5%; RD, -0.24 [95% CI, -0.47 to -0.01]) and puerperal fever (0.1% vs 0.3%; RD, -0.19 [95% CI, -0.36 to -0.01]). Conclusions and Relevance Azithromycin administered orally during labor did not reduce neonatal sepsis or mortality. These results do not support routine introduction of oral intrapartum azithromycin for this purpose. Trial Registration ClinicalTrials.gov Identifier: NCT03199547.
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Affiliation(s)
- Anna Roca
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Bully Camara
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Joel D. Bognini
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Usman N. Nakakana
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Athasana M. Somé
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Nathalie Beloum
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Toussaint Rouamba
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Fatoumata Sillah
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Madikoi Danso
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Joquina C. Jones
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Shashu Graves
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Isatou Jagne
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Pauline Getanda
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Saffiatou Darboe
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Marc C. Tahita
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Ebrahim Ndure
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Hien S. Franck
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Sawadogo Y. Edmond
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Bai L. Dondeh
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Wilfried G. J. Nassa
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Zakaria Garba
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Abdoulie Bojang
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Yusupha Njie
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | | | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé–Clinical Research Unit of Nanoro (IRSS-CRUN), Nanoro, Burkina Faso
| | - Umberto D’Alessandro
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Bonko MDA, Karama I, Kiemde F, Lompo P, Garba Z, Yougbaré S, Mens PF, Tinto H, Tahita MC, Schallig HDFH. Could combined rapid diagnostic testing for malaria and c-reactive protein be helpful for the diagnosis and management of febrile illnesses in children under-5 years of age in rural Burkina Faso? BMC Infect Dis 2022; 22:952. [PMID: 36536340 PMCID: PMC9764475 DOI: 10.1186/s12879-022-07638-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/20/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Febrile illnesses are among the most important reasons for medical consultation in sub-Saharan Africa and are frequently treated with antimicrobials due to the unavailability of appropriate diagnostic tools. This practice leads to antimicrobial resistance, with increasing mortality and morbidity as result. One of the few accessible diagnostic tools available in low resource settings is malaria rapid diagnostic tests (mRDTs) which contributed to reducing the over-prescription of anti-malarials, but cannot guide antibiotic prescriptions. To circumvent this problem, we explored whether combined testing with mRDT and c-reactive protein (CRP) could improve the diagnosis of febrile illnesses and subsequent prescription of antibiotics. METHODS Clinical specimens (blood, stool and urine) collected from 396 febrile children (axillary temperature of ≥ 37.5 °C) were analyzed with rapid diagnostic tests (malaria and CRP) and microbiology culture to establish the possible cause of fever. Actual antimicrobial prescriptions given to the children were compared with those that could be given based on combined CRP-malaria testing. RESULTS In total, 68.7% (272/396) of malaria cases were diagnosed by mRDT-Pf-HRP-2. CRP test was positive in 84.3% (334/396) of the children, but bacterial infections were confirmed in 12.4% (49/396) of them. A possible cause of fever could not be established in 20.5% (81/396) of cases. Based on the diagnostic practice in place, 265 of the children with a positive mRDT-Pf-HRP-2 received anti-malarial treatment. Furthermore, 89.5% (111/124) of negative mRDT results received antibiotic treatment and 37.1% (46/124) received antimalarial treatment. Of these 124 cases, 80 had positive CRP tests and 44 negative CRP tests. If the results of CRP testing are considered, 44 CRP/mRDT negative children would not get antibiotic treatment, resulting in a 35.5% reduction in antibiotic prescriptions. However, 2 cases with a bacterial infection would be denied appropriate treatment. CONCLUSION Combining mRDT-PfHRP2 with CRP testing is particularly useful in children for whom both tests are negative as it results in a reduction of antibiotics prescriptions. However, there is a risk to miss potential severe bacterial infections and a close follow-up of these cases is strongly recommended.
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Affiliation(s)
- Massa dit Achille Bonko
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso ,grid.5650.60000000404654431Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centers, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Ibrahima Karama
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Francois Kiemde
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Palpouguini Lompo
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Zakaria Garba
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Sibidou Yougbaré
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Petra F. Mens
- grid.5650.60000000404654431Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centers, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Halidou Tinto
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Marc Christian Tahita
- grid.457337.10000 0004 0564 0509Institut de Recherche en Sciences de la Santé- Direction Régionale du Centre-Ouest/Unité de Recherche Clinique de Nanoro, IRSS-DRCO /URCN), Nanoro, Burkina Faso
| | - Henk. D. F. H. Schallig
- grid.5650.60000000404654431Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centers, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
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Post AS, Guiraud I, Peeters M, Lompo P, Ombelet S, Karama I, Yougbaré S, Garba Z, Rouamba E, Tinto H, Jacobs J. Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso. Antimicrob Resist Infect Control 2022; 11:112. [PMID: 36064435 PMCID: PMC9446845 DOI: 10.1186/s13756-022-01142-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting.
Methods
Between October 2016–September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml.
Results
Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates.
Conclusions
The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions.
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Bonkoungou IJO, Somda NS, Traoré O, Zoma BS, Garba Z, Drabo KM, Barro N. DETECTION OF DIARRHEAGENIC ESCHERICHIA COLI IN HUMAN DIARRHEIC STOOL AND DRINKING WATER SAMPLES IN OUAGADOUGOU, BURKINA FASO. Afr J Infect Dis 2020; 15:53-58. [PMID: 33884359 PMCID: PMC8047281 DOI: 10.21010/ajid.v15i1.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/27/2022] Open
Abstract
Background: The presence of diarrheagenic Escherichia coli (DEC) in drinking water, is a grave public health problem. This study was aimed at characterization of diarrheagenic Escherichia coli isolated from drinking water and faecal samples from diarrheic patients in Ouagadougou, Burkina Faso. Materials and Methods: A total of 242 water samples consisting of 182 potable sachets and 60 from boreholes were collected in the period between October 2018 and April 2019 in the city of Ouagadougou. Faecal samples were also collected from 201 diarrheic patients visiting National Public Health Laboratory for a biological diagnosis by coproculture. The presence of virulence genes associated with DEC was determined by 16-plex polymerase chain reaction from bacteria culture. Results: From drinking water, we found 17% (42/242) Escherichia coli isolates in which 1% (2/242) DEC were detected. Among analyzed samples (182 sachet water versus 60 borehole water), the two DEC (01 ETEC and 01 EPEC) were detected in sachet water. DEC were detected in 20% (40/201) of patients. Enteroaggregative Escherichia coli (EAEC) were mostly detected in 10% followed by Enteropathogenic Escherichia coli (EPEC) in 4%, Enteroinvasive Escherichia coli (EIEC) in 2%, and Shiga toxin-producing Escherichia coli (STEC) 0.5%. However, Enterotoxigenic Escherichia coli (ETEC) was not detected alone, but in co-infections with EAEC. Conclusion: The present study documented the prevalence of Escherichia coli pathovars associated in patients with diarrhea, and shows that drinking water might be a source of DEC transmission in human.
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Affiliation(s)
- Isidore Juste Ouindgueta Bonkoungou
- Département de Biochimie-Microbiologie. UFR- Sciences de la vie et de la terre. Université Joseph Ki-Zerbo, 03 BP 7021 Ouagadougou 03, Burkina Faso
| | - Namwin Siourimè Somda
- Département Technologie Alimentaire (DTA) / IRSAT / CNRST, Burkina Faso, 03 BP 7047 Ouagadougou 03
| | - Oumar Traoré
- Département de Biochimie-Microbiologie. UFR- Sciences de la vie et de la terre. Université Joseph Ki-Zerbo, 03 BP 7021 Ouagadougou 03, Burkina Faso.,Unité de Formation et de Recherche en Sciences Appliquées à la Technologie (UFR/SAT). Université de Dédougou, BP 176 Dédougou
| | - Barthelemy Sibiri Zoma
- Laboratoire National de Santé Publique (LNSP), 09 BP 24 Ouagadougou 09, Burkina Faso.,Polygon Bio Services SARL,09 BP 969 Ouagadougou 09, Ouagadougou, Burkina Faso 969
| | - Zakaria Garba
- Département de Biochimie-Microbiologie. UFR- Sciences de la vie et de la terre. Université Joseph Ki-Zerbo, 03 BP 7021 Ouagadougou 03, Burkina Faso.,Unité de Recherche Clinique de NANORO, IRSS-CNRST, BP: 218 Ouaga 11 Burkina Faso
| | - Koine Maxime Drabo
- Institut de Recherche en Sciences de la santé, CNRST, 03 B.P. 7192 Ouagadougou 03 Burkina Faso
| | - Nicolas Barro
- Département de Biochimie-Microbiologie. UFR- Sciences de la vie et de la terre. Université Joseph Ki-Zerbo, 03 BP 7021 Ouagadougou 03, Burkina Faso
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