Management of necrotizing and non-necrotic bacterial erysipelas of the face in tropical areas: a series of four cases and a review of the literature.

The necrotizing and not necrotizing acute bacterial dermohypodermitis (DHD) are acute bacterial infections of tissues situated between the skin and the muscles. The localizations of the face are infrequent, and sometimes put diagnostic difficulties with other current facial dermatosis. We report in this article 4 cases of DHD of the face with skin source, hospitalized in the service of the Infectious and Tropical Diseases of the Teaching Hospital Yalgado Ouédraogo of Ouagadougou (Burkina Faso). The objective is to make a current situation of their etiologies and complications, and to look for the difficulties to take care of them in a country with limited resources. The patient's care journey for this disease is long while it constitutes a medical or medical-surgical emergency. Imaging, which is essential for the diagnosis of heart valve disease and the daunting complications of necrotizing fasciitis and mediastinitis, is generally available only in tertiary hospitals. Antibiotic therapy is most often inadequate or insufficient. Anti-inflammatories, widely used, according to several authors contribute to serious forms and excess mortality. Health workers in resource-limited settings need to be better educated and guidelines issued to recognize the signs of this condition in order to enable early referral of patients in specialized settings. In addition, education of the population and hygiene awareness of skin lesions should be a priority to reduce complications.

[Obstetric endometritis at the UTH-Yalgado Ouedraogo of Ouagadougou (Burkina Faso): about the management of 102 cases]. / Les endométrites obstétricales au CHU-Yalgado Ouédraogo de Ouagadougou (Burkina Faso). À propos de la prise en charge d'une série de 102 cas.

This is a descriptive cross-sectional study over a nine months period conducted at the UTH-Yalgado Ouédraogo from all patients in whom the diagnosis of endometritis at obstetrical been laid. Endo-cervical and vaginal swabs were taken from all these patients. Commensal bacteria and anaerobes were investigated in the laboratory. During the study period, 102 cases of obstetric endometritis were recorded that to say a frequency of 1.4% of admissions. The average age of patients was 25.2 years [17-43]. The childbirth mean was 2.5 ± 2 [0-7]. The reason for consultation was dominated by hyperthermia in 98% of cases. The bacterial ecosystem was mainly dominated by Escherichia coli (49.2%), Staphylococcus aureus (29.5%), Streptococcus sp (4.9%). The acid + amoxicillin clavulanic showed low activity on most germs. The average hospital stay of patients was 6.30 days [1-33]. A maternal death was recorded in 3 patients that to say fatality rate of 2.9%. The lethality of endometritis at the UTH-Yalgado Ouedraogo is greater than the rate of 1% allowed by WHO. The resistance of germs is high enough with amoxicillin. The systematization of the bacteriological study is expected to guide the antibiotic to help better fight against maternal mortality.

[Seroprevalence of HBs Ag and of anti-HCV antibodies among HIV infected people in N'Djamena, Chad]. / Séroprévalence de l'Ag HBs et de l'anticorps Anti VHC chez les personnes infectées par le VIH1 à N'Djamena, Tchad.

This is a prospective study conducted as part of a voluntary testing for HBV, HCV and HIV. The aim of the study is to determine the seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people and a control group of HIV negative people. HIV prevalence among newly diagnosed volunteers is 9.1%. The overall seroprevalence of HBs Ag and anti-HCV antibodies is respectively 13.5% and 2.0%. The seroprevalence of HBs Ag and anti-HCVantibodies in the control group (HIV-negative) is respectively 12.2% and 2%. The seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people (old and new) is respectively 16.1% and 1%.This study, the first one conducted in Chad, has allowed us to know the seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people.

Streptococcus pneumoniae invasive infections in Burkina Faso, 2007 to 2011.

OBJECTIVE: We had for aim to determine the epidemiology of meningeal and lung invasive infections due to Streptococcus pneumoniae in Burkina Faso. MATERIAL AND METHODS: We screened for S. pneumoniae with the usual bacteriology techniques and with real time polymerase chain reaction (rt-PCR) in 7917 samples of cerebrospinal fluid (CSF) and pleural fluid (PF) collected in the Ouagadougou Yalgado Ouedraogo Teaching Hospital, from 2007 to 2011. RESULTS: S. pneumoniae was identified in 476 (6%) samples including 455 (5.7%) in CSF and 21 (0.3%) in PF. Sixty-seven percent of invasive infections occurred in patients 15 years of age or less, without any significant sex ratio difference. The infections occurred most frequently between January and August, with the first and most important peak between January and May (dry season) and the second peak between June and August (at the beginning of rain season). The introduction of rt-PCR proved the under diagnosing of invasive infections by usual bacteriological methods (latex agglutination assay and culture). CONCLUSION: Invasive pneumococcal infections occur mainly in patients 15 years of age or less, without any difference in sex ratio and with peaks in the dry season. Vaccinal schedules should include all age ranges in Burkina Faso.

Hepatitis B seroprevalence in HIV-infected patients consulting in a public day care unit in Bobo Dioulasso, Burkina Faso.

OBJECTIVE: The authors had for aim to assess the prevalence of hepatitis B co-infection in a cohort of HIV-infected patients, routinely followed-up at the Day Care Unit of the Bobo Dioulasso Sanou Souro University Hospital, Burkina Faso. PATIENTS AND METHODS: The Elisa technique was used to dose HBs antigen (AgHBs), antibodies anti-HBs and anti-HBc in all the patients followed by the biological laboratory, from October to December 2008. RESULTS: The AgHBs prevalence was 12.7% [CI at 95%: 10.7-15.0%] and men were slightly more likely to be positive for AgHBs than women (16.5% [12.0-21.9%] versus 11.6% [9.4-14.1%]; P=0.047); 83.3% of the patients [80.8-85.6%] were positive for hepatitis B core antibody, and 32.6% [29.7-35.6%] for hepatitis B surface antibody; 29.9% of the patients [27.1-32.8%] had a complete profile of former hepatitis B infection, 41.3% [38.2-44.4%] expressed core antibodies only; 13.8% [11.7-16.0%] had a negative serological test, and 2.3% [1.5-3.4%] presented a vaccinal immunity. CONCLUSION: These results stress the usefulness of screening for hepatitis B in all HIV-infected patients, along with the initial biological tests. This would help adapt HIV treatment to co-infected patients and to build an expanded program of vaccination for non-immune patients.

[Molecular diagnosis of bacterial meningitis in Burkina Faso]. / Diagnostic moléculaire par PCR en temps réel d'agents bactériens responsables des méningites purulentes au Burkina Faso.

STUDY OBJECTIVES: The aim of this pilot study was to evaluate the use of real-time polymerase chain reaction (RT-PCR) in the diagnosis of bacterial meningitis in Burkina Faso. METHODOLOGY: This retrospective study reviewed the analyses of specimens collected from April 2009 through February 2010. DNA was extracted from cerebrospinal fluid (CSF) from patients with suspected meningitis from different health districts in Burkina Faso and analyzed with RT-PCR. Many patients were also tested with traditional diagnostic methods for meningitis: culture and serology (latex agglutination test). RESULTS: The study included 171 patients hospitalized in 8 health districts. Bacterial DNA for germs causing purulent meningitis was identified in 108/171 patients (63%); corresponding percentages for culture and latex were 60% (56/93) and 77% (66/86), respectively. All three methods found that NmA and Spn were the two main bacteria responsible for purulent meningitis in our cohort: with real time PCR, NmA = 59.3% and Spn = 34.3%), culture (NmA = 78.6% and Spn = 17.8%) or latex (NmA = 77.3% and Spn = 21.2%). Real-time PCR improved the sensitivity and the specificity of the diagnosis of the germs involved in this study and allowed the detection of the serogroups NmY and NmW135, which could not be detected by culture or latex agglutination test. RT-PCR permitted the detection and the characterization of bacteria responsible for purulent meningitis from CSF-contaminated cultures that could not otherwise be detected.

[Comparison of Kinyoun, auramine O, and Ziehl-Neelsen staining for diagnosing tuberculosis at the National Tuberculosis Center in Burkina Faso]. / Comparaison des performances des colorations de Kinyoun et à l'auramine O, avec celle de Ziehl-Neelsen pour le diagnostic de la tuberculose au Centre national de lutte antituberculeuse du Burkina Faso.

CONTEXT: This study was conducted at the National Tuberculosis Center in Burkina Faso from October 2007 through May 2008. OBJECTIVE: Our objective was to compare the diagnostic performance of three staining methods: Kinyoun, auramine O, and Ziehl-Neelsen. METHODS: Ziehl-Neelsen staining served as the reference method to assess the diagnostic performance of Kinyoun and auramine O staining. In all, 616 sputum smears from 233 patients were read with each method to detect acid-fast bacilli. SPSS was used for data analysis. RESULTS: The results of auramine O staining showed positive diagnoses in 15.9% of the samples; sensitivity was 100%, specificity 95.6%, and the positive and negative predictive values 75.7% and 100% respectively. Kinyoun staining produced a positive diagnosis rate of 12%, sensitivity of 96.4%, specificity of 99.5%, and positive and negative predictive values of 96.4% and 99.5%. CONCLUSION: Our study indicates that auramine O staining had a better sensitivity for detecting acid-fast bacilli than Kinyoun staining. Accordingly, the use of auramine O staining should increase the detection rate for pulmonary tuberculosis in Burkina Faso.

A seroepidemiological study of pandemic A/H1N1(2009) influenza in a rural population of Mali.

The swine-origin H1N1 influenza A virus (pH1N1(2009)) started to circulate worldwide in 2009, and cases were notified in a number of sub-Saharan African countries. However, no epidemiological data allowing estimation of the epidemic burden were available in this region, preventing comprehensive comparisons with other parts of the world. The CoPanFlu-Mali programme studied a cohort of 202 individuals living in the rural commune of Dioro (southern central Mali). Pre-pandemic and post-pandemic paired sera (sampled in 2006 and April 2010, respectively) were tested by the haemagglutination inhibition (HI) method. Different estimates of pH1N1(2009) infection during the 2009 first epidemic wave were used (increased prevalence of HI titre of ≥1/40 or ≥1/80, seroconversions) and provided convergent attack rate values (12.4-14.9%), the highest values being observed in the 0-19-year age group (16.0-18.4%). In all age groups, pre-pandemic HI titres of ≥1/40 were associated with complete absence of seroconversion; and geometric mean titres were <15 in individuals who seroconverted and >20 in others. Important variations in seroconversion rate existed among the different villages investigated. Despite limitations resulting from the size and composition of the sample analysed, this study provides strong evidence that the impact of the pH1N1(2009) first wave was more important than previously believed, and that the determinants of the epidemic spread in sub-Saharan populations were quite different from those observed in developed countries.

Impact of smear microscopy results and observed therapy on tuberculosis treatment in Mombasa, Kenya.

SETTING: Tuberculosis (TB) treatment center at Coast Provincial General Hospital in Mombasa, Kenya. OBJECTIVES: To describe TB management practices in a facility in coastal Kenya and identify factors associated with poor treatment outcomes. DESIGN: Retrospective review of patient treatment records from January 2008 to June 2009. Treatment outcomes of patients were classified as treatment success (cure or treatment completion) or poor treatment outcome (treatment failure, death or default). Relative risk regression was used to determine the association between exposures of interest and poor treatment outcomes. RESULTS: Records were obtained from a total of 183 patients: 142 (78%) had pulmonary TB, 68 (37%) were human immunodeficiency virus (HIV) infected and 81 (44%) had acid-fast bacilli (AFB) positive smear micros- copy. Most treated individuals (86%) achieved a successful treatment outcome as defined by the World Health Organization. Of those with poor treatment outcomes, 64% defaulted, 32% died, and 4% failed treatment. Initial negative AFB smear and HIV co-infection were associated with poor treatment outcomes (RR 3.32, 95%CI 1.22-8.99 and RR 4.61, 95%CI 1.69- 12.59, respectively). CONCLUSION: Strategies to accelerate accurate diagnosis of smear-negative TB and increase patient retention during treatment, especially in HIV co-infected individuals, are needed to reduce poor treatment outcomes in Kenya.

Constitutive activation and accelerated maturation of peripheral blood T cells in healthy adults in Burkina Faso compared to Germany: the case of malaria?

OBJECTIVE: It is not exactly known how frequent exposure to Plasmodium falciparum shapes the peripheral blood T-cell population in healthy West Africans. METHODS: The frequency of peripheral blood CD4(+) lymphocytes responding to Plasmodium falciparum merozoite surface protein 1 (PfMSP-1) by production of interferon-gamma (IFN-γ), interleukin-2 (IL-2) or tumor necrosis factor-alpha (TNF-α) was determined using a commercially available flow cytometric activation assay (FastImmune) in 17 healthy adults in Nouna, Burkina Faso. T-cell activation and maturation in peripheral blood of healthy adults in Burkina Faso (n=40) and Germany (n=20) were compared using immunophenotyping and three-colour flow cytometry. RESULTS: Significant numbers of PfMSP-1 -specific CD4(+) lymphocytes producing IFN-γ, IL-2 and/or TNF-α were detected in 14 healthy adults in Nouna. Cytokine profiles showed predominant production of IFN-γ and TNF-α. Compared to Germans, Burkinabé showed markedly lower proportions of CCR7+ CD45RA+ naive CD4(+) cells and slightly higher frequencies of CD95(+)CD4(+) T-cells and of CD38(+) CD8(+) T-cells. The median antibody-binding capacity of CD95(dim) CD4(+) T-cells in Burkinabé was more than twice the value observed in Germans (263 vs. 108 binding sites per cell, p<0.0001). CONCLUSIONS: We hypothesize that an IFN-γ-induced increase in the expression level of CD95 on CD4(+) lymphocytes may lower the activation threshold of resting naive CD4(+) T-cells in healthy adults living in Burkina Faso. Bystander activation of these cells deserves further study as a molecular mechanism linking strong IFN-γ responses against Plasmodium falciparum to decreased susceptibility to parasitemia observed in specific ethnic groups in West Africa.

Anti-tuberculosis drug resistance in new and previously treated pulmonary tuberculosis cases in Burkina Faso.

SETTING: National Tuberculosis (TB) Control Centre in Ouagadougou, Burkina Faso. OBJECTIVE: To evaluate Mycobacterium tuberculosis drug resistance among newly diagnosed and previously treated cases. METHODS: A total of 416 M. tuberculosis complex strains were isolated from 323 new and 93 previously treated patients under DOTS. Susceptibility to four anti-tuberculosis drugs (isoniazid [INH], rifampicin [RMP], streptomycin [SM] and ethambutol [EMB]) was determined using the proportion method. Human immunodeficiency virus (HIV) status was determined in 316 patients, 249 new and 67 previously treated cases, with informed consent. RESULTS: Among new cases, 12.4% of strains were resistant to any drug, and 3.4% were multidrug-resistant (MDR). Resistance rates were very high in previously treated patients: INH (66.7%), RMP (51.6%), SM (44.1%), EMB (50.5%) and MDR (INH+RMP; 50.5%). Of 316 patients tested, 28.7% were HIV-positive. There was no statistically significant association between HIV status and MDR-TB in new (P = 0.95) and previously treated patients (P = 0.5). CONCLUSION: Drug resistance is high in Burkina Faso. Early detection of infectious patients and completion of treatment are essential.

Mycobacterium tuberculosis drug-resistance in previously treated patients in Ouagadougou, Burkina Faso.

BACKGROUND: Tuberculosis drug-resistance becomes common in sub-Saharan Africa; however, very few data are available in Burkina Faso. The aim of this study is to assess the acquired resistance of Mycobacterium tuberculosis complex strains identified in TB patients to four first-line drugs in Ouagadougou. METHODS: One hundred and ten (110) pulmonary tuberculosis patients with acid-fast bacilli-positive sputum and in situation of failure, relapse, or treatment abandonment were included in the study. Ninety six strains, including 92 (95.8%) M. tuberculosis and 4 (4.2%) M. africanum, were isolated from the sputum samples of these patients. Their drug susceptibility testing was performed using the proportion method. The first-line drugs tested were isoniazid (INH), streptomycin (STR), ethambutol (EMB), and rifampicin (RIF). RESULTS: The overall drug-resistance rate of M. tuberculosis was 67.4% (n=60), including 3.4% to one drug, 18% to two, 10.1% to three, and 35.9% to four drugs. The resistance to INH, RIF, EMB, and STR were 67.4%, 51.7%, 50.6%, and 44.9%, respectively. Two strains of M. africanum were resistant to all drugs. Forty-six (51.7%) strains were multidrug-resistant (resistant to at least INH and RIF). CONCLUSIONS: In previously treated patients, the level of resistance of M. tuberculosis complex to commonly used anti-tuberculosis drugs is very high in Ouagadougou. Our results showed that multidrug-resistant tuberculosis could be a public health problem in Burkina Faso.

[Epidemio-clinical aspects of bacterial acute infant Pneumopathies at Yalgado Ouédraogo University Health Center]. / Aspects Epidemio-Cliniques des Pneumopathies Aiguës Bacteriennes de L'Enfant Au Chu Yalgado Ouedraogo.

INTRODUCTION: Infections of low respiratory tracks represent a public health issue and are a frequent reason for antibiotic prescription . For children in Africa, they are the main morbidity factor (50% of visits) and mortality (about 20% of infant mortality). Actually, the antibiotherapy, mainly probabilistic, rests on the awareness of the epidemiology of the germs which are responsible in a given region, at a given period. The purpose of this study was to evaluate the Epidemio-clinical aspects of bacterial acute infant Pneumopathies at Yalgado Ouédraogo Univercity Health Center. PATIENTS AND METHOD: This a descriptive retrospective study, base on the files of hospitalized patients in the Paediatric Unit of CHU YO from January 1, 2005 through December 31, 2006. RESULTS: All in all, 5803 patients with 658 cases of acute bacterial pneumopathy (11.3%) were hospitalized in the paediatric unit. Besides, acute bacterial Pneumopathies, 254 patients had another associated affection. Proteino-calorific malnutrition were frequent (59.7%), coupled with anaemia (36%). The reported most frequent germs are respectively: Streptococcus pneumoniae (29.3%), Klebsiella pneumoniae (29.3%) et Staphylococcus aureus (25%). The streptococcus was sensitive to association amoxicilline + clavulanic in 66.7% of the cases, to ceftriaxone in 57.1 % of cases. It was 100% resistant to ampicilline and to amoxicilline. The clinical evolution of our patients was favorable in 90% of the cases with 5.5% deaths. CONCLUSION: Pneumopathies affect mostly children who are less than 2 years old favored by malnutrition and anaemia. The high morbid-morbidity related to this pathology could be improved through a better awareness and regular updating of local bacterial ecology.

[Epidemio-clinical aspects of adult acute bacterial pneumonia at Yalgado Ouédraogo University Health Center]. / Aspects Epidemio-cliniques des Pneumopathies Aiguës Bacteriennes de L'Adulte au Chu Yalgado Ouedraogo.

INTRODUCTION: Bacterial Pneumopathies are low respiratory infections due to parenchyma pulmonary attack, which etiologic agent is a bacteria different from tubercular bacillus. Factually, the treatment is based on a probalistic antibiotherapy. This requires awareness of the epidemiology of the germs which are responsible in a given region, at a given period. PATIENTS AND METHOD: In order to better grasp mainly the bacteriological and therapeutic aspects of adult bacterial Pneumopathies in Burkina Faso, we have come up with a two year journal/documentary. RESULTS: The reported most frequent germs are respectively: Streptococcus pneumoniae (32,6%), Klebsiella pneumoniae (21%) et Staphylococcus aureus (13,9%). Negative Gram bacteries represented 53.5% of isolated germ and Acinetobacter was found only with HIV positive patients. The streptococcus was sensitive to association amoxicilline + clavulanic in 91.7% of the cases, to ceftriaxone in 83.3% of cases, to ampicilline and to amoxicilline in 66.7% of cases The clinical evolution of our patients was favorable in 74.5% of the cases with 21.8% deaths. The evolution was more significant within alcoholic patients (p = 0.001) as well as tobacco addicted patients (p = 0.02). CONCLUSION: The high morbi-morbidity due to acute pneumopathy could be improved through a better awareness and regular updating of local bacterial ecology.

[Antenatal transmission of hepatitis B virus in an area of HIV moderate prevalence, Burkina Faso]. / Transmission anténatale du virus de l'hépatite B en zone de prévalence modérée du VIH, Ouagadougou, Burkina Faso.

The aim of this study was to assess antenatal transmission of hepatitis B virus in a context of moderate prevalence of HIV in Burkina Faso. Among 360 counselled pregnant women for HIV and HBV testing, 307 were voluntarily enrolled at their last antenatal clinic at the university hospital, in Ouagadougou. Blood samples were collected from all the 307 mothers and tested for HBsAg, HBeAg and antibodies to HIV Blood samples were collected from 313 newborns in the 24 hours after birth and screened for HBV Data from mothers and newborns were collected and analysed using the EPI Info 2002 software. Values for p < 0.05 were considered statistically significant. HBsAg were found in 35 (11.4%) mothers, including 7 with HBeAg and 6 co-infected by both HIV and HBV. Seven babies born to 13 carrier mothers for HBsAg and HBeAg had HBsAg versus 6 born to 22 HBsAg carrier mothers HBeAg-negative. HBsAg was detected in 4 babies born to 6 HIV/HBV co-infected mothers versus 9 born to 29 mothers with HBsAg and HIV-negative. HIV infection, HBeAg and mothers excision were significantly associated with mother-to-child transmission (MTCT) of HBV (p < 0.02). HBV antenatal transmission was important in Ouagadougou and it occurred 2.5 folds more from HIV coinfected mothers than in HIV-negative mothers to newborns. These results showed the need of the implementation of national programme for HBV screening and immunisation in Burkina Faso.

[Evaluation of the acid-fast bacilli gradations before and after treatment of the expectorations by sodium hypochlorite [corrected] in the tuberculosis diagnosis]. / Evaluation de la densité bacillaire avant et après traitement des expectorations par l'hypochlorite de sodium dans le diagnostic de la tuberculose.

To assess the impact of the sputum samples treatment by sodium hypochloride (NaOCl) 5% on the acid-fast bacilli (AFB) gradations in the tuberculosis diagnosis, 516 sputum samples were collected in 244 patients. The sputum smears made before and after expectorations treatment with NaOCl 5%, were stained by Ziehl-Neelsen hot method. The values obtained from the two microscopic readings were compared by using the chi2 test of McNemar. The statistical significance was set at p < 0.05. The results obtained before using NaOCl 5% showed that 357 samples were negative, while 41 were AFB scanty (gradation 1-9), 28, 40 and 50 were positive 1+, 2+ and 3+. After treatment, among 357 AFB negative expectorations, 14 (3.9%) were AFB-positive, while the AFB gradation increased for 77 (48.4%) in the 159 positive specimens. The two microscopic readings differ significantly (p = 0.001). The application of the process on a routine basis in the laboratory will require a reorganization of the tasks in order to give back the results to the patients in time. It is necessary to take into account the aspect of the samples.

Drug resistance of Mycobacterium tuberculosis complex among newly diagnosed tuberculosis cases in Burkina Faso.

BACKGROUND: In Burkina Faso, there is no recent data about the level of drug resistance in Mycobacterium tuberculosis strains among newly diagnosed tuberculosis cases. OBJECTIVE: To provide an update of the primary drug resistance of mycobacterium tuberculosis among patients in Burkina faso. METHODS: Mycobacterium strains were identified in 323 newly diagnosed tuberculosis patients between April 2005 and September 2006, and their susceptibility to isoniazid, rifampicin, streptomycin, and ethambutol was determined according to the proportions method. Among these patients, 243 accepted voluntarily to be tested for antibodies to HIV. RESULTS: The age range of the patients was 11 and 75 years and included 221 (68.4%) males and 102 (21.6%) females. The isolates included 314 (97.2%) M. tuberculosis, eight (0.3%) M. africanum and one M. bovis. Thirty-nine (12.4%) of the M. tuberculosis strains were resistant, with 7.3% resistant to one drug, 2.9% to two drugs, 0.3% to three drugs and 1.9% to four drugs. In total 3.2% of the isolates were multidrug-resistant (MDR). One isolate of M. africanum was resistant to all drugs while the single strain of M. bovis was sensitive to all the drugs. Among the 243 patients tested for HIV 77 were positive. However, there was no relationship between drug resistance and gender, age group or HIV serostatus of the patients. CONCLUSION: The resistance rate of M. tuberculosis strains to all the four drugs tested (12.4%) and the rate of MDR (3.2%) are high. These results demand an increased effort by the National Tuberculosis Program to limit the spread of MDR strains of tuberculosis.

[Salmonella meningitis in Ouagadougou, Burkina Faso, from 2000 to 2004]. / Méningites dues à Salmonella au CHU de Ouagadougou, Burkina Faso (2000-2004).

56 strains of Salmonella were isolated from the cerebro-spinal fluids (CSF) from meningitis suspected patients at the Yalgado-Ouédraogo University hospital center in Burkina Faso, from January 2000 to December 2004. 75% of the patients were less than 3 years old; 71.4% of the CSF were purulent, with an average of 523 leucocytes/mm3 and 78% of neutrophile polynuclears. The strains identified belonged mostly to Salmonella O: 4.5 group (51.8%). In vitro, 92.7% of the strains were resistant to ampicillin and this resistance was partially restored with amoxicillin/clavulanic acid; however no strain was resistant to ceftriaxone. For the overall 56 patients, 20 different antibiotherapy regimes were used and they were successful in only 27% cases while 71% of patients died and 2% escaped from the hospital. Neurologic sequels were found in a patient treated with both ceftriaxone and chloramphenicol. These results showed that the illness occurred mainly in infants and was associated with high mortality rate. Most of the Salmonella strains were multi-drug resistant. In spite of strains multi-antibiotics resistance, adequate definition of therapeutic lines and early treatment including ceftriaxone could lead to higher cure rates and may improve the outcome.