[Susceptibility to antibiotics of Staphylococcus strains isolated in Ouagadougou, Burkina Faso]. / Sensibilite aux antibiotiques des souches de Staphylocoques isolees a Ouagadougou, Burkina Faso.

INTRODUCTION: The sensibility of bacteria in a general way decreased a lot, staphylococci present a resistance to the penicillin in more than 80% of the cases. The aim of our work was to determine the level of sensibility of staphylococci, particularly that of resistant Staphylococcus aureus to Meticilline (SARM). MATERIAL AND METHODS: It is a retrospective study concerning the profile of sensibility of the isolated strains of staphylococci of diverse pathological products.The antibiogramme was realized according to the classic technique and for the test in the oxacilline, the Mueller Hinton + 5% of NaCl was used. RESULTS: during the period of study 1296 strains of staphylococcus were isolated, 153 from hospital Staphylococcus aureus were little sensitive to the penicillin G (10%); however the oxacilline, the gentamicine and the erythromycine were very active (more than 80% of sensibility.The meticillino-sensitive Staphylococcus aureus were also sensitive to the gentamycine, erythromycine and ciprofloxacine; the character of meticillino resistant did not influence the activity of antibiotics as pristinamycin and the vancomycine (100%); however we note a resistance crossed with the erythromycine in more than 95% of the cases. CONCLUSION: the existence although weak of the strains meticillino resistant brings us to propose a regular surveillance of the SARM and to hold as active antibiotics of first line the pristinamycine, ciprofloxacine, gentamicine, with vancomycine as the alternative of last choice in a hospital environment.

[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.

[W135 meningococcus meningitis: study of 148 cases observed in 2002 and 2003 at the National Teaching Hospital of Ouagadougou, Burkina Faso]. / Méningites à méningocoque du sérogroupe W135: étude de 148 cas observes en 2002 et en 2003 au CHU-YO de Ouagadougou, Burkina Faso.

The purpose of this report is to describe the bacteriological features, clinical signs and therapeutic outcome of 148 cases of W135 meningococcus meningitis observed during meningitis outbreaks in Burkina Faso in 2002 and 2003. Diagnosis was based on microbiological study of cerebrospinal fluid. Cases of meningococcus meningitis were recorded throughout the study period with the peak number of cases occurring around the 14th week. There was a slight male predominance (56.1%) and young patients between one and 15 years accounted for 81.7% of cases. The mean interval between onset of symptoms and hospitalization was 2.6 days and the mean duration of hospitalization was 5.5 days. The most common clinical signs were fever (98.6%), stiff neck (90.5%),Brudzinski's sign (85.1%),Kernig's sign (66.2%), altered consciousness (41.9%), vomiting (36.5%) and headaches (34.5%). In most cases treatment with a singie dose of chiorazuphenicol in oil was curative. Overall mortality was 15.5% idth no correlation with sex or age. Seventeen of the 23 deaths occurred within 24 hours after their admission to the hospital. The other six deaths occurred on the second day after admission inS cases and fifth day in one case. Convulsions, shock and altered consciousness were consistent poor prognostic signs. A correlation was found between mortality and interval for hospitalization with better survival in patients receiving prompt treatment. Study of the susceptibility of 102 samples showed that W135 meningococcus was sensitive to penicillin G, ampicillin,ceftriaxone and chloramphenicol but resistant to sulfamides (cotrimoxazole). Bacterial meningitis is an Important factor of morbidity and mortality worldwide. Our findings indicate that the bacteriological, clinical and epidemiological characteristics of W135 meningococcus is do not differ greatly from those of meningococcus A. Since W135 meningitis is susceptible to antibiotics used to cure meningitis, campaigns to promote early detection and treatment must be continued.

[Evaluation of stool microscopy and culture to assist the diagnosis of pulmonary tuberculosis in a tuberculosis endemic country]. / Évaluation de la microscopie et de la culture des selles dans le diagnostic de la tuberculose pulmonaire dans un pays d'endémie tuberculeuse.

OBJECTIVE: the aim of this study is to evaluate the performance of stool microscopy and culture in the diagnosis of pulmonary tuberculosis (PTB). MATERIAL AND METHOD: In resource-limited settings, PTB is mainly diagnosed in sputum by microscopy methods. In patients unable to provide sputum, invasive procedures are necessary to obtain alternative respiratory tract specimens. Because Mycobacterium tuberculosis complex (MTC) organisms are known to survive in gastric fluid, we hypothesized that swallowed MTC organisms would be detectable in stool samples. We compared the presence of MTC organisms in sputum and stool specimens collected at the same time from the same patients. RESULTS: We included samples routinely submitted to our laboratory of microbiological diagnosis from patients with suspected PTB. In addition, a stool specimen was collected within 24 h of the sputum collection or gastric aspirate. In the 57 patients included, sputum microcopy and culture confirmed respectively 9 (21%) and 15 (26%) cases. Stool samples made it possible to confirm 9 cases by microscopy and 5 cases by culture. The sensitivity of microscopy was 60% and that of culture 33%. Sputum analysis was negative for one HIV-infected patient, but the stool sample was positive and permitted the diagnosis of PTB. CONCLUSION: This study proves that despite the low sensitivity of stool cultures it can be an alternative or additional interesting sample for the diagnosis of PTB in patients who have difficulty expectorating.

STR data for 11 autosomal STR markers from Costa Rica, Central America.

Allele frequencies for 11 STR autosomal loci (F13A01, F13B, FESFPS, LPL, CSF1PO, TH01, TPOX, VWA, D16S539, D7S820 and D13S317) were obtained from a sample of 200 unrelated individuals from Costa Rica, Central America.

Severe malaria in Burkina Faso: influence of age and transmission level on clinical presentation.

We analyzed the clinical presentation of 800 severe malaria cases six months to 15 years of age (mean +/- SD = 4.3 +/- 3.0) recruited at the pediatric ward of the Ouagadougou University Hospital, and at the Sourou and Nayala District Hospitals in Burkina Faso. Inclusion criteria followed the World Health Organization (WHO) definition of severe and complicated malaria. The children were treated according to WHO guidelines with a complete regimen of drugs that were provided free of charge as part of the study. The case fatality rate of each sign and symptom of severe malaria was calculated on the 686 children whose outcomes were known. A total of 95 patients (13.8%) died while in the hospital; the mean +/- SD age of these children was 3.2 +/- 2.1 years. The age distribution and the clinical patterns of severe malaria was compared in patients from the urban areas of Ouagadougou characterized by relatively low transmission, and from rural areas where the mean inoculation rates are at least 20-fold higher. The mean +/- SD age of the urban and rural patients was 4.8 +/- 3.0 and 2.2 +/- 1.9 years, respectively (P < 0.001). The prevalence of coma was higher in the urban subsample (53.6% versus 28.9%; P << 0.001) while that of severe anemia (hemoglobin < 5 g/dL) was higher in rural patients (47.4% versus 14.8%; P < 0.001). Our data, in line with previous results obtained comparing rural areas characterized by different inoculation rates, show that the epidemiologic context influences the clinical presentation of severe malaria.

Severe malaria in Burkina Faso: urban and rural environment.

The age distribution and the clinical patterns of severe malaria (SM) were compared in patients from urban areas characterized by relatively low transmission, and from rural areas where the mean inoculation rates are at least twenty fold higher. The mean age of the urban and rural patients was 4.8 +/- 3.0 and 2.2 +/- 1.9 respectively (p < 0.000). The prevalence of coma was higher in the urban subsample (53.6 vs 28.9%, p << 0.000) while that of severe anemia (hemoglobin < 5 g/dl) was higher in rural patients (47.4 vs 14.8%, p < 0.000). Our data, in line with previous results obtained comparing rural areas characterized by different inoculation rates, show that the epidemiological context influences the clinical presentation of SM.

[Helicobacter pylori infections in children in the tropical zone. Endoscopic and histological aspects]. / Infection à Helicobacter pylori chez l'enfant en zone tropicale. Aspects endoscopiques et histologiques.

AIMS: To assess the endoscopic and histological aspects of Helicobacter pylori (H. pylori) infection in children in a prospective study. PATIENTS AND METHODS: One hundred and four children (6 months-15 years old), with digestive symptoms admitted to the Pediatric Department of the National Hospital of Ouagadougou between February Ist and October 31 1996, underwent upper digestive endoscopy with fundic and antral biopsies for histological and bacteriological analysis. RESULTS: Endoscopy was normal in 80 cases (77%). No lesion was specific of H. pylori infection. Nodular gastritis was observed in 3% of the cases only. Duodenal ulcers were seen in 3 children (3%). 83% of the children had chronic antral gastritis, associates with H. pylori in 95% of the cases. The lesions were follicular gastritis (45%), mild atrophic gastritis (38.5%) and lymphocytic gastritis (1%). Follicular gastritis was more pronounced in the antrum than in the fundus. CONCLUSION: The high prevalence of early H. pylori infection and chronic gastritis in children contrasts with the rarity of gastric cancer in black Africa. Protective factors or peculiar strains should be searched for.

[Evolution of the demography of anesthesia practitioners in French speaking Sub-Saharan Africa]. / Evolution de la démographie des praticiens d'anesthésie en Afrique francophone au sud du Sahara.

OBJECTIVE: To assess the course of the demography of anaesthesia providers in French-speaking subsaharian countries. TYPE OF STUDY: Retrospective survey. PERSONS: Doctors trained in anaesthesia and nurse anaesthetists registered in West African medical societies. METHODS: Countries, hospitals, anaesthesia manpower, seniority and place of training were analysed. RESULTS: In the 13 French-speaking subsaharian countries including 97.5-M inhabitants, 122 doctors and 868 nurses were registered as anaesthetists in 1998. Mean ratios were one doctor trained in anaesthesia for 799,180 inhabitants and one nurse anaesthetist for 112,327 inhabitants. From 1980 to 1998, these figures increased by a factor 11 for doctors (+1100%) and by a factor two for nurses (+100%). Most doctors were working in the chief town, in both public and private health care institutions. CONCLUSIONS: In all French-speaking subsaharian countries, a major shortage of doctors trained in anaesthesia is existing.

[Pityriasis rosea in secondary schools in Ouagadougou, Burkina Faso]. / Pityriasis rosé de Gibert dans les écoles secondaires à Ouagadougou (Burkina-Faso).

BACKGROUND: Pityriasis rosea is a spontaneously regressive benign erythematous squamous dermatosis. A better understanding of this condition in developing countries would be useful. PATIENTS AND METHODS: We conducted a cross section study based on one-day surveys in Ouagadougou, Burkina Faso, secondary schools. The stratified cluster sampling method described by Henderson was used. Six thousand pupils were examined to collect epidemiology and clinical data and to determine the presence of complications and results of complementary explorations performed. RESULTS: Thirty-six cases of pityriasis rosea were observed (0.6 p. 100). Prevalence was higher in children from an unfavorable social and economic background. A typical eruption was often observed with classical localizations and morphology in 86.1 p. 100 of the cases. Pruritus was often observed with an inaugural lesion (61.1 p. 100) predominantly on the upper limbs (54.6 p. 100) and the trunk (31.8 p. 100) measuring 1 to 3 cm. A typical second eruption was found in most cases, situated on the trunk (75 p. 100), distal portions of the limbs (64.4 p. 100), proximal portions of the limbs (33.3 p. 100) and the neck (30.5 p. 100). The eruption evolved for 1 week to 1 month in most cases (61 p. 100). In 55.5 p. 100 of the cases, therapeutic abstention was the rule. Secondary treatment-related complications occurred in 38.9 p. 100 of the cases. Stool studies generally demonstrate ameba cysts. Syphilis serology was negative. DISCUSSION: Our sampling technique in the secondary school setting provided a representative sample of the urban population of African cities. This work demonstrated the variability of prevalence by social and economic conditions and is in favor of an infections cause, demonstrating several similar features with other series reported in the literature. Generally, a stool study is not necessary and syphilis serology is negative in typical cases. Health care workers should be more aware of pityriasis rosea in order to avoid poorly adapted treatment.

[Malignant keratoma]. / Kératome malin.

INTRODUCTION: Birth of an Harlequin fetus in an African maternity ward is an exceptional event. There is no question as to the diagnosis, but no treatment is available. CASE REPORT: A female infant was delivered with typical lesions of malignant keratoma. Death occurred 20 hours after birth. DISCUSSION: In countries with adequate intensive care facilities (hydration, acitretine), such infants may occasionally survive with the risk of developing major lamellar ichthyosis which remains a handicap for the rest of life. In Burkina-Faso, such therapeutic facilities are lacking as are means of antenatal diagnosis. The ethical question as to whether or not to attempt survival measures is quite different under these conditions.

[Laryngo-tracheo-bronchial foreign bodies in children at the University Hospital Center of Ouagadougou (analysis of 96 cases)]. / Les corps étrangers laryngo-trachéo-bronchiques chez l'enfant au CHU de Ouagadougou (une analyse de 96 observations).

Over a 10-year period, a series 96 patients were treated for laryngotracheal and bronchial foreign bodies in the ENT department of the Ouagadougou University Hospital Center (Burkina Faso). The purpose of this study was to analyze the epidemioclinical features and therapeutic pitfalls encountered in that series and to propose measures to improve management. The age of patients ranged from 10 months to 14 years. The male-female ratio was 1.7. Anamnesis documented foreign body aspiration was obtained in 77% of cases. The foreign body was organic in 78 cases (81.2%) including vegetal material in 56 cases. Management was delayed due to late diagnosis since only 59.3% of the patients were admitted to the hospital within the 48 first hours. Endoscopic removal was performed in all cases but such procedures remain challenging in developing countries due to a lack of proper anesthetic facilities, skilled personnel and adequate equipment. Tracheostomy was performed in 10.4% of cases mainly in patients with foreign bodies located in larynx. One patient died during extraction. In addition to providing more information and education on prevention of laryngotracheal and bronchial foreign bodies, better management requires better training of medical personnel and improvement of technical facilities.

[Pleuropulmonary staphylococcal infection in infants, in a hospital environment in Ouagadougou (Burkina Faso)]. / La staphylococcie pleuro-pulmonaire du nourisson en milieu hospitalier à Ouagadougou (Burkina Faso).

We observed 36 cases of pleuropulmonary staphylococcal infection (PPS) in infants aged 0 to 30 months, during a prospective study carried out between April 1st 1995 and March 31 1996 at the Pediatrics Department of Ouagadougou University Hospital. PPS accounted for 0.5% of all hospital admissions and 11.6% of all acute basal respiratory infections in children aged less than 30 months. Slightly more boys than girls were affected, with a sex ratio of 1.2. We identified the classic triad of symptoms: cough-fever-polypnea, associated with abdominal ballooning and a change in general condition. On X rays, the typical images showing parenchymatous bubbles were the second most frequent observation (27.8%) after parenchymatous opacities (69.5%). The most frequently used antibiotics were oxacillin (Bristopen), gentamycin (Gentallin) and cefuroxime-axetil (Zinnat). The prognosis of PPS is poor, with a high mortality rate (27.8%) and a risk of pleural recurrence. Being very young, late hospitalization, malnutrition and leukopenia were identified as factors indicating a poor prognosis. Recygling of health care personnel for the management of acute respiratory infections, a decrease in malnutrition and an improvement in vaccination cover are essential if the mortality and morbidity of acute respiratory infections, and PPS in particular, are to be reduced.

[Clinical signs of severe malaria in a pediatric hospital in Ouagadougou]. / Formes cliniques du paludisme grave en milieu hospitalier pédiatrique à Ouagadougou.

During the period of transmission of malaria, from August to November of 1993 and 1994, we conducted a study to determine the frequency of the clinical forms of severe and complicated malaria. The study involved children, from 6 months through 15 years old, admitted to the pediatric ward of the hospital in Ouagadougou, Burkina Faso. The criteria for inclusion followed the definition of severe malaria stated by the World Health Organization. We carefully noted the symptoms and signs on admission. Of the total of 719 children enrolled in the study, there was a prevalence of children under 5 years old. The most frequent clinical forms were those of coma (377 cases, 52.4%), prostration (268 cases, 37.3%), convulsion (152 cases, 21.4%), anemia (115 cases, 15.9%), and hypoglycemia (55 cases, 10.3%). No renal failure form was observed. We also observed the respiratory distress form (35 cases, 4.9%) and the hemorrhagic form (11 cases, 1.5%). Malaria remains a major cause of childhood morbidity and mortality in the developing world. Early therapeutic management of febrile attacks with chloroquine would reduce the incidence of severe and complicated malaria.

[Progressive noma: apropos of 27 cases seen at the National Hospital Center of Ouagadougou]. / Le noma évolutif: à propos de 27 cas observés au Centre Hospitalier National de Ouagadougou.

This retrospective study objects to report epidemiological profile, clinical display and take care of progressive noma at the National Hospital Center of Ouagadougou. We assign the term noma to the gangrenous gingivo-stomatitis occurring in a prone environment, leading in a few days into a sharp ulcer in the soft parts, accompanied by halitosis. This definition excludes noma like-lesions. 27 cases have been observed in the ENT department and the Paediatrics between 1991 and 1995. They were 17 boys and 10 girls aging between 2 and 8 years and most of them coming from families with modest income (76%). The consultation delay averaged 8 days. The research for associated pathologies showed 63% energizing and protein malnutrition. We only observed unilateral localisations and no case of extra-facial one. At the stage we received our patients, the gangrenous was formed and the aspect evoked noma right away. Quite a lot needs to be done for precocious diagnosis because it is at the beginning phase that best evolution is obtained. Even though no evidence of the responsibility of a specific pathogenic germ was established so far, nevertheless, the assumption that has more support remains that of a bacterial infection in a prone environment. The vital prognosis of the progressive noma appears to be much linked with intensive care and feeding again. The hope to see this poverty-linked pathology under control is essentially based on prevention: medical population information, medical personnel's awareness for early diagnosis and best take care of these patients, improvement of the living conditions of the people and the health care services.

[Evaluation of Vibrio cholerae isolation over 10 years in CHU Fann]. / Bilan de l'isolement de Vvibrio cholerae sur dix ans au CHU de Fann.

A retrospective study, concerning ten thousand five hundred and sixty five (10,565) stool samples examined from 1981 to 1990, was done at the Bacteriology Laboratory of Fann University Hospital, Dakar (Sénégal). One thousand and six hundred and eighty (1680) enteropathogen agents were detected (15.9%), five hundred ninety two (592) of which were vibrio cholerae. The quasi totality strains of the vibrio cholerae (99.8%) belonged to the Ogawa serotype; they were isolated mainly during the hot and raining season. Young male adults were the most infected. Most of the strains revealed sensitive to Sulfamids and Tetracycline.

[Etiology of vaginal infections in Ouagadougou (Burkina Faso)]. / Étiologies des infections vaginales à Ouagadougou (Burkina Faso).

OBJECTIVE: to determine the specific antimicrobial activity of the drugs proposed in the national algorithm for treatment of vaginal infections. METHOD: Over a three-month period, the bacteriological laboratory of the Yalgado-Ouédraogo University Hospital in Ouagadougou analyzed vaginal swabs from women seen at 5 health-care facilities in that city. RESULT: The study included 404 women with a mean age of 29 years. The microbes with the highest incidence rates were various species of Candida (20%), Gardnerella and/or Mobiluncus (18.8%), and Ureaplasma/Mycoplasma (10.9%). The agents isolated were highly susceptible to ciprofloxacin, erythromycin, fluconazole, miconazole, and nystatin. CONCLUSION: This study demonstrated the continuing efficacy of the drugs in the national algorithm for treatment of vaginal infections, which is associated with compliance with the recommended diagnostic procedure and therapeutic protocol.

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.

[Infectious Etiologies of the acute diarrheas of the child from 0 to 5 years at the Pediatric University hospital Charles de Gaulle (Ouagadougou, Burkina Faso)]. / Etiologies infectieuses des diarrhees aiguës de l'enfant de 0 a 5 ans au centre Hospitalier Universitaire Pediatrique Charles de Gaulle (Ouagadougou, Burkina Faso).

To identify the infectious agents responsible for acute diarrheas in children from 0 to 5 years, with the aim of improving care, we led a cross-sectional prospective study at the Pediatric University hospital Charles de Gaulle from January 1st - November 30th, 2009. A sample of 103 children's stools hospitalized for acute diarrhea was analyzed. The average age of the patients was of 9.5 months and the most affected age bracket was the one from 0 to 12 months. More than half of the cases of diarrheas (60.2%) had an infectious etiology of which 33% of viral origin, 21.4% bacterial, 9.7% parasitic and in 9.7% of the cases a co-infection. In the viral diarrheas, rotavirus was observed in 17.5% of the cases and serotypes adenoviruses 40, 41 in 15.5% of the cases. The isolated bacteria were essentially represented by enteropathogenic Escherichia coli (21 cases). This bacterium had a strong resistance to amoxicillin, cotrimoxazole (90%) as well as in the amoxicillin+Clavulanic acid (57%). The ascendancy of rotavirus in the etiology of the acute diarrheas of children from 0 to 5 years hints to a need for vaccination against this infectious agent. Aside from the ineffectiveness of group A penicillins and of the cotrimoxazole against most of the isolated bacteria calls to medical prescribers to reconsider antibiotic treatment in the diarrheas of the children.

Afin d'identifier les agents infectieux responsables des diarrhées aigues chez les enfants de 0 à 5 ans, dans le but de mieux les prendre en charge, nous avons mené une étude prospective transversale au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle du 01 janvier au 30 novembre 2009. Un échantillon de 103 selles d'enfants hospitalisés pour diarrhée aigue a été analysé. L'âge moyen des patients était de 9,5 mois et la tranche d'âge la plus touchée était celle de 0 à 12 mois. Plus de la moitié des cas de diarrhées (60,2 %) avaient une étiologie infectieuse dont 33% d'étiologie virale, 21,4 % bactérienne, 9,7% parasitaire et dans 9,7 % des cas il y avait une co-infection. Dans les diarrhées virales, les rotavirus ont été observés dans 17,5 % des cas et les adénovirus serotypes 40, 41 dans 15,5 % des cas. Les bactéries isolées étaient représentées essentiellement par Escherichia coli entéropathogène (21 cas). Cette bactérie avait une forte résistance à l'amoxicilline, au cotrimoxazole (90 %) ainsi qu'à l'amoxicilline+Acide clavulanique (57 %). La prépondérance du rotavirus dans l'étiologie des diarrhées aiguës de l'enfant de 0 à 5 ans commande la promotion de la vaccination contre cet agent infectieux. Par ailleurs l'inefficacité des pénicillines du groupe A et du cotrimoxazole contre la plupart des bactéries isolées interpelle les prescripteurs à la rationalisation de l'antibiothérapie dans les diarrhées des enfants.

Diarrhoeagenic Escherichia coli detected by 16-plex PCR in children with and without diarrhoea in Burkina Faso.

The importance of diarrhoeagenic Escherichia coli (DEC) in Africa is poorly understood, and is unknown in Burkina Faso. This study investigated the occurrence of five major DEC pathogroups in primary cultures of stool samples from 658 Burkinabe children under 5 years old using 16-plex PCR for virulence-associated genes. At least one DEC pathogroup was detected in 45% of 471 children with diarrhoea and in 29% of 187 children without diarrhoea (p <0.001). More than one DEC pathogroup was detected in 11% of children with and 1% of children without diarrhoea (p <0.001). Enteroaggregative E. coli was the most common pathogroup in both children with diarrhoea (26%) and children without diarrhoea (21%). Enteropathogenic E. coli and enterotoxigenic E. coli were detected significantly more often in children with diarrhoea (16% and 13%) than in children without diarrhoea (5% and 4%; p <0.001 for both pathogroups). Shiga toxin-producing E. coli and enteroinvasive E. coli were detected only in children with diarrhoea (2% and 1%, respectively). Diarrhoeagenic E. coli, especially enteropathogenic and enterotoxigenic, may be important, unrecognized causes of childhood diarrhoea in Burkina Faso.