Résistance aux antibiotiques des souches de staphylococcus aureus et des enterobactéries isolés au LNSP de Ouagadougou (Burkina Faso)

Le contexte africain est marqué par l'absence de réseau de surveillance de la résistance bactérienne aux antibiotiques. Des études indiquent pourtant des niveaux élevés de prévalence de Staphylococcus aureus résistant à la méticiline (SARM) et des Entérobactéries productrices de ß lactamases à spectre étendu (E-BLSE) dans les prélèvements provenant de patients hospitalisés ou en communauté. Le but de la présente étude est de décrire les phénotypes de résistances de Staphyloccocus aureus et des entérobactéries afin d'améliorer la prise en charge des maladies bactériennes. Il s'est agi d'une étude transversale réalisée du 10 Septembre 2014 au 10 Mars 2015, à partir des isolats de S. aureus et d'entérobactéries provenant de prélèvements biologiques reçus au Laboratoire National de Santé Publique (LNSP). La sensibilité aux antibiotiques des souches bactériennes a été réalisée selon les recommandations du Comité de l'Antibiogramme de la Société Française de Microbiologie (CA.SFM) 2014. La recherche de la résistance de S. aureus à la meticilline a été réalisée par l'oxacilline 5µg ; la sécrétion de ß Lactamase à Spectre Elargie (BLSE) a été confirmée après observation d'une image en « bouchon de champagne ». Au total, 665 échantillons ont été traités et 197 souches pathogènes, ont été identifiées dont 160 entérobactéries et 37 Staphylococcus aureus. Globalement, 32 % des Staphylococcus aureus étaient résistants à la méticiline. Toutes les souches étaient sensibles aux aminosides. Parmi les entérobactéries, 98,3 % des E. coli et 94,7 % de K. pneumoniae étaient résistantes à l'amoxicilline + acide clavulanique et 36,4 % de E. coli et 26,3 % K. pneumoniae présentaient une résistance aux céphalosporines de 3e génération. Les entérobactéries productrices de BLSE étaient de 35 %. L'imipenème restait actif sur 100 % des entérobactéries. Cette étude interpelle les autorités sanitaires à l'instauration d'un système de surveillance des pharmaco résistances et les agents de santé sur la promotion du bon usage des antibiotiques et les bonnes pratiques d'hygiène hospitalière

[Acute lymphoblastic leukemia among children in Ouagadougou (Burkina Faso): the results of treatment according to the protocol of the Franco-African Pediatric Oncology Group 2005]. / Les leucémies aiguës lymphoblastiques de l'enfant à Ouagadougou (Burkina Faso): résultats de la prise en charge selon le protocole du Groupe Franco-Africain d'Oncologie Pédiatrique 2005.

INTRODUCTION: acute lymphoblastic leukemia (ALL) is being diagnosed in an increasing number of children in our Department. In the developed countries, the treatment of this hematologic malignancy can cure almost 80% of children. In developing countries, few studies focus on acute leukemias in children. The results of cancer treatments in children are disappointing in most African countries, with a survival rate of 10-15%. This study aimed to investigate the clinical, biological, therapeutic and evolutionary features of ALL in children. METHODS: we conducted a retrospective study of the medical records of children hospitalized for ALL between November 2009 and October 2011 in the pilot Paediatric Oncology Unit at the Charles de Gaulle University Pediatric Hospital Center, Ouagadougou (Burkina Faso). All children treated according to the protocol of the Franco-African Pediatric Oncology Group 2005 (FAPOG) were included in the study. RESULTS: in total, nine children with ALL were hospitalized during the two year study period. The average age of patients was 10.77± 2.82 years. They were predominantly male. The average time of hospitalization was 43.11 days ± 39.54 days. The main symptoms were alteration of general state and fever. Nearly all the patients had tumor syndrome and bone marrow failure. Myelogram showed ALL type 1 in six of the nine patients. Eight patients underwent chemotherapy according the protocol of FAPOG 2005. Children's evolution was favorable in two patients who experienced remission, four patients had treatment failure. Six patients died. CONCLUSION: thanks to information campaigns, which will contribute to encourage early consultations, capacity-building measures for the medical staff allowing early diagnosis of ALL, the construction of a sufficiently equipped pediatric oncology center and a subsidy of anticancer drugs awarded by the state of Burkina Faso, the treatment of children with ALL would allow for better outcomes.

Rotavirus and norovirus in children with severe diarrhea in Burkina Faso before rotavirus vaccine introduction.

Burkina Faso introduced rotavirus vaccine (RotaTeq) to the national immunization program in November 2013. This study describes the detection rates, clinical profiles, and molecular epidemiology of rotavirus and norovirus (NoV) infections among children <5 years hospitalized (n = 154) because of acute diarrhea in Ouagadougou, Burkina Faso, from December 2012 to November 2013, just before the start of vaccination. Overall, 44% and 23% of fecal samples were positive for rotavirus and NoV, respectively, most of them detected during the cold dry season (December-March). The predominant G/P combinations were G12P[8] (47%) and G6P[6] (30%). G2P[4] (n = 3), G12P[6] (n = 3), and G6P[8] (n = 1) were also detected. Nearly all (94%) successfully genotyped NoV strains belonged to genotype GII.4. The predominance of rotavirus and NoV was noteworthy in the age group ≤6 months, with 67% rotavirus and 22% NoV, respectively. Vomiting was significantly more common among rotavirus-infected children. To conclude, this study shows high detection rates of both rotavirus and NoV in children with severe diarrhea in Burkina Faso just before the introduction of rotavirus group A vaccination. The results can be used for estimating the impact of rotavirus group A vaccination, which started in the end of 2013. Furthermore, this study shows that the G6P[6] rotavirus strains emerging in Burkina Faso in 2010 is now established as a regionally important genotype.

Epidemiology and molecular characterization of influenza viruses in Burkina Faso, sub-Saharan Africa.

BACKGROUND: The importance of influenza viruses in respiratory infections in sub-Saharan Africa has been historically overlooked, including in Burkina Faso. OBJECTIVES: This study therefore aimed at evaluating the prevalence and seasonal occurrence of influenza viruses in children under 5 years old, at risk of influenza-related complications, presenting with influenza-like illness (ILI) or severe acute respiratory infection (SARI). The study also aimed at identifying the periods with increased influenza transmission for vaccination recommendations in Burkina Faso. METHODS: From January 2014 to December 2015, ILI and SARI (2015 only) patients were recruited in six healthcare centers in Burkina Faso. Influenza A and B molecular detection and subtyping were performed. Clade clustering of a subset of A(H1N1)pdm09 and A(H3N2) strains was deduced by performing phylogenetic analyses on hemagglutinin gene sequences. Weekly surveillance data from FluNet (2011-2013; 2016) and this study (2014-2015) were used to identify periods of increased influenza activity. RESULTS: Influenza A and B viruses were detected in 15.1% (112 of 743) of ILI and 6.6% (12 of 181) of SARI patients. Overall, influenza A viruses were largely predominant (81 of 124, 65.3%), with 69.1% of A(H3N2) and 30.9% of A(H1N1)pdm09 strains. Four waves of increased transmission were identified in 2014-2015, each dominated by different influenza subtypes and clades. Between 2011 and 2016, periods of increased influenza activity varied in their frequency, duration, and timing. CONCLUSION: Influenza A and B viruses were detected in a substantial number of ILI and SARI cases in Burkina Faso. Vaccination in September-October would likely protect the highest number of patients.

[Major sickle cell syndromes and infections associated with this condition in children in Burkina Faso]. / Syndromes drépanocytaires majeurs et infections associées chez l 'enfant au Burkina Faso.

INTRODUCTION: This study aims to investigate infections in children with major sickle cell syndrome. METHODS: We conducted a monocentric descriptive retrospective hospital study in Ouagadougou, Burkina Faso, over a ten-year period. All children with major sickle cell syndrome (homozygous SS and double heterozygous SC, SDPunjab, Sß thalassemic, SOArab and SE) hospitalized for microbiologically confirmed infections were enrolled in the study. RESULTS: One hundred and thirty-three patients met our inclusion criteria. The SS phenotype accounted for 63.2% of cases and SC 36.8%. The frequency of infections was 21.8%. In 45.9% of cases, these affected children aged 0-5 years. The most frequent signs were osteoarticular pain (42.1%), cough (25.7%), abdominal pain (23.3%), pallor (43.6%). The major diagnoses were bronchopneumonia (31.6%), malaria (16.5%), osteomyelitis (12.8%) and septicemia (10.5%). The isolated pathogenic organisms were Streptococcus pneumoniae (35.5%) and Salmonella spp (33.3%). Third generation cephalosporins were the most commonly prescribed antibiotics. Gros mortality rate was 7.5%. CONCLUSION: Bacterial infections and malaria dominate the clinical picture of infections in children with major sickle cell syndrome at the at the Pediatrics University Hospital Center Charles De-Gaulle. This study highlights the importance of establishing a national program for the management of sickle-cell anemia, which could help prevent or reduce the occurrence of infections in children with sickle cell syndrome.