Molecular detection of antimicrobial resistance genes in multidrug-resistant Gram-negative bacteria isolated from clinical samples in two hospitals in Niger

Background: According to the World Health Organization (WHO), bacterial resistance to antibiotics is a global public health challenge, which is also developing in Niger. The aim of this study was to determine the prevalence of antibiotic resistance genes in Gram-negative bacilli isolated from clinical samples in the biological laboratories of two selected health facilities in Niger. Methodology: Clinical bacterial isolates were randomly collected from two biological laboratories of Zinder National Hospital and Niamey General Reference Hospital. These were multi-resistant Gram-negative bacteria that have been routinely isolated from pathological samples of patients. Molecular detection of resistance genes was carried out by polymerase chain reaction (PCR) amplification using specific primers. These include plasmid-mediated AmpC beta lactamase genes (blaCITM, blaDHAM, blaFOXM), 'Cefotaxime-Munich' type beta lactamase genes (blaCTX-M-1, blaCTX-M-2, blaCTX-M-9), KPC-type beta lactamase gene (blaKPC), Oxa-type beta lactamase gene (blaOXA-48), SHV-type beta lactamase gene (blaSHV), TEM-type beta lactamase gene (blaTEM), quinolone resistance genes (qnrA, qnrB, qnrS), and sulfonamide resistance genes (sul1, sul2, sul3). Results: A total of 24 strains of multidrug-resistant Gram-negative bacteria isolated from different clinical samples were analysed. The distribution of the resistance genes detected is as follows; AmpC blaCITM (n=6; 25.0%), AmpC blaDHAM (n=4; 17.0%), AmpC blaFOXM (n=0), blaCTX-M-1 (n=11; 46.0%), blaCTX-M-2 (n=0), blaCTX-M-9 (n=0), blaKPC (n=0), blaOXA-48 (n=2; 8..0%), blaSHV (n=5; 21.0%), blaTEM (n=0), qnrA (n=0), qnrB (n=5; 21.0%), qnrS (n=17; 71.0%), sul1 (n=22; 92.0%), sul2 (n=12; 50.0%), and sul3 (n=0). All isolates tested had at least two resistance genes. Conclusion: The results of this study provide a better understanding of the resistance situation of clinical isolates in Niger. Therefore, it is more than necessary to intensify the detection on a larger number of samples and on a national scale. This will make it possible to assess the true extent of the phenomenon and consequently guide control strategies through a national multisectoral plan.

[Prevalence of cryptosporidiosis in pediatric hospital patients in Niamey, Niger]. / Prévalence de la cryptosporidiose en milieu hospitalier pédiatrique à Niamey, Niger.

No data has been published, so far about the prevalence of cryptosporidiosis among children in Niger; a landlocked country of West Africa where malnutrition and diarrhoea are two major public health issues. The aim of the present study was to get a first evaluation of the prevalence of Cryptosporidium sp in the stools of hospitalized children in the National Hospital of Niamey (NHN) where we carried out a prospective descriptive study involving all children younger than 5 years of age in the paediatric department between February 21st and May 22nd, 2004. Direct stool examination and Ritchie technique were systematically performed, and evidence of Cryptosporidium oocysts was looked for by means of a smear from the sediment which was stained by the modified Ziehl-Neelsen technique. The weight/age ratio was calculated and analyzed with the Epi-Info software, based on the reference population defined by the US National Center for Health Statistics (NCHS). Malnutrition was defined as a weight/age ratio more than 2 SD below the NCHS's reference population. Malnutrition was considered moderate between -2 and -3 SD and severe below 3 SD. In the 3 months study 220 children were included (sex ratio = 1.18 and mean age = 20 months) showing that 65% of the children were suffering from malnutrition (moderate = 17.3%, severe = 47%). Diarrhoea was reported in 51.8% of the children. Cryptosporidium oocysts were detected in 12/220 children (5.5% of the studied population) and 7/114 (6. 1%) of those children were suffering from diarrhoea. 10 (83%) out of the 12 infected children were malnourished. This was the first study ever conducted in the paediatric department of the Niamey hospital, and it showed evidence of a 5.5% prevalence of cryptosporidiosis in the overall studied population, versus 6.1% among children with diarrhoea. 5 children without diarrhoea and 2 children under 6 months were also infected. Another study based on a larger number of patients would be necessary to address the impact of rainfall distribution on the incidence of the disease.

Effect of iron supplementation on the iron status of pregnant women: consequences for newborns.

We studied the effect of iron supplementation on the iron status of mothers and on biochemical iron status and clinical and anthropometric measures in their infants. The subjects were 197 pregnant women selected at 28 wk +/- 21 d of gestation at a mother-and-child health center in Niamey, Niger. Ninety-nine women received 100 mg elemental Fe/d throughout the remainder of their pregnancies and 98 received placebo. The prevalence of anemia and iron deficiency decreased markedly during the last trimester of pregnancy in the iron-supplemented group but remained constant in the placebo group. Three months after delivery, the prevalence of anemia was significantly higher in the placebo group. At delivery, there were no differences between the two groups in cord blood iron variables. Three months after delivery, serum ferritin concentrations were significantly higher in infants of women in the iron-supplemented group. Mean length and Apgar scores were significantly higher in infants with mothers in the iron group than in those with mothers in the placebo group.

[Current aspects of malarial chemoresistance of subjects autochthonous in the OCCGE countries (West Africa)]. / Point actuel sur la chimiorésistance du paludisme des sujets autochtones dans les états de l'OCCGE (Afrique de l'Ouest).

Within the context of the monitoring of malaria drug resistance in the countries of the OCCGE, a workshop has been organized in order to sum up the surveys carried out by the national teams. For active or passive monitoring mainly the in vivo tests have been used. The native population, mainly school children, was studied. Chloroquine resistance was detected in 1987 in Benin, and in the same year in Togo and Côte d'Ivoire. During 1988 it appeared in Senegal and Burkina Faso, in 1989 in Niger and in 1990 in Mali. Only Mauritania is as yet free of resistance. The main features of this resistance are described. It is above all parasitological and on average its rate is less than 30%.

Situation de la chimioresistance du paludisme dans les Etats membres de l'OCCGE de 1991 a 1994

La chimioresistance du paludisme depuis son apparition dans les pays de l'OCCGE vers la fin des annees 1980 fait l'objet d'une surveillance organisee en reseau sous la coordination du CRCP (Centre de Reference de la Chimioresistance du Paludisme). La situation de la chimioresistance du paludisme dans ces pays de 1991 a 1994 a ete dressee a la suite des ateliers de 1993 et 1995