Prevalence, antibiotic resistance, and virulence gene profile of Escherichia coli strains shared between food and other sources in Africa: A systematic review.

Background and Aim: Foodborne diseases caused by Escherichia coli are prevalent globally. Treatment is challenging due to antibiotic resistance in bacteria, except for foodborne infections due to Shiga toxin-producing E. coli, for which treatment is symptomatic. Several studies have been conducted in Africa on antibiotic resistance of E. coli isolated from several sources. The prevalence and distribution of resistant pathogenic E. coli isolated from food, human, and animal sources and environmental samples and their virulence gene profiles were systematically reviewed. Materials and Methods: Bibliographic searches were performed using four databases. Research articles published between 2000 and 2022 on antibiotic susceptibility and virulence gene profile of E. coli isolated from food and other sources were selected. Results: In total, 64 articles were selected from 14 African countries: 45% of the studies were conducted on food, 34% on animal samples, 21% on human disease surveillance, and 13% on environmental samples. According to these studies, E. coli is resistant to ~50 antimicrobial agents, multidrug-resistant, and can transmit at least 37 types of virulence genes. Polymerase chain reaction was used to characterize E. coli and determine virulence genes. Conclusion: A significant variation in epidemiological data was noticed within countries, authors, and sources (settings). These results can be used as an updated database for monitoring E. coli resistance in Africa. More studies using state-of-the-art equipment are needed to determine all resistance and virulence genes in pathogenic E. coli isolated in Africa.

Hygiene practices of food of animal origin operators in primary schools in the Mono Department of Benin. A cross-sectional study.

Food of animal origin is an important source of proteins for human beings. However, they are subject to microbial contamination. It is essential to ensure the safety of food products intended for school children regarding their vulnerability to food poisoning. Good sanitary quality of these products requires the respect of good practices during their processing and distribution. This study aims to evaluate the conditions of processing and sale of food of animal origin to school children in public schools, with or without canteens, in the Department of Mono in southern Benin. In the Department of Mono in the Republic of Benin, 137 operators were interviewed in public schools, with one operator per school, using a questionnaire created on the Epicollect5 platform. The interview showed that the operators involved in the processing and sale of food to school children were women. Most of these operators had primary education and did not undergo a medical examination. They transported food of animal origin mixed with other types of food. Frying and cooking were used to prepare or process the food. Direct observation revealed that food is produced in an unhealthy environment. The operators did not wear gloves during food processing but some wore aprons. All the operators washed their hands with soap and water (tap or well water) after using the toilet. There was not an adequate handwashing facility. The majority of operators used wooden cutting boards. Overall, food operators especially in schools without a canteen do not follow good hygiene and manufacturing practices in the kitchen. To guarantee food safety for school children, training should be organized to make operators aware of good hygiene and manufacturing practices in kitchens.

Analysis of the optimal cut-point for HIV-p24 antigen testing to diagnose HIV infection in HIV-exposed children from resource-constrained settings.

BACKGROUND: Nucleic-acid-testing (NAT) to diagnose HIV infection in children under age 18 months provides a barrier to HIV-testing in exposed children from resource-constrained settings. The ultrasensitive HIV-p24-antigen (Up24) assay is cheaper and easier to perform and is sensitive (84-98%) and specific (98-100%). The cut-point optical density (OD) selected for discriminating between positive and negative samples may need assessment due to regional differences in mother-to-child HIV-transmission rates. OBJECTIVES: We used receiver operator characteristics (ROC) curves and logistic regression analyses to assess the effect of various cut-points on the diagnostic performance of Up24 for HIV-infection status among HIV-exposed children. Positive and negative predictive values at different rates of disease prevalence were also estimated. STUDY DESIGN: A study of Up24 testing on dried blood spot (DBS) samples collected from 278 HIV-exposed Haitian children, 3-24-months of age, in whom HIV-infection status was determined by NAT on the same DBS card. RESULTS: The sensitivity and specificity of Up24 varied by the cut-point-OD value selected. At a cut-point-OD of 8-fold the standard deviation of the negative control (NCSD), sensitivity and specificity of Up24 were maximized [87.8% (95% CI, 83.9-91.6) and 92% (95% CI, 88.8-95.2), respectively]. In lower prevalence settings (5%), positive and negative predictive values of Up24 were maximal (75.9% and 98.8%, respectively) at a cut-point-OD that was 15-fold the NCSD. CONCLUSIONS: In low prevalence settings, a high degree of specificity can be achieved with Up24 testing of HIV-exposed children when a higher cut-point OD is used; a feature that may facilitate more frequent use of Up24 antigen testing for HIV-exposed children.