In vitro susceptibility of Candida albicans clinical isolates to eight antifungal agents in Ouagadougou (Burkina Faso).

INTRODUCTION: In recent years, the infection Candida albicans infection worldwide has risen, and the incidence of resistance to traditional antifungal therapies is also increasing. The aim of this study was to evaluate in vitro susceptibility of C. albicans clinical isolates to eight antifungal agents in Ouagadougou. MATERIALS AND METHODS: A cross-sectional study was conducted from January 2013 to December 2015 at Yalgado Ouédraogo University Teaching Hospital. Two hundred seven strains have been isolated from 347 symptomatic patients received in different clinical services. Samples were cultured on Sabouraud Dextrose Agar supplemented with Cloramphenicol. Isolates were diagnosed as C. albicans using germ tube test, chlamydospore formation on Corn Meal Agar, and Api-Candida test (Biomérieux). Antifungal susceptibility testing was performed by disk diffusion method and isolates classified as susceptible, susceptible dose-dependent and resistant. RESULTS: Three hundred forty-seven (347) patients are included in this study. Two hundred and six (206) out of 347 collected samples (59.36%) were found positive for C. albicans. The strains were mostly isolated from vulvovaginal (49%) and oral infections (40.3%). The highest resistance rates of azoles were obtained with fluconazole (66.5%), itraconazole (52.3%) and ketoconazole (22.9%) when all clinical isolates were included. The resistance rates of fluconazole, itraconazole and ketoconazole remain highest for vulvovaginal and oral isolates. The rate of resistance to the polyene amphotericin B was 32.0% for all clinical isolates and was 56.4% for vulvovaginal strains. Resistance rate to nystatin was 6.3% for all clinical isolates. Cross-resistance analysis with data of all clinical strains revealed that the incidence of resistance to ketoconazole and itraconazole in fluconazole-resistant isolates was significantly higher than recorded for fluconazole-susceptible isolates. CONCLUSION: In vitro C. albicans antifungal susceptibility test in this study showed relatively high resistance to commonly and widely used azoles (fluconazole, ketoconazole). Most C. albicans clinical isolates were susceptible to nystatin.

Anti-Candida albicans natural products, sources of new antifungal drugs: A review.

INTRODUCTION: Candida albicans is the most prevalent fungal pathogen in humans. Due to the development of drug resistance, there is today a need for new antifungal agents for the efficient management of C. albicans infections. Therefore, we reviewed antifungal activity, mechanisms of action, possible synergism with antifungal drugs of all natural substances experimented to be efficient against C. albicans for future. METHODS: An extensive and systematic review of the literature was undertaken and all relevant abstracts and full-text articles analyzed and included in the review. REVIEW: A total of 111 documents were published and highlighted 142 anti-C. albicans natural products. These products are mostly are reported in Asia (44.37%) and America (28.17%). According to in vitro model criteria, from the 142 natural substances, antifungal activity can be considered as important for 40 (28.20%) and moderate for 24 (16.90%). Sixteen products have their antifungal activity confirmed by in vivo gold standard experimentation. Microbial natural products, source of antifungals, have their antifungal mechanism well described in the literature: interaction with ergosterol (polyenes), inhibition 1,3-ß-d-glucan synthase (Echinocandins), inhibition of the synthesis of cell wall components (chitin and mannoproteins), inhibition of sphingolipid synthesis (serine palmitoyltransferase, ceramide synthase, inositol phosphoceramide synthase) and inhibition of protein synthesis (sordarins). Natural products from plants mostly exert their antifungal effects by membrane-active mechanism. Some substances from arthropods are also explored to act on the fungal membrane. Interestingly, synergistic effects were found between different classes of natural products as well as between natural products and azoles. CONCLUSION: Search for anti-C. albicans new drugs is promising since the list of natural substances, which disclose activity against this yeast is today long. Investigations must be pursued not only to found more new anti-Candida compounds from plants and organisms but also to carried out details on molecules from already known anti-Candida compounds and to more elucidate mechanisms of action.

Morbidité et mortalité de l'infection à virus de l'immunodéficience humaine chez l'enfant en milieu hospitalier à Ouagadougou (Burkina Faso)

Introduction : La pandémie de l'infection à virus de l'immuno-déficience humaine demeure une préoccupation majeure dans notre pays, menaçant l'atteinte des objectifs du millénaire pour le développement. Notre étude avait pour objectif d'analyser les aspects épidémiologiques, cliniques et évolutifs des enfants infectés par le virus de l'immunodéficience humaine et sous anti-rétroviraux dans un pays en développement. Patients et méthodes : Il s'est agi d'une étude transversale réalisée du 1er avril au 31 décembre 2010 chez des enfants suivis au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou. Résultats : Nous avons observé 27 enfants dont 26 infectés par le VIH type 1 soit 0,87% des hospitalisations, avec un sex-ratio de 1,25 et un âge moyen de 6,75 ans ; 30% des patients avaient un recul de plus d'un an sous traitement antirétroviral et un seul patient était sous un régime de 2ème ligne. Les principaux motifs d'hospitalisation rapportés étaient : les signes digestifs (67%), la fièvre (55%) et les signes respiratoires (26%). Les pathologies observées étaient surtout d'ordre infectieux (60%), dominées par le sida pédiatrique (33%), le paludisme (15%) et la méningite (11%). Dans 72,5% des cas, l'évolution clinique a été favorable ; 18,5% de décès ont été observés avec 2/3 (75%) de nourrissons. Les principaux facteurs associés au décès étaient les stades cliniques 3 et 4 de la maladie (p < 0,02). Conclusion : La morbidité et la mortalité liées au VIH pédiatrique restent élevées dans les pays à ressources limitées, malgré les traitements antirétroviraux. L'amélioration de cette situation passe par le renforcement des mesures de prévention de la transmission mère enfant du virus de l'immunodéficience humaine

[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.

[Prevalence of anti-CMV antibodies in blood donors in Ouagadougou (Burkina Faso)]. / Prévalence des anticorps anti-cytomégalovirus chez les donneurs de sang de Ouagadougou (Burkina Faso).

The aim of our study was to investigate the prevalence of CMV antibodies among blood donors at a regional blood transfusion center in Ouagadougou. Blood collected from 115 donors was tested for specific anti-CMV antibodies as well as routine markers. The donors ranged in age from 18 to 53 years (mean: 28.78 ± 8.9 years), and 72.2% were men. In all, 4.3% were positive for HIV, 12.2% for HBs Ag, 2.6% for HCV, and 1.7% for syphilis. Nearly all donors (n=106, 92.2%) had CMV IgG antibodies, but only 12.2% (n=14) IgM antibodies, and all of the latter were also positive for IgG. CMV infection was not related to the donors' HIV status (p=0.66). The seroprevalence of CMV infection was not statistically related to gender, age or occupational status. There was no significant difference in the prevalence of any routine markers between donors positive and negative for CMV. The high rate of CMV antibodies indicates that CMV infection is widespread in Burkina Faso. Although it is thus unnecessary to test blood donors routinely for CMV, immunodepressed and other risk subjects should receive CMV-negative or leukocyte-depleted blood.

[Prevalence and risk factors associated with infection by human immunodeficiency virus, hepatitis B virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso]. / Prévalences et facteurs associés aux infections a Virus de l'Immunodéficience Humaine et virus de l'épatite B, a la syphilis et a la tuberculose pulmonaire bacillifère en milieu carcéral au Burkina Faso.

This purpose of this study was to determine prevalences and risk factors associated with infection by human immunodeficiency virus, hepatitis B Virus, syphilis and bacillary pulmonary tuberculosis in prisons in Burkina Faso. From February 20 to March 20, 2009, 300 prisoners over 18 years of age held in Ouagadougou were selected to take part in this descriptive and analytical cross-sectional study. Sociodemographic data, confinement information (number, motive and prison time), medical history, substance addiction (alcohol, tobacco, drug), and the other risk behaviors (sexual relations, type of partners, sharing of toiletries or razor) were compiled for each prisoner. Serological tests were performed to detect anti-HIV antibodies, Hbs antigen, and anti-treponema antibody. In prisoners presenting signs of tuberculosis, BAAR detection was performed by direct examination of sputum. Men represented 95% of the study population. Median age was of 30.1 +/- 8.9 years (range, 18 and 63). The prevalences of HIV infection, Hbs antigen and positive syphilitic serology were 5%, 27.3% and 5.7% respectively. Four prisoners (1.3%) had bacillary pulmonary tuberculosis. Two prisoners reported homosexual intercourse and 44 reported drug abuse. Sharing of toiletries and razor blades was reported by 18.7% and 20% of the prisoners respectively. Immediate measures are needed reduce the spread of these infections in prisons in Africa.

[Effectiveness of a polymerase chain reaction using seminested and multiplex strategy for the identification of the three main bacteria responsible for meningitis in Burkina Faso]. / Efficacité d'une technique de réaction de polymérisation en chaîne (seminested et multiplex) pour l'identification des trois principales espèces bactériennes responsables de méningites au Burkina Faso.

A prospective study (from August 2006 to April 2007) was carried out with 214 cerebrospinal fluid samples with suspicion of bacterial meningitis. The aim of the study was to assess the effectiveness of the simultaneous detection of Neisseria meningitidis, Streptococcus sp. and Haemophilus influenzae using seminested polymerase chain reaction strategy. Among the 214 samples tested by both PCR and culture, the overall confirmation rate was 64% for PCR and 40.1% for culture (P = 2 x 10⁻6). Taking culture method as the standard reference, the overall sensitivity of PCR was 98.8% and specificity, 59.4%. The sensitivity of PCR was 100, 97.3 and 100% respectively for N. meningitidis, Streptococcus sp. and H. influenzae with respective specificities of 70, 93.2 and 97.2%. In conclusion, the seminested PCR strategy is a sensitive method and it can be implemented in the reference public health laboratories for an exhaustive microbiological surveillance of bacterial meningitis.

[Failure of first-line antiretroviral therapy in HIV-infected children in Ouagadougou, Burkina Faso]. / Echecs du traitement antirétroviral de première ligne chez les enfants infectés par le VIH à Ouagadougou (Burkina Faso).

Approximately one-fourth of the estimated 10,000 HIV-infected children in Burkina Faso are undergoing antiretroviral (ARV) therapy. At the Charles de Gaulle Pediatric Hospital Center in Ouagadougou, Burkina Faso, Support for ARV therapy began in July 2003 and a total of 250 children were undergoing treatment in late 2007. The purpose of this retrospective case-control study conducted over a period of 54 months from July 2003 to December 2007 was to investigate cases involving failure of first-line ARV therapy in particular with regard to cause. All patients (n = 32) showing poor virological, immunological, and/or clinical response to ARV therapy were considered as failures and thus included in the case group. The control group (n = 160) consisted of patients with good responses to treatment. Cases and controls were compared using the Chi-square test and odds ratio (OR) technique with a confidence interval at 95%. The failure rate was 12.8%. Failure was significantly correlated with low socioeconomic level (OR = 3), orphan status (OR = 4), age over 10 years (OR = 5), male gender (OR = 3), baseline viral load > or = 1,000,000 copies/mL (OR = 9), and poor compliance (OR = 37). Mortality in children who failed to respond to first-line ARV therapy was 25% due to the unavailability of a national second-line ARV therapy program. This study underlines the need for patient education to promote compliance and for creation of reference centers to prescribe ARV therapy to HIV-infected children including second-line ARV and genotyping.

[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.

[From genomics to surveillance, prevention and control: new challenges for the African meningitis belt]. / Ceinture africaine de la méningite: de la génomique aux stratégies de surveillance, de lutte et de prévention.

An international conference was held in Niamey, Niger, in November 2005. It aimed at reviewing the current situation in the meningitis belt. This region stretches from Senegal to Ethiopia and is characterized by high levels of seasonal endemicity with large epidemics of meningococcal meningitis occurring cyclically, generally caused by N. meningiditis serogroup A. WHO currently recommends a reactive strategy based on rapid detection of epidemics, intervention with antibiotics to treat cases and mass vaccination with a meningococcal polysaccharide vaccine to halt the outbreak. Epidemiological patterns of the disease in Africa have been changing with the occurrence of outbreaks outside the meningitis belt and with the emergence of serogroup W135, which first caused an epidemic among Hajj pilgrims in 2000 and then a large-scale meningitis outbreak in Burkina Faso in 2002. Consequently enhanced laboratory surveillance and confirmation of the strain responsible for the outbreak are required. New rapid dipstick tests have been developed through a collaboration between Institut Pasteur and CERMES. They are designed for bedside diagnosis and detect meningococcal antigens present in CSF using immunochromatography. The treatment of meningococcal meningitis during epidemics is based on short-course, long-acting oily chloramphenicol. An alternative is the use of ceftriaxone, which is equally effective and can be used in pregnant women and infants. A low-cost, monovalent serogroup A meningococcal conjugate vaccine for large-scale use in Africa is under development. In spite of the emergence of W135 strains in the meningitis belt, N. meningiditis A continues to be the principal strain isolated during the epidemic seasons and elimination of outbreaks of N. meningiditis serogroup A can still be considered as the primary objective of a preventive vaccination strategy.

Molecular characteristics of Neisseria meningitidis strains isolated in Burkina Faso in 2001.

In the course of an epidemic of meningitis in Burkina Faso in 2001, 27 cerebrospinal fluid samples from patients in 7 districts were forwarded to Norway for isolation and characterization of the causative agents. Neisseria meningitidis was isolated from 13 (48%) samples. The isolates were analysed using serological and genetic methods. Of the 13 strains, 4 were serogroup A, serotype 21:P1.9, sequence type (ST)-5 and belonged to clonal subgroup III, while the remaining 9 strains were serogroup W135, serotype 2a:P1.5,2, ST-11 and belonged to the electrophoretic type-37 complex. PCR analyses revealed meningococcal DNA in 13/14 culture-negative samples. Sequence analysis of the PCR products demonstrated that at least 3 different meningococcal strains were responsible for these 13 cases. Our results show that the W135 strain associated with the 2000 hajj (Muslim pilgrimage) outbreak was a significant cause of disease in Burkina Faso in 2001. Further studies are warranted to determine whether W135 is about to replace serogroup A in sub-Saharan Africa.

Serological diagnosis of human immuno-deficiency virus in Burkina Faso: reliable, practical strategies using less expensive commercial test kits.

Reported are the results of a cross-sectional survey in Burkina Faso to identify reliable, practical strategies for the serological diagnosis of HIV-1 and/or HIV-2 infections, using less-expensive commercial test kits in various combinations, as an alternative to the conventional Western blot (WB) test, which costs US$ 60. Serum samples, collected from blood donors, patients with acquired immunodeficiency syndrome (AIDS) and pregnant women, were tested between December 1995 and January 1997. Twelve commercial test kits were available: five Mixt enzyme-linked immunosorbent assays (ELISA), three Mixt rapid tests, and four additional tests including monospecific HIV-1 and HIV-2 ELISA. The reference strategy utilized a combination of one ELISA or one rapid test with WB, and was conducted following WHO criteria. A total of 768 serum samples were tested; 35 were indeterminate and excluded from the analysis. Seroprevalence of HIV in the remaining 733 sera was found to be 37.5% (95% confidence interval: 34.0-41.1). All the ELISA tests showed 100% sensitivity, but their specificities ranged from 81.4% to 100%. GLA (Genelavia Mixt) had the highest positive delta value, while ICE HIV-1.0.2 (ICE) produced the most distinct negative results. Among the rapid tests, COM (CombAIDS-RS) achieved 100% sensitivity and SPO (HIV Spot) 100% specificity. Various combinations of commercial tests, according to recommended WHO strategies I, II, III, gave excellent results when ICE was included in the sequence. The best combination of tests for strategy II, which achieved 100% sensitivity and specificity, was to use ICE and COM, the cost of which was US$ 2.10, compared with US$ 55.60 for the corresponding conventional strategy. For strategy III, the best combination, which achieved 100% sensitivity and specificity, was to use ICE, ZYG (Enzygnost Anti HIV-1/HIV-2 Plus) and COM, the cost of which was US$ 2.90 (19.2 times lower than the corresponding strategy requiring WB). No rapid test combination showed 100% sensitivity and specificity. Our results indicate that the serodiagnosis of HIV in Burkina Faso is possible by using reliable, less-expensive strategies which do not require Western blot testing. Moreover, there is a choice of strategies for laboratories working with or without an ELISA chain.

Aspect bacteriologique de la poussee meningitique de 1995 au Centre Hospitalier National Yalgado Ouedraogo (CHN-YO)de Ouagadougou; Burkina Faso

De janvier a mai 1995; les auteurs ont observe; comme chaque annee a la poussee de meningite qui s'est traduite par une augmentation sensible du nombre des hospitalisation au service des maladies infectieuses et en pediatrie. Au total 856 liquides cephalo-rachidiens ont ete soumis a un examen bacteriologique et cytologique. Cent trente-six (136) germes ont ete observes a l'examen microscopique direct; 93 souches bacteriennes isolees ont permis la realisation de 93 antibiogrammes. Des taux de sensibilite tres variables ont ete notes par rapport a l'Ampicilline; l'association Amoxicilline-acide clavulanique; au Chloramphenicol et au Sulfamethoxazoltrimethoprime. Les enfants de moins de 15 ans et les patients du sexe masculin ont ete les plus touches

Meningites purulentes a Neisseria meningitis Y: a propos de deux cas observes au Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) de Ouagadougou

Dans cette etude; les auteurs rapportent deux cas traites et gueris de meningite cerebro-spinale due au serotype Y de Neisseria meningitidis dans une region ou les methodes de diagnostic ne permettent de detecter que les antigenes A et C du meningocoque. Ils soulevent ainsi un probleme assez frequemment vecu dans les laboratoires africains qui n'arrivent pas souvent a faire une identification complete des souches becteriennes isolees. Ils soulevent egalement le probleme de vaccination qui est un probleme de sante publique dans la mesure ou les vaccins actuellement disponibles en Afrique ne protegent que contre les serotypes A et C de Neisseria meningitidis

Meningites a Salmonella a Ouagadougou; Burkina Faso: etude retrospective de 24 cas observes entre 1984 et 1993

"Les auteurs rapportent des aspects epidemiologiques relatifs a 24 cas de meningites a Salmonella diagnostiques entre 1984 et 1993 au laboratoire de Bacteriologie du Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) de Ouagadougou. 13 des 24 cas sont survenus chez des enfants de moins de 12 mois et 18/24 chez des enfants de moins de 3 ans; 14 des 24 patients etaient du sexe masculin. Salmonella typhi a ete le serotype le plus frequement en cause. Une etude de la sensibilite des souches a ete faite en faisant les disques d'Ampicilline (AMP); d'Amoxicilline + acide clavulanique (AMC); de cefotaxime (CTX); de Gentamicine (GEN); de Chloramphenicol (C) et de Sulfamethoxazol-trimethoprime (SXT); mais les differences de sensibilite aux antibiotiques n'etaient pas significatives du fait des petits nombres de souches testees. 10 cas de guerison ont ete observes contre 8 cas de deces et 6 ""evasions"""

Septicemies a Salmonella au Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) de Ouagadougou; Burkina Faso

"Entre janvier 1984 et decembre 1993; 12.843 hemocultures ont ete analysees au laboratoire de Bacteriologie du Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) de Ouagadougou; au Burkina Faso: parmi les 2.211 (17;2 pour cent) hemocultures positives observees; 1.540 (12;0 pour cent) etaient observees dues a des Salmonella; soit 69;6 pour cent des cultures positives. Le serotype Typhi representait 69;7 pour cent des isolats; les salmonelles paratyphiques 10;8 pour cent et les salmonelles dites ""mineures"" 19;5 pour cent. La repartition mensuelle des cas a montre une recrudescence des salmonelloses pendant l'hivernage; de juin a octobre. L'etude de la sensibilite des souches aux antibiotiques in vitro a permis d'observer un important taux de resistance au Cotrimoxazol (47;1 pour cent) et des sensibilites moyennes aux Cyclines (73;8 pour cent); a l'Ampicilline (79;5 pour cent) et a l'Amoxicilline (85;8 pour cent). Les plus importants taux de sensibilite ont ete obtenus avec les Cephalosporines de troisieme generation (93;1 pour cent); le Chloramphenicol (95;7 pour cent) et les Fluoroquinolones (100 pour cent)"