title: High prevalence of extended-spectrum ß-lactamase producing enterobacteriaceae among clinical isolates in Burkina Faso.
abstract: Nothing is known about the epidemiology and resistance mechanisms of extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) in Burkina Faso. The objective of this study was to determine ESBL-PE prevalence and to characterize ESBL genes in Burkina Faso.
  
  
  
  During 2 months (June-July 2014), 1602 clinical samples were sent for bacteriologic investigations to the microbiology laboratories of the tree main hospitals of Burkina Faso. Isolates were identified by mass spectrometry using a matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) BioTyper. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. The different ESBL genes in potential ESBL-producing isolates were detected by PCR and double stranded DNA sequencing. Escherichia coli phylogenetic groups were determined using a PCR-based method.
  
  
  
  ESBL-PE frequency was 58 % (179 strains among the 308 Enterobacteriaceae isolates identified in the collected samples; 45 % in outpatients and 70 % in hospitalized patients). The CTX-M-1 group was dominant (94 %, CTX-M-15 enzyme), followed by the CTX-M-9 group (4 %). ESBL producers were more often found in E. coli (67.5 %) and Klebsiella pneumoniae (26 %) isolates. E. coli isolates (n = 202; 60 % of all Enterobacteriaceae samples) were distributed in eight phylogenetic groups (A = 49, B1 = 15, B2 = 43, C = 22, Clade I = 7, D = 37, F = 13 and 16 unknown); 22 strains belonged to the sequence type ST131. No association between a specific strain and ESBL production was detected.
  
  
  
  This report shows the alarming spread of ESBL genes in Burkina Faso. Public health efforts should focus on education (population and healthcare professionals), surveillance and promotion of correct and restricted antibiotic use to limit their dissemination.
authors.affiliation: Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso. abdousal2000@yahoo.fr.|Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France. abdousal2000@yahoo.fr.|Université Montpellier 1, Montpellier, France. abdousal2000@yahoo.fr.|INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. abdousal2000@yahoo.fr.
authors.forename: Abdoul-Salam
authors.initials: AS
authors.lastname: Ouedraogo
authors.affiliation: Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso.
authors.forename: Mahamadou
authors.initials: M
authors.lastname: Sanou
authors.affiliation: Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso.
authors.forename: Aimée
authors.initials: A
authors.lastname: Kissou
authors.affiliation: Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso.
authors.forename: Soufiane
authors.initials: S
authors.lastname: Sanou
authors.affiliation: Centre Hospiatlier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
authors.forename: Hermann
authors.initials: H
authors.lastname: Solaré
authors.affiliation: Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso.
authors.forename: Firmin
authors.initials: F
authors.lastname: Kaboré
authors.affiliation: Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso.
authors.forename: Armel
authors.initials: A
authors.lastname: Poda
authors.affiliation: Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.|Université Montpellier 1, Montpellier, France.|INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Salim
authors.initials: S
authors.lastname: Aberkane
authors.affiliation: Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.|Université Montpellier 1, Montpellier, France.|INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bouzinbi
authors.affiliation: Centre Hospiatlier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
authors.forename: Idrissa
authors.initials: I
authors.lastname: Sano
authors.affiliation: Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso.
authors.forename: Boubacar
authors.initials: B
authors.lastname: Nacro
authors.affiliation: Centre Hospiatlier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
authors.forename: Lassana
authors.initials: L
authors.lastname: Sangaré
authors.affiliation: Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.|Université Montpellier 1, Montpellier, France.|INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Carrière
authors.affiliation: CIMI, team E13 (bacteriology), Sorbonne University, UPMC Université Paris 06 CR7, F-75013, Paris, France.|INSERM U1135, CIMI, team E13, Paris, France.|AP-HP, Microbiology, St-Antoine Hospital, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Decré
authors.affiliation: Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso.
authors.forename: Rasmata
authors.initials: R
authors.lastname: Ouégraogo
authors.affiliation: Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Jean-Pierre
authors.affiliation: Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.|Université Montpellier 1, Montpellier, France.|INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Godreuil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis / Q000302:isolation & purification / Q000378:metabolism; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010802:Phylogeny; D015995:Prevalence; D017422:Sequence Analysis, DNA; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D055815:Young Adult; D001618:beta-Lactamases / Q000032:analysis / Q000145:classification / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases
keywords: Burkina Faso; Clinical samples; ESBL; Enterobacteriaceae; Inpatient and outpatient