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Santé Humaine Résistance aux antimicrobiens

Expérience de l’utilisation du linézolide dans la prise en charge des infections à staphylocoques multirésistants au CHU d’Angré (Abidjan, Côte d’Ivoire) de 2022 à 2025. A propos d’une série de 8 cas

La vancomycine est le traitement de référence des infections à staphylocoques multirésistants. Toutefois, en cas d’impossibilité le linézolide, chef de file de la classe des oxazolidinones et mis sur le marché au début des années 2000 constitue une alternative de choix. En Côte d’Ivoire, il n’est utilisé depuis 2024 que dans la prise en charge de la tuberculose multirésistante, il a été possible de recevoir du linézolide sous forme de solution pour perfusion. Ainsi, 9 patients ont pu en bénéficier. Il s’agissait de patients atteints d’infections à staphylocoques multirésistants, pour lesquels il y avait peu d’alternatives. Les situations étaient variées, tant en termes d’âge (aussi bien des enfants que des patients de gériatrie), que de localisation du foyer infectieux (infections ostéoarticulaires, pleuropulmonaires, septicémies). Mais tous les cas ont été traités avec succès. Cette série de cas confirme ainsi l’intérêt de l’introduction du linézolide dans l’arsenal thérapeutique, à condition qu’il soit utilisé comme antibiotique de réserve pour préserver son efficacité.

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Dr N'guessan Deto Ursul Jean-Paul
👁 12 📥
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Santé Humaine

HOUSEHOLDS’ THERAPEUTIC BEHAVIOR: AN EMPIRICAL STUDY FOR COTE DIVOIRE

This article seeks to understand the Ivorian health policy and identify factors justifying the choice of the therapeutic route for Ivorian households. Both the public and private sectors ensure the health supply. The health system is hierarchical, with a clear order of precedence for the public health system. Resources are unevenly distributed in the country, focusing on the District of Abidjan. Health coverage ratios are well below international standards. The demand analysis using the discrete choice model reveals that the choice of health care provider is determined by individual and family factors but also by elements related to their living environment, care quality indicators and the health care supply. The financing mechanism of health costs is also decisive in the choice of households.

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Dr Koffi Christian N'DA
👁 14 📥
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Santé Environnementale Résistance aux antimicrobiens en environnement

Fungal Contamination of Small Surgical Instruments at the Sterilization Units of a Tertiary University Hospital in Abidjan, Côte d'Ivoire, West Africa

Background: Reusable surgical equipment can be a source of healthcare-associated infections. In Côte d'Ivoire, West Africa, data on fungal contamination of small surgical instruments are limited. Objective: To assess fungal carriage in small surgical instruments at a university hospital in Angré, Côte d'Ivoire. Methods: This cross-sectional study was conducted using small surgical instruments in six departments of a tertiary university hospital in Angré from February to July 2024. Samples were collected by swabbing instruments before sterilization and after opening random sterile sets. Direct examination and culture on Sabouraud dextrose agar medium containing chloramphenicol were performed. Fungal spores and hyphae were identified macroscopically and microscopically, whereas yeasts were identified using chromogenic medium and VITEK 2. Results: Of 313 samples, 70 yielded positive culture (22.4%). Fungi on surgical instruments were identified most frequently at the ear, nose and throat service (34.8%), followed by the dental service (30.4%) and intensive care unit (28.6%). The most frequently isolated mold species was Aspergillus niger (47.2%), followed by Aspergillus flavus (30.6%), Mucor spp. (21.3%), and Aspergillus fumigatus (0.9%). Among the yeasts, the most frequently identified was Candida albicans (50%), followed by Candida krusei (25%) and Candida parapsilosis (25%). Fungi identification was more frequent before sterilization (64.3%) than after opening sterile sets (35.7%). Conclusion: This study revealed the presence of fungi on small surgical instruments before sterilization and after opening random sterile sets. Implementing advanced environmental control, improving sterilization steps, and monitoring may help reduce nosocomial fungal infections from surgical instruments.

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Dr ANGORA Kpongbo Etienne
👁 26 📥
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Santé Environnementale Résistance aux antimicrobiens en environnement

Identification of Environmental Fungal Species in Clinical Services of University Hospital of Angre, Abidjan (Cote d’Ivoire)

Introduction: In hospital’s environment, hygiene of premises and ambient air quality are essential for healthcare. Airborne fungal agents constitute a health concern for patients in these premises. Objective: To identify the fungal agents of the environment in the clinical services of University Hospital of Angre. Materials and Methods: This was a descriptive cross-sectional study was carried out in the clinical services of the University Hospital of Angre from February to May 2024. Samples were taken by swabbing and exposing sterile Petri dishes to the air; then they were plated on Sabouraud-Chloramphenicol medium and incubated in oven at 37° C. Identification of yeast strains was performed using chromogenic medium and the VITEK 2 Ò Compact. Molds identification was based on the macroscopic characteristics and microscopic examination of colonies. Results: Among 429 samples, 206 positive cultures (48%) with a higher positivity rate in the surgical emergency service (93.1%). The most isolated fungal agents were molds (84%) with Aspergillus niger at 41.4%. Candida parapsilosis and Candida krusei species were the most prevalent yeasts isolated respectively at 42.3% and 23.1%. The frequency rate of fungal species was correlated to clinical services and sampling sites (p<0.001). The implementation of rigorous hygiene measures and regular decontamination of fungal niches should be systematically to avoid possible nosocomial infections.

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Dr ANGORA Kpongbo Etienne
👁 26 📥
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Santé Humaine Maladies infectieuses et tropicales

Evaluation of knowledges and experiences of female genital schistosomiasis among healthcare workers in gynecology services in Abidjan, Côte d’Ivoire

Female genital schistosomiasis (FGS), a serious clinical form of urinary schistosomiasis, is widespread in sub-Saharan Africa but little-known in Côte d'Ivoire. The objective of this study was to assess practitioners' knowledge and experience of FGS in Abidjan. Data were collected using a questionnaire from March to October 2024 in healthcare centers in Abidjan among 281 healthcare workers in gynecology and obstetrics services. Only 57% of respondents identified Schistosoma haematobium as the causative agent, and the mode of transcutaneous contamination was known by very few (0.46%). Infertility and the risk of HIV infection were recognized as consequences of the disease by 20.1% and 9.6% of respondents, respectively. The pelvic examination to confirm FGS was known by only 11% of practitioners. For treatment, 66.7% of practitioners were aware of praziquantel. However, mass drug administration with praziquantel as a prevention method was not well-known (4.55%). Regarding experience with FGS, only 5% of respondents had ever suspected or experienced cases in their facility, and in 50% of these cases, the specific treatment used was praziquantel. This study highlights that FGS is not well-known by practitioners, and health professionals' lack of information about the disease can lead to poor treatment. Implementing training and awareness-raising programs for healthcare personnel will help prevent consequences for women in areas at risk of urinary schistosomiasis.

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Dr ANGORA Kpongbo Etienne
👁 19 📥
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Multisectoriel Systemes alimentaires durables

EVALUATION OF PRACTICES AT RISK OF MICROBIAL CONTAMINATION IN THE PRODUCTION CHAIN OF VEGETABLE SALADS SOLD IN PUBLIC CATERING IN THE SUBURBAN AREA OF ABIDJAN, IVORY COAST

In Côte d'Ivoire, the absence of good hygiene practices in certain sectors is common, especially in the market gardening sector, which could increase the risk of collective food poisoning. The objective of the study was to evaluate the practices and risks of microbial contamination, in the production chain of the suburban area of Abidjan. A survey was carried out using a questionnaire with 575 people involved in the sector, in particular producers, sellers, restaurateurs and consumers on the Anyama, Adiopodoumé, Bonoua and Dabou sites. On the various sites of the study, 70% of market gardening is practiced by men, 80% of whom do not have a level of education for compliance with hygiene rules. The producers use 95% of the untreated water emanating from wells, ponds and lagoons to water the vegetables. The sites lack sanitary facilities (80%), so the producers go to the saddle near the fields. In the markets, saleswomen relieve themselves in public toilets (84.4%) by washing their hands with soap-free water (64.1%). Restaurateurs serve pre-cut vegetables (52%) and stored at room temperature for three to four hours (67.2%) before consumption. Consumers claim to consume vegetable salads (61.7%) referably at breakfast (57%) and at least once a day (66%). Constant monitoring of the application of hygiene rules must be established from the producer passing through the markets to the consumer's plate, in order to prevent the appearance of food poisoning of vegetables and guarantee the health of all.

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Dr KONAN Kouadio Fernique
👁 18 📥
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Santé Environnementale Résistance aux antimicrobiens en environnement

Antibiotic Resistance of Enterobacteria Isolated from Medicinal Plant Powders Marketed in Abidjan, Côte d’Ivoire

Objective: Medicinal plant powders are widely used in Côte d’Ivoire for treating various ailments and are often marketed without rigorous health controls. This lack of regulation increases the risk of contamination by pathogenic bacteria, particularly antibiotic-resistant enterobacteria, which poses a significant challenge for infection control. Methods: This study aimed to evaluate the antibiotic susceptibility of enterobacteria isolated from 100 samples of medicinal powders sold in different markets in Abidjan. Bacterial identification was performed using biochemical and proteomic methods (MALDI-TOF). Antibiotic susceptibility testing was conducted using the agar diffusion method, following the EUCAST/CASFM 2024_V1.0 guidelines Results: A total of 48 enterobacterial strains were isolated, including Enterobacter hormaechei (21), Escherichia coli (18), Citrobacter freundii (2), Enterobacter asburiae (2), Klebsiella pneumoniae (2), Enterobacter cloacae (1), Enterobacter bugandensis (1), and Cronobacter sakazakii (1). Antibiotic susceptibility testing revealed that 54.16% of the strains were resistant to at least one antibiotic, with the highest resistance rates observed for pefloxacin (25%) and ertapenem (12.5%). Resistance to ertapenem, a carbapenem frequently used as a last-resort treatment, is particularly concerning. Conclusions: The presence of enterobacteria in these samples suggests fecal contamination, reflecting poor hygienic conditions. These findings highlight the potential risk posed by medicinal plant powders as vectors of antibiotic-resistant bacterial strains. Implementing strict quality control measures and enhanced surveillance of antibiotic resistance is crucial to reducing their impact on public health.

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Dr KONAN Kouadio Fernique
👁 26 📥
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Santé Animale

Detection of multidrug-resistant Salmonella Enterica strains in chickens (Gallus gallus domesticus) from markets in Abidjan

Salmonella is a genus of Gram-negative bacilli, causing illnesses in humans, such as typhoid fever, which remain major public health concerns. Based on biochemistry and genomic data, Salmonella is divided into many serovars. In West Africa, Salmonella infection in humans and in food matrices is reported each year. Recently, the emergence of antibiotic-resistant strains of Salmonella represents a high risk for public health. In Côte d’Ivoire, poultry activities and poor hygiene conditions contribute to the emergence of Salmonella infection. The main objective of this study is to detect Salmonella species strains in chicken from local markets in the city of Abidjan. Four sampling sites in the Abidjan district were selected in the local markets of Yopougon (Siporex and Bagnon), Songon, Adjamé, and Abobo. Several chicken intestines (Gallus gallus domesticus) were collected in batches of in each market. The pre-treatment of solation was performed with classic methods for Salmonella-Shigella (SS). Biochemical characterization and antibiotic susceptibility testing were conducted for all isolated strains. The target of the invasive gene (invA) of Salmonella was used for molecular confirmation and DNA sequencing. Among the 22 Salmonella spp. isolates studied, 68% (15/22) of the poultry strains underwent biochemical testing (oxidase, catalase, Gram stain, and motility), with five strains testing positive. Antibiotic susceptibility testing revealed strong resistance to ampicillin and pefloxacin, and weak resistance to gentamicin and clavulanic acid. Furthermore, 59% (13/22) of the isolates were positive by Polymerase chain reaction (PCR) targeting the invA gene. Phylogenetic analysis showed a high similarity to the reference strain Salmonella Enterica serovar Paratyphi. These findings demonstrate the circulation of multidrug-resistant Salmonella strains in poultry in Côte d’Ivoire and highlight the need for continuous surveillance to enhance food safety.

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Dr KONAN Kouadio Fernique
👁 31 📥
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Santé Humaine Résistance aux antimicrobiens

Prevalence of Beta-lactam Resistance Genes (Bla Genes) in Multidrug-Resistant Strains of Escherichia coli and Klebsiella pneumoniae Isolated from Infections at a University Hospital in Abidjan, Ivory Coast

Aim: The overall objective of this study was to characterise the bla genes responsible for beta-lactam resistance in two major strains of Enterobacteriaceae (Escherichia coli and Klebsiella pneumoniae) involved in bacterial infections and producing extended-spectrum beta-lactamases. Study Design: The resistance of Enterobacteriaceae to various classes of antibiotics in general, and to the beta-lactam class in particular, is showing a worrying trend in Côte d’Ivoire and around the world. This resistance is due to the production of extended-spectrum beta-lactamases (ESBLs) encoded by bla genes. Place and Duration of Study: This study was conducted from August 2022 to February 2024 in Abidjan (Ivory Coast) at the Pasteur Institute of Ivory Coast (IPCI), at the Cocody site, specifically within the Unit for Antibiotics, Natural Substances, and Surveillance of Microorganisms and Anti-Infective Agents (ASSURMI). Methodology: These strains were isolated from biological samples collected from various hospital departments. A total of 40 Enterobacteriaceae strains were identified using MALDI-TOF mass spectrometry (MS), and antibiotic susceptibility testing (antibiogram) was performed using the Mueller-Hinton agar diffusion method. Genes conferring resistance to Beta-lactams were detected using conventional PCR. Results: The strains studied were Escherichia coli (25) and Klebsiella pneumoniae (15). Seventy-five per cent of the strains were multidrug-resistant (Escherichia coli: 19/25; Klebsiella pneumoniae: 11/15). High resistance rates ranging from 52.63% to 100% to amoxicillin-clavulanic acid, aztreonam, and third-generation cephalosporins (cefepime, ceftriaxone, cefotaxime, cefixime) were observed. The Beta-lactam resistance genes detected were blaTEM, blaCTX-M-1, blaCTX-M-8, blaSHV, and blaCTX-M- with prevalence rates of 60%, 50%, 35%, 32.5%, and 7.5%, respectively. The co-expression rate of the resistance genes was 22,5 %, 17,5 %, 15 %, 12,5 %, 7,5 % et 2,5 %, respectively, for the associations blaTEM /blaCTX-M-8, blaTEM /blaCTX-M 1, blaSHV /blaCTX-M-1, blaSHV /blaCTX-M-8, blaTEM / blaSHV, blaTEM / blaSHV / blaCTX-M-1. Conclusion: This study revealed the presence and persistence of bla genes that have been under surveillance for many years, with an increase in the prevalence of certain genes.

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Dr KONAN Kouadio Fernique
👁 23 📥