Hospital-based Surveillance Provides Insights Into the Etiology of Pediatric Bacterial Meningitis in Yaoundé, Cameroon, in the Post-Vaccine Era

Background: Meningitis is endemic to regions of Cameroon outside the meningitis belt including the capital city, Yaoundé. Through surveillance, we studied the etiology and molecular epidemiology of pediatric bacterial meningitis in Yaoundé from 2010 to 2016. / Methods: Lumbar puncture was performed on 5958 suspected meningitis cases; 765 specimens were further tested by culture, latex agglutination, and/or polymerase chain reaction (PCR). Serotyping/grouping, antimicrobial susceptibility testing, and/or whole genome sequencing were performed where applicable. / Results: The leading pathogens detected among the 126 confirmed cases were Streptococcus pneumoniae (93 [73.8%]), Haemophilus influenzae (18 [14.3%]), and Neisseria meningitidis (15 [11.9%]). We identified more vaccine serotypes (19 [61%]) than nonvaccine serotypes (12 [39%]); however, in the latter years non–pneumococcal conjugate vaccine serotypes were more common. Whole genome data on 29 S. pneumoniae isolates identified related strains (<30 single-nucleotide polymorphism difference). All but 1 of the genomes harbored a resistance genotype to at least 1 antibiotic, and vaccine serotypes harbored more resistance genes than nonvaccine serotypes (P < .05). Of 9 cases of H. influenzae, 8 were type b (Hib) and 1 was type f. However, the cases of Hib were either in unvaccinated individuals or children who had not yet received all 3 doses. We were unable to serogroup the N. meningitidis cases by PCR. / Conclusions: Streptococcus pneumoniae remains a leading cause of pediatric bacterial meningitis, and nonvaccine serotypes may play a bigger role in disease etiology in the postvaccine era. There is evidence of Hib disease among children in Cameroon, which warrants further investigation

L\'antibiotherapie de premiere intention dans le traitement de l\'empyeme pleural de l\'enfant en milieu Africain (Yaoundé-Cameroun).

We examined 125 pleural fluids collected, 67 cultures that represented 53.6% were positive. The three main germs isolated in order of decreasing frequency were Streptococcus pneumoniae (41.7%), Staphylococcus aureus (35.3%) and Haemophilus influenzae (7.5%). The most active antibiotics against each of these bacteria were : for S. pneumoniae, second and third generation cephalosporins with 100% sensitivity, amoxicilline + clavulinic acid (96.4% sensitivity), first generation cephalosporins (95% sensitivity) and 46.4% resistance to penicilline G; for S. aureus, céfuroxime, vancomycine and pristinamycine with 100% sensitivity, whereas gentamicin and tobramycin had only 91.3% sensitivity, and there was 13.8% resistance to oxacilline ; for H. influenzae, amoxicillin + clavulinic acid, first, second and third generation cephalosporins, and quinolones all showed 100% sensitivity with 100% and 60% resistance to cotrimoxazole and chloramphenicol respectively. To cover all these three germs in our environment, we recommend as first line antibiotherapy for empyema thoracis in children either of the following antibiotic combinations: amoxicillin/clavulinic acid with gentamicin or cefuroxime with gentamicin or vancomycin alone if available, against S. aureus infection.Nous avons prélevé et mis en culture 125 liquides pleuraux dont 67 soit 53,6% ont poussé. Les trois principaux germes isolés étaient dans l'ordre de fréquence décroissante : Streptococcus pneumoniae (41,7%) Staphylococcus aureus (35,3%) et Haemophilus influenzae (7,5% ). Les principaux antibiotiques actifs sur ces différents germes étaient : vis à vis de S. pneumoniae les céphalosporines de 2è et 3è génération (100%), amoxicilline+acide clavulanique (96,4%) les céphalosporines de 1ère génération (95%). La résistance à la pénicilline G était de 46,4% ; vis à vis de S. aureus, le céfuroxime, la vancomycine et la pristinamycine étaient actives à 100% contre 91,3% pour la gentamicine et la tobramycine, alors que l'oxacilline avait une résistance de 13,8% et enfin vis à vis de H. influenzae l'amoxicilline+acide clavulanique, les céphalosporines des trois générations et les quinolones avait une activité de 100% et le cotrimoxazole une résistance de 100% contre 60% pour le choramphénicol. Pour couvrir ces trois germes dans notre environnement nous proposons de prescrire en première intention dans l'empyème pleural de l'enfant l'une des deux associations suivantes : soit amoxicilline + acide clavulanique et gentamicine soit céfuroxime et gentamicine ou alors vancomycine seule en cas de S. aureus si ce dernier antibiotique est disponible. Keywords: Antibiotherapy - Child - Empyema thoracis -Yaounde - Cameroon.Clinics in Mother and Child Health Vol. 4 (1) 2007: pp. 641-64

Epidemiology of methicillin-resistant Staphylococcus aureus lineages in five major African towns: emergence and spread of atypical clones.

International audienceThe epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Africa is poorly documented. From January 2007 to March 2008, we collected 86 MRSA isolates from five African towns, one each in Cameroon, Madagascar, Morocco, Niger and Senegal. Although one or two major clones, defined by the sequence type and staphylococcal cassette chromosome mec type, predominated at each site, genetic diversity (ten clones) was relatively limited in view of the large geographical area studied. Most of the isolates (n = 76, 88%) belonged to three major clones, namely ST239/241-III, a well-known pandemic clone (n = 34, 40%), ST88-IV (n = 24, 28%) and ST5-IV (n = 18, 21%). The latter two clones have only been sporadically described in other parts of the world. The spread of community-associated MRSA carrying the Panton-Valentine leukocidin genes is a cause for concern, especially in Dakar and possibly throughout Africa

Epidemiology of methicillin-susceptible Staphylococcus aureus lineages in five major African towns: high prevalence of Panton-Valentine leukocidin genes.

International audienceThe epidemiology of methicillin-susceptible Staphylococcus aureus (MSSA) in Africa is poorly documented. From January 2007 to March 2008, 555 S. aureus isolates were collected from five African towns in Cameroon, Madagascar, Morocco, Niger, and Senegal; among these, 456 unique isolates were susceptible to methicillin. Approximately 50% of the MSSA isolates from each different participating centre were randomly selected for further molecular analysis. Of the 228 isolates investigated, 132 (58%) belonged to five major multilocus sequence typing (MLST) clonal complexes (CCs) (CC1, CC15, CC30, CC121 and CC152) that were not related to any successful methicillin-resistant S. aureus (MRSA) clones previously identified in the same study population. The luk-PV genes encoding Panton-Valentine leukocidin (PVL), present in 130 isolates overall (57%), were highly prevalent in isolates from Cameroon, Niger, and Senegal (West and Central Africa). This finding is of major concern, with regard to both a source of severe infections and a potential reservoir for PVL genes. This overrepresentation of PVL in MSSA could lead to the emergence and spread of successful, highly virulent PVL-positive MRSA clones, a phenomenon that has already started in Africa

Broken tempos: Of means and memory in a Senegalese university laboratory

Focusing on the Laboratory of Toxicology and Analytical Chemistry of the Faculty of Pharmacy at Cheikh Anta Diop University in Senegal, this article foregrounds temporality as a key dimension of the postcolonial history of African science. This laboratory, like many others across Africa, is experienced by its current and former members as a space of shortage. I explore how memories of ‘means’ and past scientific activity in Dakar and abroad give meaning to subsequent experiences of the lab as a place filled with inactive ‘antiques’ and ‘wreckage’. I suggest that the waning of means not only displaces scientific activity ‘elsewhere’ but also fragments its tempos, altering its rhythms along with its social, moral and affective qualities. The interpenetration of past and future generates nostalgia, segmented narratives and trajectories, quests for immediacy and continuity, as well as new engagements with routines of scientific regulation and management. Paying attention to the intersection of materiality and temporality – by taking seriously African scientists’ longing for science that moves forward, keeps pace, begins now and fills up time – thus opens up new ways of understanding what science means and what it means to do science in times of promise and decline, emergence and interruption, hope and uncertainty in postcolonial Africa. </jats:p

Global phylogeography and evolutionary history of Shigella dysenteriae type 1.

International audienceTogether with plague, smallpox and typhus, epidemics of dysentery have been a major scourge of human populations for centuries(1). A previous genomic study concluded that Shigella dysenteriae type 1 (Sd1), the epidemic dysentery bacillus, emerged and spread worldwide after the First World War, with no clear pattern of transmission(2). This is not consistent with the massive cyclic dysentery epidemics reported in Europe during the eighteenth and nineteenth centuries(1,3,4) and the first isolation of Sd1 in Japan in 1897(5). Here, we report a whole-genome analysis of 331 Sd1 isolates from around the world, collected between 1915 and 2011, providing us with unprecedented insight into the historical spread of this pathogen. We show here that Sd1 has existed since at least the eighteenth century and that it swept the globe at the end of the nineteenth century, diversifying into distinct lineages associated with the First World War, Second World War and various conflicts or natural disasters across Africa, Asia and Central America. We also provide a unique historical perspective on the evolution of antibiotic resistance over a 100-year period, beginning decades before the antibiotic era, and identify a prevalent multiple antibiotic-resistant lineage in South Asia that was transmitted in several waves to Africa, where it caused severe outbreaks of disease