Antimicrobial Resistance of Klebsiella pneumoniae -ESBL Producing Strains Isolated from Clinical Specimens in Abidjan (Cote de Ivoire)

Aims: The objective of this study is to detect the prevalence of qnr genes in broad-spectrum beta-lactamase producing Klebsiella pneumoniae, involved in hospital and community-acquired infections. Study Design: It is a retrospective study. Place and Duration of Study: Bacteriology and virology laboratorie of Institut Pasteur, Abidjan, Côte d'Ivoire. Methodology: From January 2011 to June 2016, 350 Klebsiella pneumoniae were isolated from various clinical specimens and identified by conventional bacteriological tests. Antibiotic resistance (beta-lactams, quinolones and aminoglycosides) and detection of broad-spectrum beta-lactamases were assessed by the diffusion method and the synergy test, respectively. Molecular characterization of quinolone resistance genes (qnr A, qnr B and qnr S) was performed by the conventional polymerase chain reaction (PCR). Results: Of the 350 Klebsiella pneumoniae isolates, 91(26%) were detected as ESBL producer, 36.2% (n=33) recovered from urine, 24.2% (n=22) from pus and 20.8% (n=19) from blood culture respectively. 46(33%) strains were idenifed to carry qnr genes, qnrB predominate 33(71%), followed by qnr 12(26.1%) and qnrA 1(2.2%). The strains exhibited high resistance to most of the agents tested, expect imipemen, low resistance to amikacin 4.1%, moderate to cefoxitin 31.8% and 54.9% with amoxicillin-clauvanic acid. Conclusion: Although these observed prevalences are small proportions, this can be seen as a warning signal for the future. The emergence and dissemination of resistance genes in Côte d'Ivoire could pose a public health problem. Thus, the establishment of a relevant resistance surveillance policy to better control the circulation of multidrug-resistant strains is necessary

Molecular Detection of Antibiotic Resistance of Helicobacter pylori from Gastric Biopsies in Abidjan (Côte d'Ivoire)

Aims: To determine the genes of resistance to amoxicillin, clarithromycin and metronidazole of Helicobacter pylori in gastric biopsies in Côte d'Ivoire. Place and Duration: The study was performed at the department of gastroenterology of Cocody Hospital and University Center, at the laboratory of Bacteriology-Virology and at the molecular biology platform of Pasteur Institute of Côte d'Ivoire from August 2015 to December 2016. Methodology: The rapid urease test was performed in endoscopy room and 98 positive biopsies were retained for the study. Gastric biopsies were collected and transported within a maximum of 4 hours. DNA extraction was followed by Polymerase Chain Reaction (PCR) amplification. Results: The rdxA / frxA, 23S rRNA and pbp1 genes conferring resistance to metronidazole, clarithromycin and amoxicillin respectively were identified in 12.2% (12/98), 26.5% (26/98) and 58.2% (57/98). Cross-resistance genotypes to these three antibiotics were detected in 8.2% (8/98) of the samples. Conclusion: These results show a high level of resistance of Helicobacter pylori to amoxicillin and presence of cross-resistance to the three commonly used antibiotics. These results support the need for an evaluation of Helicobacter pylori current therapeutic protocol in Côte d'Ivoire

Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the autonomous district of Abidjan (Cote d’Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF)

Abstract Introduction As part of the implementation of its mission “to integrate hygiene activities into healthcare”, the general directorate of health conducted in 2018 with its technical structures, an evaluation of the implementation of Infection Prevention and Control (IPC) using the WHO IPCAF tool in 30 health-care facilities in the autonomous district of Abidjan. Materials and methods This were a cross-sectional survey with a conceptualized component considering the issue of injection safety and sanitary waste management, which was conducted in the named health-care facilities from March 20 to 28, 2018. The scores of the essential components of the IPC made it possible to assess the IPC level of each health-care facility evaluated and the overall IPCAF score of all facilities. Results The overall median IPCAF score of the health-care facilities was 242.5/800 and corresponded to an inadequate level overall. No facility reached the “advanced” level of performance, 5 facilities (17%) reached the “intermediate” level, 10 (33%) fell into the “basic” level, and 15 (50%) were at the “inadequate” level. Baseline institutions had much higher scores than first contact institutions. Conclusion IPC component activities were inadequate and fragmented in the under-resourced health facilities at the time of the assessment. It would be appropriate to provide adequate resources and develop expertise in IPC through strong political will and leadership. This will contribute to the achievement of universal health insurance objectives with safe health services for patients