Meningitis Outbreak Caused by Neisseria meningitidis Serogroup C ST 10217 in 2019 in Diapaga, Burkina Faso

Introduction: Meningitis caused by Neisseria meningitidis constitutes a burden for the countries in the meningitis belt of sub-Saharan in general and particularly for Burkina Faso. In 2019 the Diapaga health district experienced a meningitis epidemic due to N. meningitidis serogroup C. Methods: This is a cross-sectional study with a descriptive aim in the health district of Diapaga where all cases of meningitis were included in this work. Rapid diagnostic tests (RDTs), culture as well as real-time PCR were used for the biological analysis of cerebral spinal fluid (CSF) samples. Results: Of 155 CSF samples analysed, 42% (65/155) were tested positve. Of them, N. meningitidis C accounted for 83% of all positive cases. Likewise, all thirteen (13) NmC strains were susceptible to oxacillin, ceftriaxone, penicillin and chloramphenicol. All strains of NmC belonged to the sequence type (ST) 10 217 and to the clonal complex (CC) 10 217. These CCs belonged to the same variant PorA type: P1.21-15.16;FetA type: F1-7;PorB type: 3-463. Conclusion: Burkina Faso had known an epidemic of meningitis caused by NmC in 2019 in the health district of Diapaga. This outbreak was contained in time due to the performance of the epidemiological surveillance system which made it possible to investigate on time and introduce the vaccine against the pathogen NmC.

Bacteriological Profile of Effusion Fluids Infections at Charles De Gaulle University Pediatric Hospital from 2017 to 2020

Introduction: Microbiology of effusion fluids in children in Burkina Faso is characterized by the scarcity of data. This work aimed to study the bacteriological and antibiotics susceptibility profile of bacteria involved in effusion fluid infections in paediatrics in order to improve the choice of probabilistic antibiotics therapy. Methods: A cross-sectional, descriptive study was used in children aged 0 to 15 years from 2017 to 2020 at the Charles De Gaulle Pediatric University Hospital Center (CHUP-CDG) in Ouagadougou. Classical bacteriology methods such as macroscopy, Gram staining, identification galleries and antibiotics susceptibility testing were used. Results: Of 231 samples, 64 bacteria were isolated. The most common bacterial strains of pleural fluid were Staphylococcus aureus (25%) and 40% for Enterobacteriaceae. Of the peritoneal fluid, 77% were Enterobacteriaceae with 57% Escherichia coli;and from joint fluid, 33% were S. aureus and 22% for P. aeruginosa. The overall susceptibility profile showed 29% extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), 10% methicillin-resistant S. aureus (MRSA), and 8% carbapenemases. Conclusion: Bacteriological profile is characterized by ESBL-producing Enterobacteriaceae and MRSA. The most active antibiotics were macrolides, aminoglycosides, and cefoxitin (methicillin) for Gram-positive cocci, carbapenems, and aminoglycosides for Gram-negative bacilli. Then, the monitoring of antibiotics resistance must be permanent.

ST of Streptococcus pneumonia Circulating in Burkina Faso before the Introduction of PCV-13, 2013

Introduction: Burkina Faso experiences regular cases of Streptococcus pneumoniae meningitis. As part of the strategy to reduce cases of meningitis, the 13-valent pneumococcal conjugate vaccine (PCV-13) has been introduced in the Expanded Programme on Immunisation (EPI). Despite these efforts, there are some cases of pneumococcal meningitis including both vaccine and non-vaccine serotypes. The objective of this study was to describe the pneumococcal sequence types (ST) circulating in Burkina Faso before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV-13). Methods: It was a descriptive cross-sectional study that took place from 27th October 2013 to 7th January 2014. S. pneumoniae strains were collected in Burkina Faso and Multi Locus Sequence Typing (MLST) was performed at the Pneumococcal Laboratory at the Centers for Disease Control and Prevention (CDC) in the USA (United States of America). MLST consists of 4 steps: amplification, purification, sequencing and interpretative reading of the results. The amplification used 7 primers consisting of sequences of aroe, gdh, gki, recP, spi, xpt, ddl genes. Results: Of 37 strains tested, 10 serotypes were identified. Serotype 1 was prevalent in 48.7% (18/37) followed by serotype 25F in 10.8% (4/37). Serotypes 5 and 12F/12A/12B/44/46 were 8.1% (3/37) each. Serotype 1 contained 5 STs including ST303 24.3% (9/37), ST217 8.1% (3/37) and ST618 8.1% (3/37);followed by serotype 25F with ST105 10.8% (4/37), serotype 5 with ST289 8.1% (3/37) and serogroup 12F/12A/12B/44/46 with ST 989 8.1% (3/37). Conclusion: Pneumococci are characterised by their great variability both in number of serotypes and in ST within the same serotype. Thus, 10 serotypes have been identified. Also, within serotype 1, 5 different STs have been described. These data indicate the complexity of the pneumococcus which is strongly involved in purulent bacterial meningitis at national level. This requires continuous surveillance of pneumococcal meningitis through laboratory capacity building.