Jean-David Perrier-Gros-Claude

Genetic Diversity and Quinolone Resistance in Campylobacter jejuni Isolates from Poultry in Senegal

ABSTRACT We used the multilocus sequence typing (MLST) method to evaluate the genetic diversity of 46 Campylobacter jejuni isolates from chickens and to determine the link between quinolone resistance and sequence type (ST). There were a total of 16 ST genotypes, and the majority of them belonged to seven clonal complexes previously identified by using isolates from human disease. The ST-353 complex was the most common complex, whereas the ST-21, ST-42, ST-52, and ST-257 complexes were less well represented. The resistance phenotype varied for each ST, and the Thr-86-Ile substitution in the GyrA protein was the predominant mechanism of resistance to quinolone. Nine of the 14 isolates having the Thr-86-Ile substitution belonged to the ST-353 complex. MLST showed that the emergence of quinolone resistance is not related to the diffusion of a unique clone and that there is no link between ST genotype and quinolone resistance. Based on silent mutations, different variants of the gyrA gene were shown to exist for the same ST. These data provide useful information for understanding the epidemiology of C. jejuni in Senegal.

Chromobacterium violaceum: A case of diarrhea in senegal

A 5-year-old infant with diarrhea had heavy growth of Chromobacterium violaceum cultured from stool. This organism is restricted geographically between latitudes 35 degrees N and 35 degrees S. It can cause sepsis and various focal infections but is not a well-known cause of diarrhea.

Hepatitis C antibodies among blood donors, Senegal, 2001.

To the Editor: Prevalence of chronic hepatitis C virus (HCV) among blood donors has been assessed in a few West African countries; most recent estimates range from 1.1% to 6.7% (1–4). A recent meta-analysis of studies, including a confirmation test, yielded an average prevalence of HCV infection of 3.0% (5). Until 2001, no systematic screening of HCV infection occurred among blood donors in Senegal, and blood donation legislation is still pending. We report an assessment of the proportion of blood donors from the Hopital Principal de Dakar who had HCV antibodies in 2001. Blood donors were all volunteers, recruited independently from the hospitalized patients and registered in a local donors association. We screened for risk factors for bloodborne infections in potential donors through a clinical examination and a confidential questionnaire. Persons with a history of jaundice or a risk behavior were excluded. Serum samples collected from blood donors from June to December 2001 were screened for HCV antibodies by a third-generation enzyme immunoassay (EIA) (HCV Murex 4.0; Abbott Laboratories, Abbott, IL). Confirmation was performed by a recombinant-immunoblot assay (INNO-LIA HCV Ab III update; [Innogenetics, Gent, Belgium]). HCV RNA was detected by a qualitative reverse transcription–polymerase chain reaction (Roche Amplicor HCV test [Hoffman-LaRoche, Basel, Switzerland]). Genotype was determined by the INNO-LiPA HCV II assay (Innogenetics). Presence of hepatitis B surface antigen (HbsAg) and alanine-aminotransferase (ALAT) level are routinely assessed, as well as HIV and human T-lymphotropic virus type l infection. The age of the 1,081 donors ranged from 18 years to 61 years (mean 35.6 years), and 81% were men. First-time donors accounted for 31% and were younger than repeat donors (mean 30.5 years vs. 37.8 years; p 50 years 1.8%; chi-square trend = 4.39; p = 0.03). ALAT levels of infected study participants were in the normal range (17–55 IU). One participant had an ALAT level above normal. Genotype 2ac has been identified on line immunoassay–positive samples (three samples not tested). HBsAg was detected in 13% of the new donors. No co-infection with HCV and hepatitis B virus was found. The prevalence of HCV antibodies in blood donors in Dakar in 2001 appears to be one of the lowest in West Africa, close to published estimates for Mauritania and Benin (1.1% and 1.4%, respectively) and lower than in other West African countries such as Ghana or Guinea, where prevalence ranges from 2.8% to 6.7% (1–4). This finding is in keeping with results of a hospital case-control study on HCV infection and liver cirrhosis or cancer, conducted in 1995 in Dakar. While that study did not identify HCV infection in 73 controls, 2 of 73 case-patients (2.7%) had HCV antibodies (6). Conversely, high HCV prevalence was found in groups at risk: antibodies were present in 12 of 15 hemodialysis patients, and HCV RNA was found in 6 of the 12 HVC antibody-positive patients (genotype 2ac, the same as in our study); 7% of a cohort of 58 HIV-1 patients receiving highly active antiretroviral therapy had a positive HCV serologic result (7,8). In the urban setting of Dakar, HCV infection seems still to be confined to groups at risk. The contribution of HCV to chronic liver diseases has not been yet demonstrated. Approximately 15,000 blood donations are annually made in Dakar. A systematic screening of HCV antibodies in blood donors could prevent, on average, 120 bloodborne HCV infections each year. Given these data and the price of EIA and LIA, the screening cost per HCV-positive sample identified, and infection subsequently averted, is approximately 200,300 CFA (U.S.

Ceftazidime-Resistant Salmonella enterica, Morocco

305). This estimate is low since it includes only the marginal cost of the reagent kits. This screening cost could be reduced by discarding blood units that test positive after only one enzyme-linked immunosorbent assay (156,000 CFA or U.S.

In vitro susceptibility of quinolone-resistant Enterobacteriaceae uropathogens to fosfomycin trometamol, in Dakar, Senegal

237), at the price of nearly 3% of blood units wrongly discarded. France has demonstrated that this strategy has the best cost-effectiveness ratio, as long as the prevalence remains below 8% (9). This cost compares favorably with the cost per HIV infection averted through improvement of blood safety (range U.S.

Prevalence and antibiotic-resistance of Salmonella isolated from beef sampled from the slaughterhouse and from retailers in Dakar (Senegal)

20–U.S.

Characterization of extended‐spectrum‐β‐lactamase (CTX‐M‐15)‐producing strains of Salmonella enterica isolated in France and Senegal

1,000), assessed in some highly HIV-prevalent southern African countries (Tanzania, Zambia, Zimbabwe) (10). The HCV-positive discarded blood units will be added to the blood units testing positive for hepatitis B surface (13%), HIV, and HTLV, which accounted for nearly one third of all donations in 2001. These findings argue in favor of maintaining a roster of regular, seronegative donors to save numbers of blood units.

Antimicrobial Resistance in Outpatient Escherichia coli Urinary Isolates in Dakar, Senegal

To the Editor: Nontyphoidal salmonellosis (NTS) is a major food-borne illness worldwide. Extended-spectrum cephalosporins (ESCs) are currently preferred drugs for treatment of children with NTS. However, resistance to ESCs has emerged worldwide and has become a serious public health problem. This resistance is caused by production of various class A extended-spectrum β-lactamases (ESBLs) and class C cephalosporinases in Salmonella enterica (1).

Prevalence and characterization of extended-spectrum β-lactamase-producing clinical Salmonella enterica isolates in Dakar, Senegal, from 1999 to 2009

We conducted a study in order to confirm the eligibility of fosfomycin trometamol as an alternative treatment to quinolones for urinary tract infections. Among 102 quinolone-resistant Enterobacteriaceae strains, resistance rates to first line-prescribed antibiotics were above 77%. The resistance rate to fosfomycin was 2%.