| Annelies S. Post, I. Guiraud, M. Peeters, P. Lompo, S. Ombelet, I. Karama, S. Yougbaré, Z. Garba, E. Rouamba, H. Tinto, Jan Jacobs Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso Journal Article In: Antimicrobial Resistance & Infection Control, vol. 11, iss. 1, pp. 112, 2022, ISSN: 2047-2994. @article{Post2022,
title = {Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso},
author = {Annelies S. Post and I. Guiraud and M. Peeters and P. Lompo and S. Ombelet and I. Karama and S. Yougbar\'{e} and Z. Garba and E. Rouamba and H. Tinto and Jan Jacobs},
url = {https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01142-7},
doi = {10.1186/s13756-022-01142-7},
issn = {2047-2994},
year = {2022},
date = {2022-01-01},
journal = {Antimicrobial Resistance \& Infection Control},
volume = {11},
issue = {1},
pages = {112},
abstract = {BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions.},
keywords = {ANC, Antimicrobial resistance, Asymptomatic bacteriuria, Burkina Faso, Community, Escherichia coli, Pregnancy, Rural Africa},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions. |
 | Toussaint Rouamba, Sékou Samadoulougou, Mady Ouédraogo, Hervé Hien, Halidou Tinto, Fati Kirakoya-Samadoulougou Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017 Journal Article In: Malar. J., vol. 20, no. 1, pp. 211, 2021, ISSN: 1475-2875. @article{Rouamba2021-gn,
title = {Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017},
author = {Toussaint Rouamba and S\'{e}kou Samadoulougou and Mady Ou\'{e}draogo and Herv\'{e} Hien and Halidou Tinto and Fati Kirakoya-Samadoulougou},
doi = {10.1186/s12936-021-03703-4},
issn = {1475-2875},
year = {2021},
date = {2021-05-01},
urldate = {2021-05-01},
journal = {Malar. J.},
volume = {20},
number = {1},
pages = {211},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Malaria in endemic countries is often asymptomatic
during pregnancy, but it has substantial consequences for both
the mother and her unborn baby. During pregnancy, anaemia is an
important consequence of malaria infection. In Burkina Faso, the
intensity of malaria varies according to the season, albeit the
prevalence of malaria and anaemia as well as their risk factors,
during high and low malaria transmission seasons is
underexplored at the household level. METHODS: Data of 1751
pregnant women from October 2013 to March 2014 and 1931 pregnant
women from April 2017 to June 2017 were drawn from two
cross-sectional household surveys conducted in 24 health
districts of Burkina Faso. Pregnant women were tested for
malaria in their household after consenting. Asymptomatic
carriage was defined as a positive result from malaria rapid
diagnostic tests in the absence of clinical symptoms of malaria.
Anaemia was defined as haemoglobin level less than 11 g/dL in
the first and third trimester and less than 10.5 g/dL in the
second trimester of pregnancy. RESULTS: Prevalence of
asymptomatic malaria in pregnancy was estimated at 23.9% (95%
CI 20.2-28.0) during the high transmission season
(October-November) in 2013. During the low transmission season,
it was 12.7% (95% CI 10.9-14.7) between December and March in
2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and
June 2017. Anaemia prevalence was estimated at 59.4% (95% CI
54.8-63.8) during the high transmission season in 2013. During
the low transmission season, it was 50.6% (95% CI 47.7-53.4)
between December and March 2013-2014 and 65.0% (95% CI
62.8-67.2) between April and June, 2017. CONCLUSION: This study
revealed that the prevalence of malaria asymptomatic carriage
and anaemia among pregnant women at the community level remain
high throughout the year. Thus, more efforts are needed to
increase prevention measures such as IPTp-SP coverage in order
to reduce anaemia and contribute to preventing low birth weight
and poor pregnancy outcomes.},
keywords = {Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Malaria in endemic countries is often asymptomatic
during pregnancy, but it has substantial consequences for both
the mother and her unborn baby. During pregnancy, anaemia is an
important consequence of malaria infection. In Burkina Faso, the
intensity of malaria varies according to the season, albeit the
prevalence of malaria and anaemia as well as their risk factors,
during high and low malaria transmission seasons is
underexplored at the household level. METHODS: Data of 1751
pregnant women from October 2013 to March 2014 and 1931 pregnant
women from April 2017 to June 2017 were drawn from two
cross-sectional household surveys conducted in 24 health
districts of Burkina Faso. Pregnant women were tested for
malaria in their household after consenting. Asymptomatic
carriage was defined as a positive result from malaria rapid
diagnostic tests in the absence of clinical symptoms of malaria.
Anaemia was defined as haemoglobin level less than 11 g/dL in
the first and third trimester and less than 10.5 g/dL in the
second trimester of pregnancy. RESULTS: Prevalence of
asymptomatic malaria in pregnancy was estimated at 23.9% (95%
CI 20.2-28.0) during the high transmission season
(October-November) in 2013. During the low transmission season,
it was 12.7% (95% CI 10.9-14.7) between December and March in
2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and
June 2017. Anaemia prevalence was estimated at 59.4% (95% CI
54.8-63.8) during the high transmission season in 2013. During
the low transmission season, it was 50.6% (95% CI 47.7-53.4)
between December and March 2013-2014 and 65.0% (95% CI
62.8-67.2) between April and June, 2017. CONCLUSION: This study
revealed that the prevalence of malaria asymptomatic carriage
and anaemia among pregnant women at the community level remain
high throughout the year. Thus, more efforts are needed to
increase prevention measures such as IPTp-SP coverage in order
to reduce anaemia and contribute to preventing low birth weight
and poor pregnancy outcomes. |
