Coexistence between the TOHO-type and Brazilian extended-spectrum (BES)-type of extendedspectrum β-lactamase (ESBL)-produced by bacteria caused public health issue. Several studies have been reported on the coexistence between blaTEM, blaCTX-M and blaSHV genes in ESBL in broad spectrum enterobacteria. The present study involved the prevalence of coexistence of blaTOHO and blaBES genes in enterobacteria identified in hospitalized and outpatients at Saint Camille Hospital in Ouagadougou (Burkina Faso). Firstly, the study was led by microbiological identification of enterobacteria, secondly antibiogram was performed by diffusion method and finally the molecular characterization was done by conventional polymerase chain reaction (PCR) to search for antibiotic resistance genes blaTOHO and blaBES. The ultraviolet (UV) lamp (Gene Flash) for the photography of gels allowed the visualization of specific bands of TOHO and BES genes. Among 250 strains of Gram negative bacilli collected, 60 strains (24.1%) showed resistance profile to antibiotics used. Molecular characterization showed the coexistence between blaTOHO and blaBES genes in 53.3% in bacteria strains carried by the patients. The highest prevalence was observed in Escherichia coli (34.4%) and Klebsiella pneumoniae (21.9%) strains. For the first time in Ouagadougou, Burkina Faso, this study therefore established the coexistence between blaTOHO and blaBES genes in ESBL produced enterobacteria at Saint Camille Hospital.

Resistance to a wide variety of common antibiotics is observed among clinical strains designated as extended-spectrum β-lactamase (ESBL) producers. These produce enzymatic proteins that effectively inactivate cephalosporins and aztreonam and are a serious global health problem that complicates treatment strategies. Many studies report a high prevalence of ESBL producers among Gram-negative bacilli. The purpose of this work was to identify resistance genes in enterobacterial strains. Gramnegative bacilli resistant to at least one third-generation cephalosporin, aztreonam or showing a synergy image between amoxicillin + clavulanic acid and a third generation cephalosporin were isolated during an antibiogram. Antibiotic resistance was detected for the following antibiotics: Ceftriaxone, Cefotaxime, Ceftazidime and Aztreonam. Classical polymerase chain reaction (PCR) analyzes of Pseudomonas extended resistance (PER) and Guiana extended-spectrum (GES) β-lactamase genes were performed using specific primers in 60 ESBL-producing isolates. Among 250 strains of Gram negative bacilli collected, 60 strains (24%) showed resistance to antibiotics used. Stool samples are a major source of ESBL producers. The highest prevalence of resistant strains (35%) was observed in Escherichia coli. The GES and PER genes were simultaneously detected at a proportion of 13.33%. This study represents the first detection of PER and GES genes in multidrug-resistant enterobacteria in Burkina Faso.

Several studies have been reported on the bla TEM , bla CTX-M and bla SHV genes in Extended-spectrum βlactamase (ESBL) producing Enterobacteria, however very few studies reported in the literature are related to bla BES in ESBL producing Enterobacteria. This study concerns the molecular epidemiology of the bla BES gene in Enterobacteria identified from in-patients and outpatients at Saint Camille hospital of Ouagadougou (Burkina Faso). The study was first involved microbiological identification of Enterobacteria that are implicated in antibiotic resistance using API 20 E system; the antibiotics susceptibility test was secondly performed by the diffusion method and the molecular characterization was finally made by PCR to detect the bla BES gene. Data were entered and analyzed using Excel 2013 and EPI Info version 6.0 software. A p-value < 0.05 was considered as significant. A total of 60 isolates of ESBL-producing Enterobacteria were found: 21 (35%) Escherichia coli; 18 (30%) Klebsiella pneumoniae; 6 (10%) Enterobacter cloacae; 4 (7%) Proteus mirabilis; 4 (7%) Serratia marcescens; 3 (5%) Citrobacter freundii; 1 (1.6%) Enterobacter aerogenes; 1 (1.6%) Citrobacter brakii; 1 (1.6%) Citrobacter youngae and 1 (1.6%) Salmonella arizonae. Molecular characterization revealed the presence of the bla BES gene in 38 (63.3%) of bacterial isolates carried by patients. The presence of bla BES gene in ESBL producing Enterobacteria at Saint Camille Hospital in Ouagadougou was therefore established in this study for the first time in Burkina faso.