Approche intégrée pour la détection de la résistance bactérienne au Mali à l’aide de milieux chromogènes.

This study, focusing on bloodstream infections and conducted in a rural setting in Mali, aimed to assess bacterial resistance using a two-step diagnostic approach.The first step consisted of preliminary on-site detection of bacteria using manually prepared CHROMagar media, providing a simple, rapid, and cost-effective method.The second step involved phenotypic and genotypic confirmation of isolates in a reference laboratory using advanced techniques such as MALDI-TOF MS, VITEK® 2, and conventional PCR to validate resistance profiles.Among the 508 blood cultures analyzed, 29.1% (148/508; 95% CI [25][26][27][28][29][30][31][32][33]) were positive, identifying 16.9% (86/508; 95% CI [13.7-20.2])resistant strains.Of these, 75.6% (65/86; 95% CI [66.6-84.6])were Enterobacteriaceae resistant to β-lactams and carbapenems, 13.9% (12/86; 95% CI [6.5-21.3])corresponded to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), and 10.5% (9/86; 95% CI [4-16.9]) to other bacterial species.The most frequently detected resistance genes included CTX-M in 39% (49/126; 95% CI [30.3-47.5]),TEM/SHV in 26% (32/123; 95% CI [18.2-33.8]),genes encoding carbapenemases (KPC, VIM, NDM, OXA-48) in 15% (19/127; 95% CI [8.7-21.3]),and genes encoding other β-lactamases (OXA-1, bla-BEL, bla-ADCb, FOX-1) in 9% (11/122; 95% CI [4-14])."