Prevalence, species diversity, and antimicrobial resistance profiles of <i>Campylobacter</i> spp. among children under five years of age with acute diarrhea in Ouagadougou, Burkina Faso.

Abstract

<i>Campylobacter</i> species are major causes of pediatric gastroenteritis worldwide, yet their burden remains underestimated in West Africa due to diagnostic challenges. This study aimed to determine the prevalence, species diversity, and antimicrobial resistance (AMR) profiles of <i>Campylobacter</i> spp. among children under 5 years of age with acute diarrhea in Ouagadougou, Burkina Faso. From 1 May 2023 to 30 April 2024, 383 stool samples were collected at the Centre Hospitalier Universitaire P&#xe9;diatrique Charles de Gaulle. Samples were analyzed using standard culture on Karmali selective agar and biochemical identification via the API Campy system. AMR testing was performed using the disk diffusion method. <i>Campylobacter</i> spp. were detected in 33 samples (8.6% prevalence). Infection was significantly associated with the 12-23 months age group (48.5%; <i>P</i> &lt; 0.05). <i>Campylobacter jejuni</i> was the most common species (42.4%), followed by <i>C. coli</i> (21.2%) and <i>C. fetus</i> subsp. <i>fetus</i> (21.2%). Other species included <i>C. hyointestinalis</i> (6.1%), <i>C. sputorum</i> (6.1%), and <i>C. lari</i> (3.0%). Alarmingly, 100% of isolates were resistant to ampicillin, erythromycin, and tetracycline. High resistance rates were also observed for amoxicillin-clavulanic acid (93.9%) and ciprofloxacin (75.8%). Gentamicin showed the highest susceptibility (57.6%). All isolates (100%) were classified as multidrug-resistant (MDR). These results highlight a high prevalence of MDR <i>Campylobacter</i> in Ouagadougou, with total resistance to erythromycin, the first-line treatment. The identification of <i>C. fetus</i> at 42&#xb0;C suggests a high environmental and zoonotic pressure. These findings underscore the urgent need for enhanced genomic surveillance and updated clinical management guidelines for pediatric diarrhea in the region.IMPORTANCEThis study highlights the burden and antimicrobial resistance of <i>Campylobacter</i> spp. among children under five with acute diarrhea in Burkina Faso. Culture-based detection identified <i>Campylobacter</i> in 8.6% of children, confirming its role as an important but under-recognized cause of pediatric diarrheal disease. High levels of antimicrobial resistance, including complete resistance to erythromycin, raise concerns about the effectiveness of commonly used treatment options. The identification of multiple <i>Campylobacter</i> species, including <i>C. fetus</i>, suggests a broader diversity of circulating strains and possible zoonotic transmission pathways. These findings provide valuable baseline data to strengthen antimicrobial resistance surveillance, improve diagnostic practices, and support evidence-based treatment strategies in West African settings.