Epidemiological and bacteriological aspects of skin lesions in pupils attending primary schools in central Côte d’Ivoire (Bouaké)
Keywords:
Skin lesions - Staphylococcus aureus- MRSA - schoolchildren - Côte d’Ivoire (Bouake).Abstract
In Sub-Saharan Africa, skin infections mainly affect children. Among this, cutaneous anthrax is known
to affect domestic animals and young children might have contact with infected animals or
contaminated animal products. The objective of this study was to describe the epidemiological,
bacteriological aspects of skin lesions and to assess the risk of acquiring cutaneous anthrax in the
school environment in Bouaké. It is a cross-sectional descriptive and analytical study. Epidemiological
data were collected using a simple questionnaire. Skin lesions were analyzed using conventional
bacteriological methods. Antimicrobial susceptibility of isolates was tested using the Kirby-Bauer
technique according the Antibiogram Committee’s recommendations of the French Society of
Microbiology 2019. Of the 3174 schoolchildren, 1220 (38.43%) had skin lesions. 325 (26.63%)
schoolchildren were included in the study and had a mean age of 9 years (± 5) with a sex ratio of M/F at
1.65. Young schoolchildren aged 5 to 10 years were the most affected (76.62%). The majority had
regular contact with domestic animals (64.31%). The rate of hand washing after defecation was 41.38%.
Skin lesions were located on the lower limbs (91.69%), with superficial lesions (88.79%), ulceration
(81.03%) and trauma (79.40%) being the most common. Culture of swabs was positive in 85.29% of
cases and 277 bacterial strains were identified. The bacteria identified were mainly Staphylococcus
aureus (71.84%), and Streptococcus spp. (6.50%). Bacillus spp. was observed rarely, and neither classic
B. anthracis nor the atypical B. cereus biovar anthracis were identified. The resistance phenotypes
reported in Staphylococcus aureus were PASE (95%), MRSA (34%), and VAN-R (15%).The high
prevalence of MRSA requires also health surveillance in these schools. Our results can be used in the
management or antibiotic treatment of skin infections.
