Antimicrobial Resistance in Senegal: Bacterial Ecology and Resistance Profiles from Cheikh Ahmadoul Khadim National Hospital of Touba

Background: Antimicrobial resistance (AMR) is a growing concern in sub-Saharan Africa, where infectious diseases remain highly prevalent. In Senegal, available AMR data are limited and fragmented. Methods: We conducted a retrospective study at Cheikh Ahmadoul Khadim National Hospital, Touba (January-December 2024). All hospitalized patients with culture-confirmed bacterial infections were included. Bacterial identification and antimicrobial susceptibility testing followed CA-SFM/EUCAST 2024 guidelines. Results: Among 369 patients (median age 36 years; 59% male), 251 cultures were positive (68%). Gram-negative bacilli predominated (69.5%), mainly Escherichia coli (24.2%) and Klebsiella spp. (22.1%). Gram-positive cocci accounted for 30%, dominated by Staphylococcus aureus (20.4%). Resistance to first-line antibiotics was high: penicillins ≈ 50%, third-generation cephalosporins 20% - 36% in Enterobacterales, and trimethoprim-sulfamethoxazole ≥ 37%. Carbapenem resistance remained low (<12%), and amikacin, fosfomycin, and nitrofurantoin retained activity. MRSA prevalence was 14.3%. Conclusion: AMR is widespread in Senegal, with ESBL-producing Enterobacterales and MRSA circulation. Strengthened surveillance and stewardship are urgently required.