Occurrence and Antimicrobial Resistance of Shigella Isolates in Ready-to-Eat Foods Sold near Primary Schools in Burkina Faso: Implications for Food Safety and Public Health*
Ready-to-eat (RTE) foods constitute an important source of affordable meals for schoolchildren in many low-income countries. However, inadequate hygiene practices during preparation, handling, and sale may facilitate contamination by enteric pathogens, including antimicrobial-resistant bacteria. This study investigated the occurrence of Shigella spp. in RTE foods sold near primary schools in Tenkodogo, Burkina Faso, and assessed antimicrobial resistance profiles and factors associated with contamination. A cross-sectional study was conducted from December 2024 to January 2025, including 69 food vendors from nine primary schools. A total of 102 RTE food samples were collected aseptically. Shigella was identified using culture, biochemical tests, and multiplex PCR targeting ipaH and species-specific genes (wbgZ, rfpB, rfc). Antimicrobial susceptibility was determined by disk diffusion (EUCAST). Sociodemographic and hygiene data were collected via structured questionnaire and observation. Associations with contamination were explored using Firth’s penalized logistic regression. Shigella contamination prevalence was 5.9% (6/102; 95% CI: 2.2% - 12.4%). All isolates were Shigella sonnei. Resistance rates were high for azithromycin (100%), ampicillin (66.7%), and cefoxitin (66.7%). All isolates remained susceptible to ciprofloxacin. The multiple antibiotic resistance (MAR) index ranged from 0.1 to 0.9. No wrapped food was contaminated (0/28) versus 14.6% (6/41) of unwrapped foods (aOR = 0.06; 95% CI: 0.00 - 0.62). Foods exposed to flies had a non-significantly higher contamination rate (28.6% vs 6.5%). Although prevalence was low, the presence of azithromycin resistant S. sonnei in foods consumed daily by schoolchildren is a public health concern. Simple, low-cost interventions promoting food wrapping and reducing fly exposure through improved waste management could substantially reduce contamination. The high azithromycin resistance challenges empiric uses of this drug for pediatric shigellosis in this setting. Strengthening AMR surveillance along the informal food chain is urgently needed.
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