Rising Burden of ESBL-Producing Escherichia coli and Klebsiella pneumoniae in Burkina Faso: A Five-Year Retrospective Analysis.

Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are major contributors to antimicrobial resistance worldwide. Data from Burkina Faso remain limited, despite growing concerns about multidrug resistance in urinary pathogens. We conducted a retrospective cross-sectional study using microbiological records from three medical laboratories in Ouagadougou between January 2018 and December 2022. All urine culture isolates of E. coli and K. pneumoniae were included. Patient demographics, hospitalization status, and antimicrobial susceptibility profiles were extracted. ESBL production was confirmed phenotypically using the double disk synergy test. Statistical analyses were performed to compare prevalence and resistance patterns across species and patient groups. A total of 4,234 isolates were analyzed, comprising 3,084 E. coli (72.8%) and 1,150 K. pneumoniae (27.2%). ESBL prevalence rose from 3.8% in 2018 to 24.7% in 2022, with E. coli consistently showing higher rates in later years. Sociodemographic analysis revealed significantly higher ESBL prevalence among patients aged ≥ 60 years compared with younger age groups (18.9%), hospitalized patients compared with outpatients (16.9% vs. 14.1%; p = 0.02), and male patients compared with females (17.5% vs. 14.5%; p = 0.015). ESBL producers demonstrated markedly greater resistance to fluoroquinolones, and aminoglycosides (p < 0.001), while carbapenems remained largely effective. ESBL prevalence among urinary isolates in Ouagadougou has increased substantially, with E. coli emerging as the predominant producer. The association with older age, inpatient status, and male gender highlights key risk groups. These findings underscore the urgent need for strengthened antimicrobial stewardship, infection control, and expanded surveillance across Burkina Faso.