Introduction. Antibiotic resistance is a major global health challenge that disproportionately affects low-resource countries, particularly those in West Africa. E. coli, a major pathogen in childhood diarrhea, is both a prominent infectious agent and a reservoir of resistance genes, including resistance to last-resort antibiotics such as carbapenems. Methodology. The study focused on 98 clinical E. coli isolates collected from stool samples of patients in a hospital setting in Bamako. The analyses included screening for DEC-specific virulence genes, detection of resistance genes across various classes of antibiotics (e.g., beta-lactams, carbapenems, fluoroquinolones), and identification of class I, II, and III integrons. The bla_NDM gene was sequenced to identify mutations associated with carbapenem resistance. Results. Among the isolates, 85.7% carried at least one virulence gene. Of these, half involved co-infections, commonly combining EPEC, EAEC, and ETEC strains. Regarding antibiotic resistance, 94.9% of isolates harbored at least one resistance gene, and 50% were multidrug-resistant. The most frequently detected genes were bla_TEM, qnrS1, and aphA3. Class II integrons were significantly associated with multidrug resistance (p = 0.01). Sequencing of the bla_NDM gene revealed point mutations likely to affect protein function, suggesting an evolution toward increased resistance to carbapenems. Conclusion. The high prevalence of multidrug-resistant diarrheagenic E. coli strains in this study highlights the local antibiotic pressure and the serious health threat it represents. This study shows that the new β-lactamase bla_NDM gene has disseminated in the hospital environment of Bamako. It should be noted that this will become a major challenge for clinicians.

The COVID-19 pandemic highlighted the need for rapid and accurate diagnosis of respiratory viral infections and reinforced the importance of integrated respiratory virus surveillance systems. Rapid diagnostic tests (RDTs) provide timely results but may show limited sensitivity compared with molecular assays. This study aimed to evaluate the diagnostic performance of the BD Veritor™ System for Rapid Detection of Respiratory Viruses for detecting respiratory syncytial virus (RSV), Influenza A, and Influenza B in Mali, using multiplex real-time RT-PCR as the reference standard. A total of 1202 nasopharyngeal and/or oropharyngeal swab specimens collected between March 2020 and March 2022 from suspected respiratory infection cases were analyzed. Samples were tested using the BD Veritor™ rapid antigen assay and compared with the ViroQ^® SARS-CoV-2/FluA/FluB/RSV multiplex RT-PCR assay performed on the LightCycler^® 480 II system. Diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen’s kappa coefficient. The BD Veritor™ assay demonstrated consistently high specificity (>91%) for all viral targets, whereas sensitivity remained low, ranging from 21.05% to 30.43%. Positive predictive values ranged from 24.78% to 46.15%, while negative predictive values remained above 83%. Agreement with RT-PCR was low (κ = 0.14–0.24), indicating limited concordance between the two methods. The reduced sensitivity observed may partly be explained by low viral loads, prolonged frozen storage of samples before antigen testing, and the complex epidemiological context associated with the co-circulation of respiratory viruses during the COVID-19 pandemic. Although the BD Veritor™ assay may provide useful support for rapid clinical orientation and triage in resource-limited settings, negative results should be interpreted cautiously and confirmed by RT-PCR whenever possible.