Antibiotic Resistance of Campylobacter spp. in a Pediatric Cohort Study [Epidemiology and Surveillance]

Objectives

To determine phenotypic patterns of antibiotic resistance and epidemiology of drug-resistant Campylobacter spp. from a low-resource setting.

Methods

A birth cohort of 303 was followed until 5 years of age. Stool from asymptomatic (n= 10,008) and diarrhea samples (n=3175) were cultured for Campylobacter. Disk diffusion to CIP, NAL, ERY, AZM, TET, GM, AMP, AMC, CRO, C and TMS were determined. Antibiotic resistance between C. jejuni and non-C. jejuni isolates, and surveillance and diarrhea samples were compared and the association between personal macrolide exposure and subsequent occurrence of a macrolide resistant Campylobacter spp. was assessed.

Results

Of 917 Campylobacter isolates, 77.4% of C. jejuni isolates and 79.8% non-C. jejuni isolates were resistant to ciprofloxacin while 4.9% of C. jejuni isolates and 24.8% of non-C. jejuni isolates were not susceptible to azithromycin. Of the 303 children, 33.1% were ever diagnosed with a Campylobacter strain non-susceptible to both azithromycin and ciprofloxacin. Personal macrolide exposure did not affect the risk of macrolide resistant Campylobacter. Amoxicillin and clavulanic acid (94.0%) was one of the antibiotics with the highest rates of susceptibility.

Conclusion

There is a high incidence of quinolone and macrolide resistant Campylobacter infections in infants under 24 months of age. Given the lack of association between personal exposure to macrolides and a subsequent Campylobacter infection resistant to macrolides, there is a need to evaluate the source of MDR Campylobacter. This study provides compelling evidence to propose amoxicillin/clavulanic acid as a treatment for Campylobacteriosis.

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