Patients with antimicrobial-resistant nontyphoidal Salmonella infection were more likely to have bloodstream infection and to be hospitalized than were patients with pansusceptible infection. Mitigation of antimicrobial resistance in Salmonella will likely benefit human health.

We summarize antimicrobial resistance surveillance data in human and chicken isolates of Campylobacter . Isolates were from a sentinel county study from 1989 through 1990 and from nine state health departments participating in National Antimicrobial Resistance Monitoring System for enteric bacteria (NARMS) from 1997 through 2001. None of the 297 C. jejuni or C. coli isolates tested from 1989 through 1990 was ciprofloxacin-resistant. From 1997 through 2001, a total of 1,553 human Campylobacter isolates were characterized: 1,471 (95%) were C. jejuni , 63 (4%) were C. coli , and 19 (1%) were other Campylobacter species. The prevalence of ciprofloxacin-resistant Campylobacter was 13% (28 of 217) in 1997 and 19% (75 of 384) in 2001; erythromycin resistance was 2% (4 of 217) in 1997 and 2% (8 of 384) in 2001. Ciprofloxacin-resistant Campylobacter was isolated from 10% of 180 chicken products purchased from grocery stores in three states in 1999. Ciprofloxacin resistance has emerged among Campylobacter since 1990 and has increased in prevalence since 1997.

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The indoor pool where the lifeguards worked was located in a large municipal recreation center. The swimming area consisted of 3 separate pools joined by two 4-foot (120-cm) waterfalls. The pool area contained 3 wall spouts, 4 fan sprays, 4 bridge sprays, a large and a small water slide, a leviXjpi! tator pump, a "bubbler," and a "mushroom" fountain. Two hot tubs located in an alcove behind the lap pool were disinfected with hydrogen peroxide and a bromine solution. Pool water was disinfected with chlorine and recirculated through the water spray features.Discussion with aquatics supervisors revealed persistently increased combined chlorine levels and alkaline pool water, but review of logs showed that water chemistry parameters consistently met current standards. Water spray features ran continuously when the pool first opened in November 1986. Within several months, the guards complained of oppressive humidity when water spray features were in use, and an hourly rotation system was devised to keep some of the features on at all times and others on intermittently. Despite this system, the lifeguards frequently turned off the water spray features in an effort to improve air quality. Employee health records indicated that at least 10 lifeguards had experienced pool-related respiratory and systemic symptoms during the 3 years since the pool had opened. A number of lifeguards had quit as a result ofthese symptoms.Following extensive ventilation system and engineering improvements, the pool reopened in May 1990. Within 3 months, we recognized a second outbreak ofgranulomatous lung disease among both newly hired and