Campylobacter: fluoroquinolone resistance in Latin-American countries

Abstract

ABSTRACT.Campylobacter jejuni and C. coli are zoonotic bacteria recognised as a major cause of human gastroenteritis and frequent cause of bacterial food-borne illness around the world. A great variety of food-producing animals, especially poultry are important reservoir involved in their spread to humans. Campylobacter gastroenteritis is generally a self-limiting disease avoiding antimicrobial prescription but, when antibiotic therapy is indicated, erythromycin and fluoroquinolone are the drugs of choice. However, Campylobacter has become increasingly resistant to fluoroquinolones with high isolation rates among human and animal strains. This review shows and discusses the data generated in Latin America in relation to fluoroquinolone resistance in Campylobacter highlighting that i) fluorquinolone resistant strains are reported with high frequencies in several countries; ii) the available data allows to confirm that human infection by fluoroquinolone-resistant Campylobacter are originated mainly from the food chain animals and environmental sources; iii) Campylobacter isolation, identification and antimicrobial susceptibility testing have been performed with different analytical methods making necessary the harmonisation and standardisation of diagnostic methods and iv) strengthening Campylobacter antimicrobial resistance surveillance programs and capacity building with the association between public health services and the academic world are necessary.Key words: Campylobacter, fluoroquinolone, resistance, Latin-America. RESUMEN.Campylobacter jejuni y C. coli son bacterias zoonóticas reconocidas como causa importante de gastroenteritis en humanos y agente frecuente de infecciones alimentarias en todo el mundo. Una gran variedad de animales productores de alimentos para consumo humano, especialmente aves, son importantes reservorios involucrados en su transmisión al ser humano. La gastroenteritis por Campylobacter es generalmente autolimitada, dispensando la prescripción de antibióticos, pero cuando la terapia antibiótica es necesaria, la eritromicina y las fluoroquinolonas son los antimicrobianos de elección. Sin embargo, Campylobacter a llegado a ser cada vez más resistente a fluoroquinolonas, con altas tasas de aislamiento, tanto en seres humanos como en animales. Esta revisión muestra y discute los datos generados en América Latina con relación a la resistencia a fluoroquinolonas en Campylobacter destacando que i) cepas resistentes a fluoroquinolonas son reportadas con altas frecuencias en diversos países; ii) los datos disponibles permiten confirmar que la infección humana por Campylobacter resistentes a fluoroquinolonas se origina principalmente por fuentes animales y ambientales; iii) el aislamiento, la identificación y las pruebas de susceptibilidad antimicrobiana para Campylobacter han sido realizadas mediante diferentes métodos analíticos haciendo necesarias la armonización y estandarización de los métodos diagnósticos y iv) es necesario fortalecer los programas de vigilancia de la resistencia antimicr...

Genomic Analysis of Chilean Strains ofCampylobacter jejunifrom Human Faeces

“…On the other hand, the combination of the high ciprofloxacin resistance observed among Chilean isolates and their possible association with animal origin provides new evidence supporting the statement that food-producing animals and the food chain is the main source for transmission of resistant strains in Latin American countries [12].…”

“…No resistance was observed among C. jejuni clinical strains isolated between 1996 and 1997 by Fernández et al [39], while resistance to this antibiotic as high as 48% was reported later on by Collado et al [21]. It has been stated that food-producing animals and the food chain are the main source for transmission of fluoroquinolone-resistant strains in Latin American countries [12]. However, more studies to determine the sources of this increasing resistance to fluoroquinolones are warranted.…”

“…C. jejuni is the most frequently isolated species among patients with diarrhoea (about 90%), followed by C. coli , with 5-10% of cases [12]. For that reason, C. jejuni is the most studied species.…”

Genomic analysis of the diversity, antimicrobial resistance and virulence potential of clinical Campylobacter jejuni and Campylobacter coli strains from Chile

“…However, all of the strains belonging to ST-1359, the most frequent ST identified, harbored this mutation. Since fluoroquinolones are not the first choice antimicrobials for human campylobacteriosis, it has been suggested that high levels of resistance might be a consequence of their broad use in animal husbandry in Latin America [ 55 ]. These animal production practices might be responsible for the dissemination of antibiotic resistance genes among Chilean Campylobacter strains.…”

Prevalencia y caracterización del perfil de susceptibilidad antimicrobiana de Campylobacter jejuni y Campylobacter coli en niños con diarrea de la ciudad de Loja, Ecuador

“…Cuando está indicada la terapia antimicrobiana, los macrólidos (eritromicina, claritromicina o azitromicina) son los agentes de elección para el tratamiento de los casos de Campylobacter confirmados por cultivo, especialmente en niños. Las fluoroquinolonas (ciprofloxacina) son utilizadas en adultos para el tratamiento empírico de la diarrea del viajero y casos de diarreas sin agente etiológico diagnosticado mientras que la gentamicina se reserva para el tratamiento de infecciones sistémicas y extraintestinales 20,21 . Considerando el surgimiento de resistencia a los antimicrobianos de elección, la OMS recomienda realizar pruebas de susceptibilidad antimicrobiana in vitro, tanto para proporcionar una orientación sobre el tratamiento apropiado de la campylobacteriosis como para contribuir al conocimiento epidemiológico y a la vigilancia de la resistencia en Campylobacter 2 .…”