Evolution of susceptibilities of Campylobacter spp. to quinolones and macrolides

Abstract

Erythromycin, new macrolides, and quinolones are alternatives for the treatment of Campylobacter infections. Concerns related to the emergence of resistance to both groups of drugs have been raised. We studied the evolution of antimicrobial susceptibilities of 275 clinical isolates of microorganisms of the genus Campylobacter isolated in our institution during a 5-year period (1988 to 1992). The microorganisms studied were C. jejuni (n = 230), C. coli (n = 42), and C. fetus (n = 3). The overall resistance rates (determined by the agar dilution method and the recommendations of the National Committee for Clinical Laboratory Standards) were as follows: erythromycin, 2.3%; clarithromycin, 2.3%; azithromycin, 1.9%o; ciprofloxacin, 28.5%; norfloxacin, 31%; ofloxacin, 26.3%; and nalidixic acid, 36.8%. The evolution of resistance (percent resistance in 1988 versus percent resistance in 1992) was as follows: erythromycin, 2.6 versus 3.1; clarithromycin, 2.6 versus 3.1; azithromycin, 2.6 versus 3.1; ciprofloxacin, 0 versus 49.5; norfloxacin, 2.6 versus 55.5; ofloxacin, 0 versus 45.6; nalidixic acid, 2.6 versus 56.8. Our data show stable macrolide activity against Campylobacter spp. and the rapid development of quinolone resistance over the last 5 years.

Antimicrobial resistance of thermophilic Campylobacter

“…Several studies have also shown an increase in the occurrence of macrolide resistance among Campylobacter causing infections in man [24,46,52]. The reason for the high frequency of macrolide resistance among C. coli from pigs has not been finally determined.…”

“…Intravenous aminoglycosides is the treatment of choice for serious Campylobacter bacteraemia and other systemic infections. However, increases in the occurrence of Campylobacter, causing infections in man, that are resistant to macrolides and fluoroquinolones, have been reported in several countries [13,16,24,45,46,52,55,57]. In these cases other antimicrobial agents may be used for treatment.…”

Acquisition of Quinolone Resistance and Point Mutation of the gyrA Gene in Campylobacter jejuni Isolated from Broilers and in vitro-Induced Resistant Strains

“…However, several subsequent reports have described the emergence of quinolone-resistant Campylobacter isolates after therapy with quinolones [1,23]. Since the late 1980s, resistance to quinolones in human Campylobacter isolates has been recognized in many countries including Spain [22], Finland [19], Austria [9] and the Netherlands [8]. In Japan, C. jejuni and C. coli isolated from humans, cattle, pigs and broilers between 1979 and 1982 were all susceptible to quinolones [21], whereas resistant isolates have been recognized in human patients since 1989 and the resistance rate is increasing [24].…”

Antimicrobial Susceptibilities of Campylobacter Strains Isolated from Broilers in the Southern Part of Japan from 1995 to 1999.

“…Quinolones were proposed for the treatment of Campylobacter enteritis early in the 80's since these agents demonstrated an exellent in vitro activities against campylobacters [6,8,14] and quinolone-resistant campylobacters were not widely recognized then. However, several reports showed appearance of quinolone-resistant campylobacters from late in the 80's [5,16,18]. In Japan, fluoroquinolone-resistant strains of C. jejuni isolated from human sporadic diarrhea have remarkably increased in number ever since 1993 [21].…”