Human Campylobacteriosis in Italy: Emergence of Multi-Drug Resistance to Ciprofloxacin, Tetracycline, and Erythromycin

Abstract

Campylobacter spp. is one of the main cause of bacterial gastroenteritis in the world. The increase of antibiotic resistance in this species is a threat to public health. A Campylobacter spp. surveillance study was performed in Italy in the 2013–2016 period by the Enter-Net Italia network. The most prevalent Campylobacter species identified causing gastroenteritis was Campylobacter jejuni (73.4%) and 45% of all the annual cases of campylobacteriosis were reported in the summer period. High rates of ciprofloxacin and tetracycline resistance in Campylobacter spp. have been observed. An increasing percentage of Campylobacter coli strains simultaneously resistant to ciprofloxacin, tetracycline and erythromycin has been found. Molecular mechanisms of resistance have been investigated and the role of efflux pumps evaluated. Antibiotic resistance in Campylobacter spp. is an increasing serious threat that requires coordinated action to minimize the emergence and spread of antimicrobial resistant strains from animals to humans throughout the food chain.

Genetic stability of Campylobacter coli in patients with primary antibody deficiencies

“…Moreover, C. coli was also the most frequent isolate (5%) in patients with asymptomatic PAD, followed by C. jejuni (1.2%), whereas in immunocompetent individuals, C. jejuni is one of the most prevalent etiologic agents of gastroenteritis and C. coli has a low prevalence in diarrheal disease. 3,4 Differently from the French data, we showed that the same C. coli strain has been isolated for more than 10 years in an asymptomatic patient with XLA. 2 As previously shown, 5 after this long-lasting silent infection, the same intestinal strain caused recurrent episodes of sepsis and leg cellulitis, without changing its molecular pattern.…”

Prevalence, Population Diversity and Antimicrobial Resistance of Campylobacter coli Isolated in Italian Swine at Slaughterhouse

“…In our study, we noted the presence of the tet (O) gene in 88.88% of isolated pigs, indicating a very strong correlation (98.76%) between phenotypic and genotypic resistances, which decrease to the 80% level of concordance in humans. The high resistance to tetracycline of bacteria isolated from food, including Campylobacter, remains a serious problem in many European countries [40]. Fluoroquinolone resistance in our strains was mainly due to the presence of the Thr86Ile GyrA mutation.…”

“…High levels of resistance to ciprofloxacin (52.3%) and tetracyclines (51.5%) were also observed in C. coli from fattening pigs, with a lower percentage for erythromycin (15.6%). Combined resistance to ciprofloxacin and erythromycin was reported in 61.2% of C. coli isolates from fattening pigs in Spain [40]. In Italy, high rates of ciprofloxacin and tetracycline resistance in Campylobacter spp.…”

New and alternative strategies for the prevention, control, and treatment of antibiotic-resistant Campylobacter

“…[42][43][44][45][46] The resistance to fluoroquinolones is especially a concern as in many countries, the majority of Campylobacter isolates are no longer susceptible to this class of antibiotics. 18,[47][48][49][50] In the U.S., a recent CDC report revealed a rising trend of ciprofloxacin-resistant Campylobacter for the past two decades and the resistance rate reached 29% in 2017. 9 A unique feature of fluoroquinolone resistance in Campylobacter is its continued persistence or even increased prevalence in the absence of antibiotic usage.…”