Short‐Term and Medium‐Term Clinical Outcomes of Quinolone‐Resistant<i>Campylobacter</i>Infection

Evans, Meirion Rhys; Northey, Gemma; Sarvotham, Tinnu; Rigby, C.; Hopkins, A. Lynne; Thomas, Daniel Rhys

doi:10.1086/598932

Cited by 16 publications

(17 citation statements)

References 23 publications

(36 reference statements)

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“…In agreement with previous data, only a few C. jejuni/C. coli patients had prolonged diarrhoea [17,23,24]. In contrast, 80% of C. concisus patients reported prolonged diarrhoea of >2 weeks.…”

Section: Discussionsupporting

confidence: 92%

Short-term and medium-term clinical outcomes of Campylobacter concisus infection

Nielsen

Engberg

Ejlertsen

et al. 2012

Clinical Microbiology and Infection

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Clin Microbiol Infect 2012; 18: E459–E465 Abstract There are only sparse data on the short‐term and medium‐term clinical impacts of Campylobacter concisus infection. A clinical study was performed during a 2‐year period to determine the clinical manifestations in C. concisus‐positive adult patients. A case patient was defined as an adult patient (≥18 years) with a C. concisus‐positive stool sample during the study period. Clinical data were obtained with use of a questionnaire supplemented with the patients’ medical records, if any. The short‐term and medium‐term clinical manifestations in these patients were compared with those of patients with Campylobacter jejuni/Campylobacter coli infection. One hundred and seventy‐four C. concisus patients and 196 C. jejuni/C. coli patients participated in the study. Patients with pre‐existing inflammatory bowel disease or microscopic colitis or enteric co‐infection were excluded from review of the clinical manifestations. Comparison of the short‐term clinical manifestations in 139 C. concisus patients with those in 187 C. jejuni/C. coli patients showed a significantly lower prevalence of fever, chills, mucus and blood in stools, and weight loss. However, 80% of C. concisus patients, but only 32% of C. jejuni/C. coli patients, had diarrhoea for >2 weeks. After a 6‐month follow‐up period, 12% of C. concisus patients were diagnosed with microscopic colitis, whereas no C. jejuni/C. coli patients were diagnosed with non‐infective colitis. Irritable bowel symptoms were common in both groups at follow‐up. C. concisus infection seems to cause a milder course of acute gastroenteritis than C. jejuni/C. coli infection, but is associated with more prolonged diarrhoea.

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Section: Discussionsupporting

confidence: 92%

Short-term and medium-term clinical outcomes of Campylobacter concisus infection

Nielsen

Engberg

Ejlertsen

et al. 2012

Clinical Microbiology and Infection

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“…What appears more limiting are dose-response models that describe the probability of illness based on the conditional probability of infection and including people who are already compro mised, such as those under going anti biotic therapy. Although there is definitive data on pARB being more pathogenic or causing more severe illness than their antimicrobial susceptible equivalents (Barza 2002;Helms et al 2004Helms et al , 2005Travers and Barza 2002), that may not always be the case (Evans et al 2009;Wassenaar et al 2007). Clear examples of excess mortality include associ ated blood stream infections for methicillin resistant Staphylococcus aureus (MRSA) and from third generation cephalosporinresistant E. coli (G3CREC).…”

Section: Applicability Of Traditional Risk Assessment Approachesmentioning

confidence: 99%

Human Health Risk Assessment (HHRA) for Environmental Development and Transfer of Antibiotic Resistance

Ashbolt

Amézquita²,

Backhaus³

et al. 2013

Environ Health Perspect

566

331

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Background: Only recently has the environment been clearly implicated in the risk of antibiotic resistance to clinical outcome, but to date there have been few documented approaches to formally assess these risks.Objective: We examined possible approaches and sought to identify research needs to enable human health risk assessments (HHRA) that focus on the role of the environment in the failure of antibiotic treatment caused by antibiotic-resistant pathogens.Methods: The authors participated in a workshop held 4–8 March 2012 in Québec, Canada, to define the scope and objectives of an environmental assessment of antibiotic-resistance risks to human health. We focused on key elements of environmental-resistance-development “hot spots,” exposure assessment (unrelated to food), and dose response to characterize risks that may improve antibiotic-resistance management options.Discussion: Various novel aspects to traditional risk assessments were identified to enable an assessment of environmental antibiotic resistance. These include a) accounting for an added selective pressure on the environmental resistome that, over time, allows for development of antibiotic-resistant bacteria (ARB); b) identifying and describing rates of horizontal gene transfer (HGT) in the relevant environmental “hot spot” compartments; and c) modifying traditional dose–response approaches to address doses of ARB for various health outcomes and pathways.Conclusions: We propose that environmental aspects of antibiotic-resistance development be included in the processes of any HHRA addressing ARB. Because of limited available data, a multicriteria decision analysis approach would be a useful way to undertake an HHRA of environmental antibiotic resistance that informs risk managers.Citation: Ashbolt NJ, Amézquita A, Backhaus T, Borriello P, Brandt KK, Collignon P, Coors A, Finley R, Gaze WH, Heberer T, Lawrence JR, Larsson DG, McEwen SA, Ryan JJ, Schönfeld J, Silley P, Snape JR, Van den Eede C, Topp E. 2013. Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance. Environ Health Perspect 121:993–1001; http://dx.doi.org/10.1289/ehp.1206316

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“…3e10 Quinolone resistance emerged among Campylobacter species and might increase the duration of diarrhea and limit the utility of quinolone, 12e15 but one study questioned the clinical significance of quinolone resistance. 16 Enteritis caused by Campylobacter is normally self-limiting, and patients usually recover without antimicrobial therapy. In contrast, physicians usually prescribe systemic antimicrobial agents for patients with Campylobacter bacteremia.…”

Section: Introductionmentioning

confidence: 99%

Bacteremia caused by antimicrobial resistant Campylobacter species at a medical center in Taiwan, 1998–2008

Liao

Chuang

Huang

et al. 2012

Journal of Infection

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Short‐Term and Medium‐Term Clinical Outcomes of Quinolone‐ResistantCampylobacterInfection

Cited by 16 publications

References 23 publications

Short-term and medium-term clinical outcomes of Campylobacter concisus infection

Short-term and medium-term clinical outcomes of Campylobacter concisus infection

Human Health Risk Assessment (HHRA) for Environmental Development and Transfer of Antibiotic Resistance

Bacteremia caused by antimicrobial resistant Campylobacter species at a medical center in Taiwan, 1998–2008

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