Species identification and antimicrobial susceptibility of Campylobacter spp. and related organisms: a 2-year survey in a tertiary university hospital

Abstract

Objective: To identify at species level, in a prospective study in a tertiary university hospital during the two years 1996 and 1997, all isolates of Campylobacferspp. and related organisms and to determine their susceptibility to erythromycin and ciprofloxacin. Methods:The feces were collected in Caw-Blair medium, and isolation was performed on Karmali agar incubated at 35°C. BACTEC Plus aerobic/f vials were used for blood cultures. Identification was performed by biochemical methods for Campylobacter jejuni and by molecular hybridization for the other species. MlCs for erythromycin and ciprofloxacin were determined by Etest. Result.:In total, 142 isolates from 140 infected patients, including 135 fecal isolates and seven blood isolates, were analyzed. Clinical findings of the seven patients with bacteremia and the seven patients with gastroenteritis due to species other than Campylobacfer jejuni or Campylobacter coli showed a predominance of immunocompromised patients. The fecal isolates include 113 (83.7%) Campylobacfer jejuni, nine (6.6%) Campylobacter coli, four Arcobacter butzleri, two Campylobacter fetus and one Helicobacter pullorum. Of the seven isolates from blood culture. three were Campylobacter jejuni, three Campylobacter fetus and one Helicobacter cinaedi. Resistance to ciprofloxacin (MIC >4 mgk) was reported for 18 (1 5.6%) Campylobacfer jejuni isolates, three Campylobacfer coli isolates, one Campylobacter fetus isolate and one Arcobacfer bufzleri isolate. Resistance to erythromycin (MIC >8 mgL) was found for two isolates of Campylobacter coli, which were also resistant to ciprofloxacin, and the isolate of Helicobacter cinaedi.Conclusions: This study reports a predominance of Campylobacfer jejuni from stools, but a variety of more rarely isolated species was found in immunocompromised patients, emphasizing the necessity to identify fecal as well as blood isolates to the species level. Antimicrobial susceptibility tests to major antibiotics active against campylobacteria should be done routinely to follow the rate of resistance.

In Vitro Activities of New Fluoroquinolones against Campylobacter jejuni and Campylobacter coli Isolates Obtained from Humans in 1980 to 1982 and 1997 to 2001

“…A much lower frequency of 2.4, 27.1, and 17.9% in 1988, 1993, and 1996, respectively, was found by Murphy et al (19). The different methods used for the determination of resistance, the differences in the breakpoints, which varied from Ն2 to Ͼ8 g/ml and from Ն4 to Ͼ8 g/ml for quinolones and macrolide-TETs, respectively (5,8,10,14,25,26), made a direct comparison of the data presented here with those of other studies difficult. This supports the urgency of developing standardized methods for testing the anticampylobacter activity in vitro.…”

“…GAT was previously reported to be particularly active against the Enterobacteriaceae (11) and approximately 8-to 16-fold more potent than CIP (MIC 90 ϭ 4 g/ml versus Ն32 g/ml) against Campylobacter (10), as also shown in the presentstudy.Nodifferencewasseenintheactivityoffluoroquinolones and the unrelated drugs against C. jejuni compared to C. coli. However, the number of C. coli strains studied here was too small compared to the number of C. jejuni strains, which is also the most frequently isolated species from humans (14,21,25). As in several recent studies (6,8,10,14,19,21,25), a high frequency of resistance to CIP and to the other newer fluoroquinolones and other antibiotics was detected here among C. jejuni and C. coli isolates through the last period studied, namely, 1997 to 2001.…”

“…However, the number of C. coli strains studied here was too small compared to the number of C. jejuni strains, which is also the most frequently isolated species from humans (14,21,25). As in several recent studies (6,8,10,14,19,21,25), a high frequency of resistance to CIP and to the other newer fluoroquinolones and other antibiotics was detected here among C. jejuni and C. coli isolates through the last period studied, namely, 1997 to 2001. A significant increase in the geometric mean of the MICs and the percent resistance to all of the fluoroquinolones was observed among C. jejuni and C. coli isolates collected in 1997 to 2001 compared to those observed for isolates collected in 1980 to 1982, and this corresponded to recent data (5); the reported increase of resistant strains isolated in 1998 to 2000 to CIP and nalidixic acid was 30.6% compared to 0% in 1987 and 1988.…”

“…Although infections with these bacteria are usually self-limited so that a treatment with antibiotics is not required, clinical complications and systemic and postinfectious manifestations may occur (13,14,18,22).…”

Antimicrobial Resistance in Campylobacterjejuni and Campylobacter coli Strains Isolated in 1991and 2001-2002 from Poultry and Humans in Berlin,Germany

“…To separate susceptible from resistant Campylobacter strains, we chose to use NCCLS breakpoints for the family Enterobacteriaceae and Staphylococcus spp., as the vast majority of experimenters working with antimicrobial resistance in Campylobacter spp. do at present (1,9,10,16,19,30). Other methods used internationally, e.g., the German Standard DIN 58940-4 (3), do have other breakpoint values for the Enterobacteriaceae.…”