JAC Advance Access originally published online on November 12, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 1035-1039
© 2003 The British Society for Antimicrobial Chemotherapy
Multidrug resistance in Campylobacter jejuni strains collected from Finnish patients during 1995–2000
1 Antimicrobial Research Laboratory, National Public Health Institute, Turku; 2 Department of Medicine, Turku University Central Hospital, Turku; 3 Laboratory of Enteric Pathogens, National Public Health Institute, Helsinki, Finland
Received 16 July 2003; returned 15 August 2003; revised 25 September 2003; accepted 27 September 2003
Objectives: The resistance of Campylobacter jejuni to fluoroquinolones is increasing globally. This study was performed to delineate those antimicrobial agents that are effective in vitro against ciprofloxacin-resistant C. jejuni isolates and potentially suitable for the treatment of severe disease when fluoroquinolone resistance or multidrug resistance is known or suspected.
Methods: During 1995–2000 we collected 376 C. jejuni strains, of which 354 were of foreign origin from multiple countries and 22 were of domestic origin. The MICs of 12 antimicrobial agents against the isolates were determined.
Results: Of the 376 strains, 174 (46%) were resistant to ciprofloxacin. Among other antimicrobials, resistance was most common to tetracycline (46%) and ampicillin (17%). Of the ciprofloxacin-resistant strains, 68% and 25%, respectively, were resistant to tetracycline and ampicillin, and 3% were resistant to erythromycin, gentamicin or clindamycin. One (0.6%) ciprofloxacin-resistant isolate was resistant to co-amoxiclav and none was resistant to imipenem. Resistance to three or more antimicrobial groups was detected in 22% of the isolates. Multidrug resistance was significantly associated with ciprofloxacin resistance (33% versus 12%; P < 0.01). Eight (2%) strains were resistant to macrolides, of which 75% were also resistant to ciprofloxacin, but none was resistant to co-amoxiclav or imipenem.
Conclusions: Macrolides still appear to be the first-choice alternative for suspected C. jejuni enteritis, if antimicrobial treatment is needed. The in vitro susceptibilities suggest that clinical trials to treat enteritis caused by multidrug-resistant C. jejuni with co-amoxiclav, and life-threatening infections with a carbapenem, may be valuable.
Keywords: drug resistance, fluoroquinolones, macrolides, diarrhoea
* Correspondence address. Antimicrobial Research Laboratory, National Public Health Institute, PO Box 57, 20521 Turku, Finland. Tel: +358-2-3316600; Fax: +358-2-3316699; E-mail: antti.hakanen{at}utu.fi
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