JAC Advance Access published online on November 12, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg489
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Antimicrobial Research
Laboratory, National Public Health Institute, Turku; Department of Medicine,
Turku University Central Hospital, Turku;
* Corresponding author. E-mail: antti.hakanen{at}utu.fi.
Received 16 July 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
Multidrug resistance in Campylobacter
jejuni strains collected
from Finnish patients during 1995-2000
2 Laboratory of Enteric Pathogens, National Public
Health Institute, Helsinki, Finland
3 Antimicrobial Research
Laboratory, National Public Health Institute, Turku;
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