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JAC Advance Access published online on May 19, 2009
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkp179
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Risk factors for ciprofloxacin-resistant Campylobacter infection in Wales

Meirion R. Evans1,2,*, Gemma Northey1, Tinnu S. Sarvotham1, A. Lynne Hopkins1, Christine J. Rigby1 and Daniel Rh. Thomas2

1 Department of Primary Care and Public Health, Cardiff University, Cardiff, UK 2 Communicable Disease Surveillance Centre, National Public Health Service for Wales, Cardiff, UK

Received 17 February 2009; returned 27 March 2009; revised 9 April 2009; accepted 24 April 2009

* Corresponding author. Communicable Disease Surveillance Centre, National Public Health Service for Wales, Temple of Peace and Health, Cathays Park, Cardiff CF10 3NW, UK. Tel: +44-2920-402471; Fax: +44-2920-402526; E-mail: meirion.evans{at}nphs.wales.nhs.uk

Objectives: To identify risk factors for ciprofloxacin resistance in both travel-related and domestically acquired Campylobacter infection.

Methods: Case–comparison study of patients with ciprofloxacin-resistant and ciprofloxacin-susceptible Campylobacter infection conducted in Wales during 2003 and 2004.

Results: Foreign travel was the major risk factor for ciprofloxacin-resistant infection [adjusted odds ratio (adjOR) 24.0, 95% confidence interval (95% CI) 12.6–45.9]. Among travellers, case patients were five times more likely to drink still bottled water (adjOR 4.7, 95% CI 1.0–21.7), whilst among non-travellers, case patients were three times more likely to drink sparkling bottled water (adjOR 3.3, 95% CI 1.5–7.4). There was no increased risk associated with eating poultry or prior quinolone use.

Conclusions: Foreign travel remains the most important risk factor for ciprofloxacin-resistant Campylobacter infection. The possible association of both domestic- and travel-related ciprofloxacin-resistant Campylobacter infection with bottled water needs to be further explored.

Key Words: drug resistance , fluoroquinolones , case–control studies


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