Medizinische Mikrobiologie und Diagnose

Human Campylobacter jejuni and Campylobacter coli Isolates: Demographic Pattern and Antimicrobial Susceptibility to Clinically Important Antimicrobials used in Livestock

Abstract

Ludwig Hartmann, Oliver Schieweck, Jörg-Christian Greie and Florian Szabados

Background: Campylobacteriosis is the leading zoonotic disease in developed countries with C. jejuni and C. coli being the two predominant causative pathogens. It has been shown that quinolone consumption in livestock is associated with increased quinolone resistance of Campylobacter isolates from food producing animals and infected patients. However, susceptibility testing of clinical isolates is not commonly performed and, consequently, resistance rates of human C. jejuni and C. coli isolates in areas of high consumption of antimicrobials in livestock may be undervalued. A strong association between C. jejuni infections and patients` age and gender has been highlighted by several authors. However, there is still little information on the demographic pattern in C. coli infections.
Methods: 1135 C. jejuni and 156 C. coli human isolates were obtained within a rural region of Germany. The study area was characterised by intensive swine and poultry farming involving high consumption of clinically important antimicrobials. Isolates were analysed for susceptibility to amoxicillin, ciprofloxacin, tetracycline and erythromycin using the EUCAST disc diffusion method. Furthermore, data were stratified with respect to patients age and gender.
Results: Contrary to male-biased distribution in C. jejuni isolates, C. coli was the predominant species in female patients with a maximum female surplus in young children and middle-aged adults. Resistance rates of C. coli vs. C. jejuni to amoxicillin, ciprofloxacin, tetracycline and erythromycin were 46.2% vs. 48.3%, 62.8% vs. 64.5%, 68.6% vs. 35.2% and 14.7 vs. 0.6%, respectively. Resistance rates were found to correlate with usage of these antimicrobials in livestock.
Conclusion: The high prevalence of C. coli in female patients may point to sex-specific behavioural or physiological aspects. The observed high to moderate resistance rates of Campylobacter isolates warrant prudent use of antimicrobials in livestock as well as routine susceptibility testing of human isolates to ensure efficacy of antimicrobial therapy.