Campylobacter is a leading foodborne bacterial pathogen, which causes gastroenteritis in humans. This pathogenic organism is increasingly resistant to antibiotics, especially fluoroquinolones and macrolides, which are the most frequently used antimicrobials for the treatment of campylobacteriosis when clinical therapy is warranted. As a zoonotic pathogen, Campylobacter has a broad animal reservoir and infects humans via contaminated food, water or milk. Antibiotic usage in both animal agriculture and human medicine, can influence the development of antibiotic-resistant Campylobacter. This review will describe the trend in fluoroquinolone and macrolide resistance in Campylobacter, summarize the mechanisms underlying the resistance to various antibiotics and discuss the unique features associated with the emergence, transmission and persistence of antibiotic-resistant Campylobacter. Special attention will be given to recent findings and emphasis will be placed on Campylobacter resistance to fluoroquinolones...

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Antibiotic resistance in Campylobacter: emergence, transmission and persistence.

Campylobacter infections in humans are considered to be mainly food-borne, in which foods of animal origin play an important role. The majority of Campylobacter infections are sporadic (single) cases or small family outbreaks, and the actual source of these types of infection is rarely microbiologically identified. This chapter describes the detection and prevalence of Campylobacter in a wide range of different types of food. Food products, however, may harbor only low numbers of campylobacters, and bacterial cells may be seriously injured by processing procedures such as freezing, cooling, heating, and salting. Survival of Campylobacter on eggshells, however, is considered to be poor because of the sensitivity of the organism to drying. Unpasteurized milk is a well-documented cause of a number of outbreaks of campylobacteriosis. Sufficient heating of red meat products, which are relatively infrequently contaminated with low numbers of Campylobacter, will eliminate this risk of human infection. Several investigations on the detection of Campylobacter in different types of seafood have been carried out. The majority of Campylobacter studies on growth characteristics and survival were carried out during the early 1980s, and summarizing reviews can be found in articles by Doyle and Stern and Kazmi. Reduction of the potential risk of contaminated poultry products has to be achieved by the application of good hygienic practices by both the producers of poultry meat products and the consumers of these products.

Campylobacter in the food supply

Objective: To study antimicrobial resistance in zoonotic bacteria isolated from food animals in different countries using uniform methodology. Methods: Samples were taken at slaughter from chickens, pigs and cattle in four EU countries per host. Escherichia coli (indicator organism; n 5 2118), Salmonella spp. (n 5 271) and Campylobacter spp. (n 5 1325) were isolated in national laboratories and MICs tested in a central laboratory against, where appropriate, ampicillin, cefepime, cefotaxime, ciprofloxacin, chloramphenicol, erythromycin, gentamicin, nalidixic acid, streptomycin, tetracycline and trimethoprim/sulfamethoxazole. Results: Isolation rates were high for E. coli, low for Salmonella and intermediate for Campylobacter. MIC results showed resistance prevalence varied among compounds, hosts and countries. For E. coli and Salmonella, resistance to newer compounds (cefepime, cefotaxime, ciprofloxacin) was absent or low, but to older compounds (except gentamicin), resistance was variable and higher. E. coli isolates from Sweden showed low resistance, whereas among isolates from Spain (pigs), resistance to ampicillin, chloramphenicol, streptomycin, tetracycline and trimethoprim/sulfamethoxazole was higher; the UK, France, the Netherlands, Germany, Italy and Denmark were intermediate. For Campylobacter spp. isolates from chickens, nalidixic acid and ciprofloxacin resistance was >30% in France and the Netherlands, >6% in the UK and zero in Sweden. Nalidixic acid resistance was high in cattle (20%‐64%), whereas ciprofloxacin resistance was markedly lower in cattle, variable in pigs (3%‐21%) and highest in Sweden. Generally, Campylobacter coli was more resistant than Campylobacter jejuni.

A European survey of antimicrobial susceptibility among zoonotic and commensal bacteria isolated from food-producing animals

Infection with Campylobacter jejuni is now considered to be the most common cause of acute bacterial gastroenteritis in humans worldwide. It occurs more frequently than infections caused by Salmonella species, Shigella species, or Escherichia coli O157:H7. Although C. jejuni is also recognized for its association with serious post-infection neurological complications, most patients with C. jejuni infections have a self-limited illness. Nevertheless, a substantial proportion of these infections are treated with antibiotics. These include severe and prolonged cases of enteritis, infections in immune-suppressed patients, septicaemia and other extra-intestinal infections. Under these circumstances, erythromycin is often recommended as the drug of first choice. However, erythromycin-resistant Campylobacter have emerged during therapy with macrolides. Moreover, the widespread use of macrolides, including erythromycin, in veterinary medicine has accelerated this resistance trend. Several countries including Canada, Japan and Finland have reported C. jejuni isolates with low and stable rates of macrolide resistance. In contrast, the increasing level of macrolide resistance in C. jejuni is becoming a major public health concern in other parts of the world such as the United States, Europe and Taiwan. Macrolide resistance in Campylobacter is mainly associated with point mutation(s) occurring in the peptidyl-encoding region in domain V of the 23S rRNA gene, the target of macrolides. Several rapid and practical techniques have recently been developed for the identification of macrolide-resistant isolates of C. jejuni. The aim of this mini-review is to give an overview of the worldwide distribution of macrolide resistance in C. jejuni and Campylobacter coli as well as its possible association with the massive use of these agents in food animals. Mechanisms implicated in macrolide resistance in C. jejuni and also techniques that have been developed for the efficient detection of macrolide-associated mutation(s) will be discussed in detail.

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A Serafin

Papers

Occurrence and resistance to antibiotics of Campylobacter jejuni and Campylobacter coli in animals and meat in northeastern Italy.