Quinolone-resistant Campylobacter Jejuni Infections in Minnesota, 1992-1998

Author(s): Smith, K. E., Besser, J. M. , Hedberg, C. W. , Leano, F. T. , Bender, J. B. , Wicklund, J. H. , Johnson, B. P. , Moore, K. A. , Osterholm, M. T.

Journal/Book: New Engl J Med. 1999; 340(20): 1525-1532.

Abstract: Background. Increasing resistance to quinolones among campylobacter isolates from humans has been reported in Europe and Asia, but not in the United States. We evaluated resistance to quinolones among campylobacter isolates from Minnesota residents during the period from 1992 through 1998. Methods. All 4953 campylobacter isolates from humans received by the Minnesota Department of Health were tested for resistance to nalidixic acid. Resistant isolates and selected sensitive isolates were tested for resistance to ciprofloxacin. We conducted a case-comparison study of patients with ciprofloxacin-resistant Campylobacter jejuni isolated during 1996 and 1997. Domestic chicken was evaluated as a potential source of quinolone-resistant campylobacter. Results. The proportion of quinolone-resistant C. jejuni isolates from humans increased from 1.3 percent in 1992 to 10.2 percent in 1998 (P Conclusions. The increase in quinolone-resistant C. jejuni infections in Minnesota is largely due to infections acquired during foreign travel. However, the number of quinolone-resistant infections acquired domestically has also increased, largely because of the acquisition of resistant strains from poultry. The use of fluoroquinolones in poultry, which began in the United States in 1995, has created a reservoir of resistant C. jejuni. (N Engl J Med 1999;340:1525-32.) Source InformationFrom the Acute Disease Epidemiology Section (K.E.S., C.W.H., J.B.B., J.H.W., B.P.J., K.A.M., M.T.O.) and the Division of Public Health Laboratories (J.M.B., F.T.L.), Minnesota Department of Health, Minneapolis; and the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta (K.E.S.). Address reprint requests to Dr. Smith at the Acute Disease Epidemiology Section, Minnesota Department of Health, 717 Delaware St. SE, Minneapolis, MN 55440-9441.Members of the investigation team are listed in the Appendix. AppendixMembers of the investigation team were Seth Baker, David Boxrud, Ami Buikema, Larry Carroll, Pamela Chapman, Craig Grimes, Jennifer Hall, Becky Huebner, John Hunt, Michelyn Jones, Peter Lynch, Carlota Medus, Tracy Miller, Kim Moore, Megha Mungekar, Megan Ryan, Kendra Schmidt, Scott Seys, Dana Soderlund, Dana Stephens, Maureen Sullivan, Ellen Swanson, and Charlott Taylor at the Minnesota Department of Health, Minneapolis; and Norman Danner, Mimi Derry, Demetria Downs, David Grussing, Henry Keizer, and Kevin Vought at the Minnesota Department of Agriculture, St. Paul.

Keyword(s): antibiotika. resistance. vet

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