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Campylobacter jejuni in hospitalized patients with diarrhea, Kolkata, India.

Mukherjee P, Ramamurthy T, Bhattacharya MK, Rajendran K, Mukhopadhyay AK - Emerging Infect. Dis. (2013)

View Article: PubMed Central - PubMed

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Although we used the culture method, which is the standard for screening fecal samples, some molecular methods, such as PCR and real-time PCR, are now used for screening Campylobacter spp. from fecal samples on the Indian subcontinent... The results from molecular methods are showing more infection with Campylobacter spp. and high mixed infection cases and suggest the usefulness of molecular methods in combination with cultures... Macrolides and fluoroquinolones generally are the first- and second-line choices, respectively, of antimicrobial drugs for treating Campylobacter enteritis... In India, resistance of Campylobacter spp. to several antimicrobial drugs has been reported since the early 1990s... Likewise, ciprofloxacin resistance in Campylobacter spp. increased markedly in Dhaka, Bangladesh, during 2005–2008 and in Karachi, Pakistan, during 1992–2002... All tested strains were resistant to trimethoprim–sulfamethoxazole, and most (97%) were resistant to quinolone (nalidixic acid) and fluoroquinolones (norfloxacin, ciprofloxacin, and ofloxacin) (Figure)... Multidrug resistance was frequent among many of the isolates: ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (19%); tetracycline, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (10.2%); and tetracycline, ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (6.8%)... These results indicate that macrolides may be useful for treating campylobacteriosis in this region... The resistance patterns are influenced by various factors, possibly including pressure exerted by use of antimicrobial drugs... Various reports have stated that introduction of fluoroquinolones for use in veterinary practice has been associated with a dramatic rise in Campylobacter strains showing resistance to these drugs... We could not detect any allele of plasmid-mediated quinolone resistance genes (qnr) among C. jejuni isolates and the different class of mobile genetic elements that generally carry the antimicrobial resistance gene cassettes... However, we found that most of the C. jejuni isolates had a mutation in the quinolone-resistance determining region of gyrA (Thr-86 to Ile), which led the isolates to become resistant for quinolone and fluoroquinolones... This finding suggests that intestinal inflammation may directly influence malabsorption of nutrients... Hence, it is essential to examine the effect of Campylobacter infection in the developing world in the context of many recent developments in the human gut microbiome.

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Antimicrobial drug susceptibility profile of 142 Campylobacter jejuni isolates, Kolkata, India, 2008–2010. Black bars, resistant; gray bars, intermediate resistance; white bars, susceptible. AMP, ampicillin; NAL, nalidixic acid; NOR, norfloxacin; ERY, erythromycin; GEN, gentamicin; TET, tetracycline; CIP, ciprofloxacin; OFX, ofloxacin; FZD, furazolidone; CHL, chloramphenicol; AZM, azithromycin; STR, streptomycin; TMP–SXT, trimethoprim–sulfamethoxazole.
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Figure 1: Antimicrobial drug susceptibility profile of 142 Campylobacter jejuni isolates, Kolkata, India, 2008–2010. Black bars, resistant; gray bars, intermediate resistance; white bars, susceptible. AMP, ampicillin; NAL, nalidixic acid; NOR, norfloxacin; ERY, erythromycin; GEN, gentamicin; TET, tetracycline; CIP, ciprofloxacin; OFX, ofloxacin; FZD, furazolidone; CHL, chloramphenicol; AZM, azithromycin; STR, streptomycin; TMP–SXT, trimethoprim–sulfamethoxazole.

Mentions: Macrolides and fluoroquinolones generally are the first- and second-line choices, respectively, of antimicrobial drugs for treating Campylobacter enteritis. Since the late 1980s, resistance to these drugs has complicated treatment. In India, resistance of Campylobacter spp. to several antimicrobial drugs has been reported since the early 1990s (6). Fluoroquinolone resistance was not reported in 1994 but reached 79% during 2001–2006 (2). Likewise, ciprofloxacin resistance in Campylobacter spp. increased markedly in Dhaka, Bangladesh, during 2005–2008 (7) and in Karachi, Pakistan, during 1992–2002 (8). We tested 142 C. jejuni isolates for antimicrobial susceptibility by disk diffusion method on Muller-Hinton agar with 5% sheep blood and incubated them at 37°C in microaerophillic environment for 48 h before obtaining results. All tested strains were resistant to trimethoprim–sulfamethoxazole, and most (97%) were resistant to quinolone (nalidixic acid) and fluoroquinolones (norfloxacin, ciprofloxacin, and ofloxacin) (Figure). Approximately 26.1% and 17.6% of the isolates were resistant to ampicillin and tetracycline, respectively. Susceptibility to erythromycin, azithromycin, gentamicin, furazolidone, and chloramphenicol was very high (>97%) in most isolates. Multidrug resistance was frequent among many of the isolates: ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (19%); tetracycline, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (10.2%); and tetracycline, ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (6.8%). These results indicate that macrolides may be useful for treating campylobacteriosis in this region.


Campylobacter jejuni in hospitalized patients with diarrhea, Kolkata, India.

Mukherjee P, Ramamurthy T, Bhattacharya MK, Rajendran K, Mukhopadhyay AK - Emerging Infect. Dis. (2013)

Antimicrobial drug susceptibility profile of 142 Campylobacter jejuni isolates, Kolkata, India, 2008–2010. Black bars, resistant; gray bars, intermediate resistance; white bars, susceptible. AMP, ampicillin; NAL, nalidixic acid; NOR, norfloxacin; ERY, erythromycin; GEN, gentamicin; TET, tetracycline; CIP, ciprofloxacin; OFX, ofloxacin; FZD, furazolidone; CHL, chloramphenicol; AZM, azithromycin; STR, streptomycin; TMP–SXT, trimethoprim–sulfamethoxazole.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713969&req=5

Figure 1: Antimicrobial drug susceptibility profile of 142 Campylobacter jejuni isolates, Kolkata, India, 2008–2010. Black bars, resistant; gray bars, intermediate resistance; white bars, susceptible. AMP, ampicillin; NAL, nalidixic acid; NOR, norfloxacin; ERY, erythromycin; GEN, gentamicin; TET, tetracycline; CIP, ciprofloxacin; OFX, ofloxacin; FZD, furazolidone; CHL, chloramphenicol; AZM, azithromycin; STR, streptomycin; TMP–SXT, trimethoprim–sulfamethoxazole.
Mentions: Macrolides and fluoroquinolones generally are the first- and second-line choices, respectively, of antimicrobial drugs for treating Campylobacter enteritis. Since the late 1980s, resistance to these drugs has complicated treatment. In India, resistance of Campylobacter spp. to several antimicrobial drugs has been reported since the early 1990s (6). Fluoroquinolone resistance was not reported in 1994 but reached 79% during 2001–2006 (2). Likewise, ciprofloxacin resistance in Campylobacter spp. increased markedly in Dhaka, Bangladesh, during 2005–2008 (7) and in Karachi, Pakistan, during 1992–2002 (8). We tested 142 C. jejuni isolates for antimicrobial susceptibility by disk diffusion method on Muller-Hinton agar with 5% sheep blood and incubated them at 37°C in microaerophillic environment for 48 h before obtaining results. All tested strains were resistant to trimethoprim–sulfamethoxazole, and most (97%) were resistant to quinolone (nalidixic acid) and fluoroquinolones (norfloxacin, ciprofloxacin, and ofloxacin) (Figure). Approximately 26.1% and 17.6% of the isolates were resistant to ampicillin and tetracycline, respectively. Susceptibility to erythromycin, azithromycin, gentamicin, furazolidone, and chloramphenicol was very high (>97%) in most isolates. Multidrug resistance was frequent among many of the isolates: ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (19%); tetracycline, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (10.2%); and tetracycline, ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (6.8%). These results indicate that macrolides may be useful for treating campylobacteriosis in this region.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Although we used the culture method, which is the standard for screening fecal samples, some molecular methods, such as PCR and real-time PCR, are now used for screening Campylobacter spp. from fecal samples on the Indian subcontinent... The results from molecular methods are showing more infection with Campylobacter spp. and high mixed infection cases and suggest the usefulness of molecular methods in combination with cultures... Macrolides and fluoroquinolones generally are the first- and second-line choices, respectively, of antimicrobial drugs for treating Campylobacter enteritis... In India, resistance of Campylobacter spp. to several antimicrobial drugs has been reported since the early 1990s... Likewise, ciprofloxacin resistance in Campylobacter spp. increased markedly in Dhaka, Bangladesh, during 2005–2008 and in Karachi, Pakistan, during 1992–2002... All tested strains were resistant to trimethoprim–sulfamethoxazole, and most (97%) were resistant to quinolone (nalidixic acid) and fluoroquinolones (norfloxacin, ciprofloxacin, and ofloxacin) (Figure)... Multidrug resistance was frequent among many of the isolates: ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (19%); tetracycline, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (10.2%); and tetracycline, ampicillin, nalidixic acid, norfloxacin, ciprofloxacin, ofloxacin, and trimethoprim–sulfamethoxazole (6.8%)... These results indicate that macrolides may be useful for treating campylobacteriosis in this region... The resistance patterns are influenced by various factors, possibly including pressure exerted by use of antimicrobial drugs... Various reports have stated that introduction of fluoroquinolones for use in veterinary practice has been associated with a dramatic rise in Campylobacter strains showing resistance to these drugs... We could not detect any allele of plasmid-mediated quinolone resistance genes (qnr) among C. jejuni isolates and the different class of mobile genetic elements that generally carry the antimicrobial resistance gene cassettes... However, we found that most of the C. jejuni isolates had a mutation in the quinolone-resistance determining region of gyrA (Thr-86 to Ile), which led the isolates to become resistant for quinolone and fluoroquinolones... This finding suggests that intestinal inflammation may directly influence malabsorption of nutrients... Hence, it is essential to examine the effect of Campylobacter infection in the developing world in the context of many recent developments in the human gut microbiome.

Show MeSH