Find in Library

<p>Abstract</p> <p>Background</p> <p><it>Campylobacter jejuni</it> and <it>Campylobacter coli</it> are food-borne pathogens of great importance and feature prominently in the etiology of developing world enteritis and travellers’ diarrhoea. Increasing antimicrobial resistant <it>Campylobacter</it> prevalence has been described globally, yet data from Peru is limited. Our objective was to describe the prevalence trends of fluoroquinolone and macrolide-resistant <it>C. jejuni</it> and <it>C. coli</it> stool isolates from three regions in Peru over a ten-year period.</p> <p>Methods</p> <p>Surveillance for enteric pathogens was conducted in Lima, Iquitos and Cusco between 2001 and 2010. <it>Campylobacter</it> stool isolates were tested for susceptibilities to ciprofloxacin, azithromycin and erythromycin. Susceptibilities were reviewed for 4652 isolates from Lima ( <it>n</it> = 3419), Iquitos ( <it>n</it> = 625) and Cusco ( <it>n</it> = 608).</p> <p>Results</p> <p>Comparing the study periods of 2001-2005 and 2006-2010, prevalence of ciprofloxacin-resistant <it>C. jejuni</it> isolates rose in the study areas of Lima (73.1% to 89.8%, <it>p</it> < 0.001) and Iquitos (24.1% to 48.9%, <it>p</it> < 0.001). Ciprofloxacin-resistant <it>C. coli</it> rates also increased in Lima (48.1% to 87.4%, <it>p</it> < 0.001) and Cusco (10.0% to 65.9%, <it>p</it> = 0.005). Small but significant increases in azithromycin-resistant and erythromycin-resistant <it>C. jejuni</it> prevalence were noted in Iquitos (2.2% to 14.9%, <it>p</it> < 0.001; 3.2% to 14.9%, <it>p</it> = 0.002), and erythromycin-resistant <it>C. coli</it> rates increased in Lima (0.0% to 5.3%, <it>p</it> = 0.038). The prevalence of <it>C. jejuni</it> isolates resistant to both ciprofloxacin and azithromycin increased in Iquitos (0.3% to 14.9%, p < 0.001) and Lima (0.3% to 1.6%, p = 0.011), and prevalence of <it>C. jejuni</it> isolates resistant to both ciprofloxacin and erythromycin rose in Iquitos (0.0% to 14.9%, p < 0.001). Ciprofloxacin and erythromycin resistant <it>C. coli</it> prevalence increased in Lima (0.0% to 5.3%, p = 0.034).</p> <p>Conclusions</p> <p>These results have implications for the empirical management of enterocolitis in Peru. Ongoing surveillance is essential to guide appropriate antimicrobial use in this setting. Local epidemiological studies to explore the relationship between increasing antimicrobial resistance and agricultural or human antibiotic use may be valuable.</p>