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Open Access Highly Accessed Research article

Campylobacter antimicrobial resistance in Peru: a ten-year observational study

Simon Pollett1*, Claudio Rocha1, Rito Zerpa2, Lilian Patiño2, Augusto Valencia3, Máximo Camiña4, José Guevara5, Martha Lopez6, Nancy Chuquiray7, Eduardo Salazar-Lindo8, Carlos Calampa9, Martín Casapia10, Rina Meza1, Maruja Bernal1, Drake Tilley1, Michael Gregory1, Ryan Maves1, Eric Hall1, Franca Jones1, C Sofia Arriola11, Marieke Rosenbaum1, Juan Perez1 and Matthew Kasper1

Author Affiliations

1 Bacteriology Department, U.S Naval Medical Research Unit-6 (NAMRU-6), Venezuela Ave, Block 36, Callao 2, Lima, Peru

2 Instituto Nacional de Salud del Niño, Lima, Peru

3 Hospital Nacional Docente Madre-Niño, Lima, Peru

4 Hospital de Emergencias Pediátricas, Lima, Peru

5 Hospital Nacional Daniel A.Carrion, Lima, Peru

6 Laboratorio Servisalud, Cusco, Peru

7 EsSalud Hospital Alberto Sabogal Sologuren, Lima, Peru

8 Laboratorio Gastrolab, Lima, Peru

9 Hospital Apoyo de Iquitos, Iquitos, Peru

10 Hospital Regional, Iquitos, Peru

11 Facultad de Medicina Veterinaria, Universidad de San Marcos, San Marcos, Peru

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BMC Infectious Diseases 2012, 12:193  doi:10.1186/1471-2334-12-193

Published: 16 August 2012

Abstract

Background

Campylobacter jejuni and Campylobacter coli are food-borne pathogens of great importance and feature prominently in the etiology of developing world enteritis and travellers’ diarrhoea. Increasing antimicrobial resistant Campylobacter prevalence has been described globally, yet data from Peru is limited. Our objective was to describe the prevalence trends of fluoroquinolone and macrolide-resistant C. jejuni and C. coli stool isolates from three regions in Peru over a ten-year period.

Methods

Surveillance for enteric pathogens was conducted in Lima, Iquitos and Cusco between 2001 and 2010. Campylobacter stool isolates were tested for susceptibilities to ciprofloxacin, azithromycin and erythromycin. Susceptibilities were reviewed for 4652 isolates from Lima ( n = 3419), Iquitos ( n = 625) and Cusco ( n = 608).

Results

Comparing the study periods of 2001-2005 and 2006-2010, prevalence of ciprofloxacin-resistant C. jejuni isolates rose in the study areas of Lima (73.1% to 89.8%, p < 0.001) and Iquitos (24.1% to 48.9%, p < 0.001). Ciprofloxacin-resistant C. coli rates also increased in Lima (48.1% to 87.4%, p < 0.001) and Cusco (10.0% to 65.9%, p = 0.005). Small but significant increases in azithromycin-resistant and erythromycin-resistant C. jejuni prevalence were noted in Iquitos (2.2% to 14.9%, p < 0.001; 3.2% to 14.9%, p = 0.002), and erythromycin-resistant C. coli rates increased in Lima (0.0% to 5.3%, p = 0.038). The prevalence of C. jejuni 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 C. jejuni isolates resistant to both ciprofloxacin and erythromycin rose in Iquitos (0.0% to 14.9%, p < 0.001). Ciprofloxacin and erythromycin resistant C. coli prevalence increased in Lima (0.0% to 5.3%, p = 0.034).

Conclusions

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.

Keywords:
Campylobacter; Antibiotic resistance; Fluoroquinolones; Macrolides; Peru