Short-term and medium-term clinical outcomes of quinolone-resistant Campylobacter infection.
BACKGROUND
Campylobacter species is a leading cause of bacterial gastroenteritis worldwide. Quinolone resistance has emerged as an increasing problem among persons with Campylobacter infection over the past decade, but the clinical consequences are unclear.


METHODS
A case-comparison study of patients infected with ciprofloxacin-resistant or ciprofloxacin-susceptible Campylobacter species was conducted in Wales during the period 2003-2004. Campylobacter isolates were classified as resistant or susceptible to ciprofloxacin on the basis of standardized disk diffusion methods. Participants were interviewed by telephone at the time of illness, 3 months later, and 6 months later to compare disease severity, duration of illness, and medium-term clinical outcomes.


RESULTS
There was no difference between 145 persons with ciprofloxacin-resistant infection and 411 with ciprofloxacin-susceptible infection with regard to the severity or duration of acute illness. Mean duration of diarrhea was similar in patients with ciprofloxacin-resistant versus ciprofloxacin-susceptible infection (8.2 vs. 8.6 days; P = .57) and did not alter significantly after adjustment for potential covariates, including age, underlying disease, foreign travel, use of antidiarrheal medication, and use of antimicrobials in a multiple linear regression model. There was no difference between case patients and comparison patients in the frequency of reported symptoms or in general practitioner consultation rates at either the 3-month or the 6-month follow-up interview.


CONCLUSIONS
In this study, there was no evidence of more-severe or prolonged illness in participants with quinolone-resistant Campylobacter infection, nor was there evidence of any adverse medium-term consequences. This suggests that the clinical significance of quinolone resistance in Campylobacter infection may have been overestimated.
Evans
Meirion R
MR
Department of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom. meirion.evans@nphs.wales.nhs.uk
Northey
Gemma
G
Sarvotham
Tinnu S
TS
Rigby
Christine J
CJ
Hopkins
A Lynne
AL
Thomas
Daniel Rh
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002167:Campylobacter / Q000187:drug effects* / Q000302:isolation & purification; D002169:Campylobacter Infections / Q000188:drug therapy* / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015363:Quinolones / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014852:Wales; D055815:Young Adult
D000900:Anti-Bacterial Agents; D015363:Quinolones