Risk factors for ciprofloxacin-resistant Campylobacter infection in Wales.
OBJECTIVE
To identify risk factors for ciprofloxacin resistance in both travel-related and domestically acquired Campylobacter infection.


METHODS
Case-comparison study of patients with ciprofloxacin-resistant and ciprofloxacin-susceptible Campylobacter infection conducted in Wales during 2003 and 2004.


RESULTS
Foreign travel was the major risk factor for ciprofloxacin-resistant infection [adjusted odds ratio (adjOR) 24.0, 95% confidence interval (95% CI) 12.6-45.9]. Among travellers, case patients were five times more likely to drink still bottled water (adjOR 4.7, 95% CI 1.0-21.7), whilst among non-travellers, case patients were three times more likely to drink sparkling bottled water (adjOR 3.3, 95% CI 1.5-7.4). There was no increased risk associated with eating poultry or prior quinolone use.


CONCLUSIONS
Foreign travel remains the most important risk factor for ciprofloxacin-resistant Campylobacter infection. The possible association of both domestic- and travel-related ciprofloxacin-resistant Campylobacter infection with bottled water needs to be further explored.
Evans
Meirion R
MR
Department of Primary Care and Public Health, Cardiff University, Cardiff, UK. meirion.evans@nphs.wales.nhs.uk
Northey
Gemma
G
Sarvotham
Tinnu S
TS
Hopkins
A Lynne
AL
Rigby
Christine J
CJ
Thomas
Daniel Rh
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002167:Campylobacter / Q000187:drug effects* / Q000302:isolation & purification; D002169:Campylobacter Infections / Q000453:epidemiology* / Q000382:microbiology*; D016022:Case-Control Studies; D002939:Ciprofloxacin / Q000494:pharmacology*; D004326:Drinking; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014195:Travel; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin