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Quinolone Resistance Comes Home to Roost

In Europe and Asia, resistance to quinolone antibiotics in human infection has been associated with widespread use of quinolones in poultry feed. A Minnesota study extends this observation to the U.S.

From 1992 to 1998, 6,674 cases of diarrhea caused by Campylobacter jejuni were reported in Minnesota, and 91 percent of bacterial isolates were analyzed by the state health department. The prevalence of quinolone resistance increased significantly from 1.3 percent in 1992 to 10.2 percent in 1998. Foreign travel (particularly to Mexico) and use of a quinolone before the collection of stool specimens were independent risk factors for quinolone resistance.

Researchers also cultured 91 fresh and frozen chickens on sale in Minnesota stores during the fall of 1997, two years after quinolones were approved for use in U.S. poultry. C. jejuni was isolated from 74 percent; 19 percent of these isolates were quinolone resistant. Among patients with domestically acquired campylobacter diarrhea in 1997 who didn't take quinolones, those with resistant isolates were significantly more likely than those with sensitive isolates to have a bacterial subtype also found in chickens.

Comment: The authors call for an international effort to break the ominous link between antibiotic use in animal feed and antibiotic resistance in human disease. They note that erythromycin resistance remained quite rare during their study and that erythromycin may now be the best choice for treating both domestic and foreign campylobacter gastroenteritis.

— A Zuger

Published in Journal Watch General Medicine June 1, 1999

Citation(s):

Smith KE et al. Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998. N Engl J Med 1999 May 20 340 1525-1532.

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