Detection of campylobacters in patients with sporadic diarrhea and antibacterial action of 37 drugs against Campylobacter jejuni

Abstract

Campylobacters were examined in 7246 patients with sporadic diarrhea who were treated in the Department of Internal Medicine, Pediatrics or Infectious Diseases, for a period of four years and nine months between April 1979 and December 1983 (December 1981 in the Department of Infectious Diseases), and the following results were obtained.Campylobacter jejuni, C. coli and C. fetus subsp. fetus were detected in 5.2%, 0.1% and 0.04%, respectively, in the Department of Internal Medicine, C. jejuni and C. coli in 14.5% and 0.2% in the Department of Pediatrics and C. jejuni in 11.2% in the Department of Infectious Diseases.An epidemiological study was carried out on 201 of these patients. The results showed that the age of patients ranged from six months to 82 years and 61%(123) were young patients aged 10 or less. Thus, campylobacters were frequently detected especially in infants and children. Regarding the rate of detection classified by sex, the bacteria were found in 119 males and 82 females. The ratio of males to females aged 15 or less was 3 to 2, indicating that the detection rate was predominant in males.With regard to clinical symptoms, diarrhea was observed in 100% of the patients and abdominal pain in about 50%. Especially in children, fever was present in 73.6% and bloody stools in 39.3%. Polymicrobial infection was noticed in 21 patients (10.4%). In these patients, Salmonella was most frequently identified; that is, in 15 of 21. Fourty-four (88%) of 50 patients excreted 105 CFU or mor of C. jejuni per gram up to three days after onset of this disease and the number of bacteria excreted had a tendency to decrease in proportion to the increase in the days of illness.The antibacterial action of 37 drugs against C. jejuni was determined and the following results were obtained. The antibacterial action of five drugs of the macrolide group, five of the aminoglycosid group, two of the tetracycline group, chloramphenicol and five of the pyridonecarboxylic acid group was found to be strong. Also, ampicillin was found to have a strong antibacterial action. However, the action of three drugs of the penicillin group, 10 of the cephalosporin group, novobiocin, colistin, polymyxin B and bacitracin was found to be weak. There was one strain of Campylobacter (0.7%) that showed a high MIC value of 25 μ/ml against erythromycin.