Abstract
BackgroundCampylobacter jejuni is a major cause of gastroenteritis worldwide. In Thailand, several strains of C. jejuni have been isolated and identified as major diarrheal pathogens among adult travelers. To study the epidemiology of C. jejuni in adult travelers and U.S. military personnel with acute diarrhea in Thailand from 1998-2003, strains of C. jejuni were isolated and phenotypically identified, serotyped, tested for antimicrobial susceptibility, and characterized using pulsed-field gel electrophoresis (PFGE).ResultsA total of 312 C. jejuni isolates were obtained from travelers (n = 46) and U.S. military personnel (n = 266) in Thailand who were experiencing acute diarrhea. Nalidixic acid and ciprofloxacin resistance was observed in 94.9% and 93.0% of the isolates, respectively. From 2001-2003, resistance to tetracycline (81.9%), trimethoprim-sulfamethoxazole (57.9%), ampicillin (28.9%), kanamycin (5.9%), sulfisoxazole (3.9%), neomycin (2.0%), and streptomycin (0.7%) was observed. Combined PFGE analysis showed considerable genetic diversity among the C. jejuni isolates; however, four PFGE clusters included isolates from the major Lior serotypes (HL: 36, HL: 11, HL: 5, and HL: 28). The PFGE analysis linked individual C. jejuni clones that were obtained at U.S. military exercises with specific antimicrobial resistance patterns.ConclusionsIn summary, most human C. jejuni isolates from Thailand were multi-resistant to quinolones and tetracycline. PFGE detected spatial and temporal C. jejuni clonality responsible for the common sources of Campylobacter gastroenteritis.
Highlights
Campylobacter jejuni is a major cause of gastroenteritis worldwide
Frequency and distribution of C. jejuni serotypes From a total of 312 C. jejuni isolates obtained in this study, 266 isolates were from U.S soldiers and 46 were from foreign travelers seen at Bumrungrad Hospital, Bangkok
In summary, our study demonstrates the usefulness of pulsed-field gel electrophoresis (PFGE) in local epidemiological studies or in the study of small outbreaks occurring over a short time interval rather than in the long-term epidemiological studies that have been studied by others [26]
Summary
Campylobacter jejuni is a major cause of gastroenteritis worldwide. In Thailand, several strains of C. jejuni have been isolated and identified as major diarrheal pathogens among adult travelers. To study the epidemiology of C. jejuni in adult travelers and U.S military personnel with acute diarrhea in Thailand from 1998-2003, strains of C. jejuni were isolated and phenotypically identified, serotyped, tested for antimicrobial susceptibility, and characterized using pulsed-field gel electrophoresis (PFGE). Campylobacter jejuni is a major cause of gastroenteritis worldwide, especially in children, travelers, and military personnel deployed to developing countries [1,2,3,4]. PFGE is considered to be the most discriminatory method of characterizing C. jejuni and C. coli and identifying specific Campylobacter spp. in outbreak studies [14,15,16]. The combination of PFGE and other typing techniques can identify common sources of Campylobacter and other bacterial infections [17,18,19]
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