Kassenborg Heidi D, Smith Kirk E, Vugia Duc J, Rabatsky-Ehr Therese, Bates Martha R, Carter Michael A, Dumas Nellie B, Cassidy Maureen P, Marano Nina, Tauxe Robert V, Angulo Frederick J
Minnesota Department of Health, Minneapolis, MN, USA.
Clin Infect Dis. 2004 Apr 15;38 Suppl 3:S279-84. doi: 10.1086/381597.
A 12-month, population-based, case-control study of Campylobacter infections was conducted at Foodborne Disease Active Surveillance Network surveillance areas during 1998-1999. Of 858 Campylobacter isolates tested for antimicrobial susceptibility to the fluoroquinolone ciprofloxacin, 94 (11%) were resistant. Travel outside of the United States was reported by 27 (42%) of 64 patients with fluoroquinolone-resistant Campylobacter infection and by 51 (9%) of 582 patients with fluoroquinolone-susceptible Campylobacter infection (odds ratio [OR], 7.6; 95% confidence interval [CI], 4.3-13.4). When patients with domestically acquired fluoroquinolone-resistant Campylobacter infection were compared with matched healthy control subjects in a multivariate analysis, those infected were 10 times more likely to have eaten chicken or turkey cooked at a commercial establishment (18 [55%] of 33 case patients vs. 7 [21%] of 33 controls; matched OR, 10.0; 95% CI, 1.3-78). Although travel outside of the United States was associated with fluoroquinolone-resistant Campylobacter infection, most infections among study participants were domestically acquired. This study provides additional evidence that poultry is an important source of domestically acquired fluoroquinolone-resistant Campylobacter infection. Control measures should include efforts to improve food handling in commercial establishments.
1998 - 1999年期间，在食源性疾病主动监测网络监测区域开展了一项为期12个月、基于人群的弯曲杆菌感染病例对照研究。在对858株弯曲杆菌分离株进行环丙沙星氟喹诺酮类抗菌药物敏感性测试中，94株（11%）耐药。在64例氟喹诺酮耐药弯曲杆菌感染患者中，27例（42%）报告有美国境外旅行史；在582例氟喹诺酮敏感弯曲杆菌感染患者中，51例（9%）有美国境外旅行史（比值比[OR]为7.6；95%置信区间[CI]为4.3 - 13.4）。在多变量分析中，将国内获得性氟喹诺酮耐药弯曲杆菌感染患者与匹配的健康对照者进行比较，感染患者食用在商业场所烹制的鸡肉或火鸡肉的可能性高10倍（33例病例患者中有18例[55%]，33例对照中有7例[21%]；匹配OR为10.0；95% CI为1.3 - 78）。虽然美国境外旅行与氟喹诺酮耐药弯曲杆菌感染有关，但研究参与者中的大多数感染是在国内获得的。本研究提供了更多证据表明家禽是国内获得性氟喹诺酮耐药弯曲杆菌感染的重要来源。控制措施应包括努力改善商业场所的食品处理。
