Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
Clin Infect Dis. 2011 Oct;53(7):644-50. doi: 10.1093/cid/cir504.
It is well acknowledged that the use of antimicrobial drugs in food animals leads to antimicrobial drug resistance in foodborne bacteria such as Campylobacter; however, the role of human antimicrobial usage is much less investigated. The aim of this study was to quantify the odds of campylobacteriosis conferred by human consumption of fluoroquinolones and macrolides.
We conducted a registry-based retrospective case-control study on 31 669 laboratory-confirmed cases of campylobacteriosis between 1999 and 2005 in Denmark. Data were obtained from several Danish databases: the National Registry of Enteric Pathogens, the Danish Civil Registration System, the Danish National Prescription Database, and the Integrated Database on Labor Market Research. Odds ratios (OR) for campylobacteriosis were calculated by conditional logistic regression.
The risk of campylobacteriosis was reduced 1 month after exposure to macrolides (OR, 0.72; 95% confidence interval [CI], 0.56-0.92). Macrolide exposure 1 month to 2 years before infection was associated with an increased risk of a Campylobacter diagnosis (OR, 1.5; 95% CI, 1.4-1.6). A history of fluoroquinolone use was also associated with increased risk (OR, 2.5; 95% CI, 1.8-3.5). This risk was higher for resistant isolates than for susceptible ones.
Treatment with macrolides may protect against Campylobacter infection for a limited period of time, possibly due to the antibacterial effects of the drug or its metabolites. Fluoroquinolone treatment confers increased risk, probably due to a combination of competitive and selective effects, similar to what has been observed for nontyphoid Salmonella infection.
众所周知，在食用动物中使用抗菌药物会导致食源性病原体如弯曲杆菌中出现抗菌药物耐药性；然而，人类使用抗菌药物的作用却鲜少被研究。本研究旨在定量评估人类食用氟喹诺酮类和大环内酯类抗菌药物对弯曲杆菌病的患病风险。
我们对丹麦 1999 年至 2005 年间确诊的 31669 例弯曲杆菌病的实验室病例进行了基于登记的回顾性病例对照研究。数据来自几个丹麦数据库：肠道病原体国家登记处、丹麦民事登记系统、丹麦国家处方数据库和劳动力市场研究综合数据库。通过条件逻辑回归计算弯曲杆菌病的比值比（OR）。
在接触大环内酯类药物后 1 个月内，弯曲杆菌病的发病风险降低（OR，0.72；95%置信区间[CI]，0.56-0.92）。感染前 1 个月至 2 年内接触大环内酯类药物与增加的弯曲杆菌诊断风险相关（OR，1.5；95% CI，1.4-1.6）。氟喹诺酮类药物的使用史也与风险增加相关（OR，2.5；95% CI，1.8-3.5）。耐药分离株的风险高于敏感分离株。
大环内酯类药物治疗可能在有限的时间内对弯曲杆菌感染起到保护作用，这可能是由于药物或其代谢物的抗菌作用。氟喹诺酮类药物治疗会增加风险，这可能是由于竞争和选择性作用的综合影响，类似于非伤寒沙门氏菌感染的情况。
