Academic journal article Environmental Health Perspectives

The Persistence of Fluoroquinolone-Resistant Campylobacter in Poultry Production

Academic journal article Environmental Health Perspectives

The Persistence of Fluoroquinolone-Resistant Campylobacter in Poultry Production

Article excerpt

BACKGROUND: The use of antibiotics in food animal production has been associated with antibioticresistant infections in humans. In 2005, the Food and Drug Administration (FDA) banned fluoroquinolone use in U.S. poultry production in order to reduce the prevalence of fluoroquinoloneresistant Campylobacter. Little is known about the potential efficacy of this policy.

OBJECTIVES: Our primary objective was to follow temporal changes in the prevalence of fluoroquinoloneresistant Campylobacter among poultry products from two conventional producers who announced their cessation of fluoroquinolone use in 2002 (3 years before the FDA's ban). Our secondary objective was to compare, over time, the prevalence of fluoroquinolone-resistant Campylobacter in conventional poultry products to those from producers who claim to use no antibiotics.

METHODS: We collected poultry samples from two conventional producers and three antibioticfree producers over the course of 20 weeks in 2004 (n = 198) and 15 weeks in 2006 (n = 210). We compared the rates of fluoroquinolone resistance among Campylobacter isolates from the different producers.

RESULTS: We found no significant change in the proportion of fluoroquinolone-resistant Campylobacter isolates from the two conventional producers over the study period. In addition, Campylobacter strains from the two conventional producers were significantly more likely to be fluoroquinolone resistant than those from the antibiotic-free producers.

CONCLUSIONS: The results from this study indicate that fluoroquinolone-resistant Campylobacter may be persistent contaminants of poultry products even after on-farm fluoroquinolone use has ceased. The FDA's ban on fluoroquinolones in poultry production may be insufficient to reduce resistant Campylobacter in poultry products.

KEY WORDS: antibiotic, antimicrobial, Campylobacter, chickens, ciprofloxacin, fluoroquinolones, food microbiology, poultry, resistance, veterinary. Environ Health Perspect 115:1035-1039 (2007). doi:10.1289/ehp.10050 available via [Online 19 March 2007]

Resistance to antimicrobials is a growing crisis in clinical medicine, and it is generally recognized that misuse and overuse in any sector contributes to this burden. Antimicrobial use in food animal production is an area of concern because the on-farm selection of antimicrobialresistant zoonotic pathogens can lead to human exposure and infection via various pathways, including meat and poultry products. Fluoroquinolone use in poultry production selects for fluoroquinolone-resistant Campylobacter populations and is associated with an increase in fluoroquinolone-resistant Campylobacter infections in humans via poultry exposure (Gupta et al. 2004, 2005).

Campylobacter is an important foodborne zoonotic pathogen causing enteritis and diarrhea (campylobacteriosis). Campylobacter infection is also associated with a number of rare neuropathologic sequelae, including GuillainBarre syndrome (Hughes et al. 1999). In the United States, Campylobacter is the most common cause of bacterial diarrhea, with over a million people estimated to be affected annually [Centers for Disease Control and Prevention (CDC) 2005]. Campylobacteriosis is typically self-limiting, with symptoms rarely lasting more than 10 days (Butzler 2004; CDC 2005); however, it can be fatal in more vulnerable populations (Djuretic et al. 1996; Manfredi et al. 1999; Tee and Mijch 1998).

Indeed, antimicrobial therapy is essential for elderly, pregnant, and immunocompromised patients for whom hydration and electrolyte maintenance may be insufficient (Allos 2001). Until recently, fluoroquinolones were regularly prescribed for those requiring antimicrobial therapy. However, a sharp increase in the prevalence of fluoroquinoloneresistant Campylobacter, shown to occur in parallel with the use of fluoroquinolones in U.S. poultry production, has limited fluroquinolones' effectiveness in the clinical setting (Allos 2001; Collignon 2005; Gupta et al. …

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