Bacteremia caused by antimicrobial resistant Campylobacter species at a medical center in Taiwan, 1998-2008

详细信息    查看全文

• 作者：Chun-Hsing Liao ; Chia-Yunn Chuang ; Yu-Tsung Huang ; Ping-Ing Lee ; Po-Ren Hsueh
• 关键词：Bacteremia ; Campylobacter species ; Fluoroquinolone resistance ; Macrolide resistance ; Taiwan
• 刊名：Journal of Infection
• 出版年：2012
• 出版时间：November, 2012
• 年：2012
• 卷：65
• 期：5
• 页码：392-399
• 全文大小：291 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Summary

Objectives

This study was intended to delineate the clinical and microbiological characteristics of patients with bacteremia caused by Campylobacter species.

Methods

Twenty-four patients with Campylobacter bacteremia were treated at the National Taiwan University Hospital from 1998 to 2008. All isolates from the 24 patients were confirmed to the species level by multiplex PCR (cadF, hipO and asp gene) and 16S RNA gene sequencing.

Results

Bacteremia was caused by Campylobacter coli in 15 (62.5 % ) patients, Campylobacter fetus in 6 (25 % ), and Campylobacter jejuni in 3 (12.5 % ). Of the 24 patients, 16 were male. The major underlying conditions included chronic renal insufficiency (41.7 % ), liver cirrhosis (37.5 % ), malignancy (33.3 % ), and previous abdominal surgery (33.3 % ). The most common infections were intra-abdominal infection (54.2 % ), followed by primary bacteremia (41.7 % ), and cellulitis (4.2 % ). The mean Pittsburgh bacteremia score was 2.5 (range, 0-9). During the bacteremic episodes, six (25 % ) patients developed septic shock. Third-generation cephalosporins were administered to 12 (50 % ) patients as empirical therapy. All-cause mortality was 4.2 % at 14 days and 12.5 % at 30 days. The majority of the isolates were resistant to third-generation cephalosporins and quinolones, with minimum inhibitory concentration (MIC₉₀) values of 32?mg/L for cefotaxime, 128?mg/L for ceftriaxone, and 32?mg/L for both ciprofloxacin and levofloxacin. All isolates possessed a parC mutation (Arg-139-Gln) and 15 exhibited an additional gyrA mutation (Thr-86-Ile). Among these isolates, 20.8 % were susceptible to erythromycin (MIC¡Ü0.5?mg/L).

Conclusion

Bacteremia caused by antimicrobial resistant Campylobacter species is alarming although the mortality rate is low.