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1 April 2005

Volume 191, Number 7
The Journal of Infectious Diseases 2005;191:1050–1055
© 2005 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2005/19107-0005$15.00
DOI: 10.1086/428453
MAJOR ARTICLE

Adverse Health Events Associated with Antimicrobial Drug Resistance in Campylobacter Species: A Registry‐Based Cohort Study

Morten Helms,1

Jacob Simonsen,1

Katharina E. P. Olsen,2 and

Kåre Mølbak3

1Department of Epidemiology Research, Danish Epidemiology Science Centre, 2Unit of Gastrointestinal Infections and 3Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark

Background.Resistance to clinically important antimicrobial agents, particularly fluoroquinolones and macrolides, is increasing among Campylobacter isolates, but few studies have explored the human health consequences of such resistance.

Methods.In a registry‐based cohort study, we determined the risk of invasive illness and death associated with infection with quinolone‐ and erythromycin‐resistant Campylobacter strains, while adjusting for comorbidity. We linked data from the Danish Surveillance Registry for Enteric Pathogens with data from the Civil Registration System and National Health Registries.

Results.Of 3471 patients with Campylobacter infection, 22 (0.63%) had an adverse event, defined as invasive illness or death, within 90 days of the date of receipt of samples. Patients infected with quinolone‐resistant Campylobacter strains had a 6‐fold increased risk of an adverse event within 30 days of the date of receipt of samples, compared with patients infected with quinolone‐ and erythromycin‐susceptible Campylobacter strains (adjusted odds ratio [AOR], 6.17 [95% confidence interval {CI}, 1.62–23.47]). However, infection with erythromycin‐resistant strains was associated with a >5‐fold risk of an adverse event within 90 days of the date of receipt of samples (AOR, 5.51 [95% CI, 1.19–25.50]).

Conclusions.The present study provides evidence of the human health consequences of resistance to clinically important agents among Campylobacter infections and the need for increased efforts to mitigate such resistance.

Received 10 August 2004; accepted 2 December 2004; electronically published 1 March 2005.

Reprints or correspondence: Dr. K. Mølbak, Statens Serum Institut, Artillerivej 5, DK‐2300 Copenhagen S, Denmark ().

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  • Presented in part: Towards a Risk‐Analysis of Antibiotic Resistance international symposium, Berlin, 10 November 2003 (J Vet Med B Infect Dis Vet Public Health 2004;51:364–9); Joint World Health Organization/Food and Agriculture Organization of the United Nations/World Organisation for Animal Health Expert Workshop on Non‐Human Antimicrobial Usage and Antimicrobial Resistance: Scientific Assessment, Geneva, 1–5 December 2003.

    Financial support: Directorate for Food, Fisheries, and Agro Business (Danish Ministry of Food, Agriculture, and Fisheries, Denmark); Center for Veterinary Medicine, US Food and Drug Administration.

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