National surveillance of Campylobacter infections and resistance in the Netherlands; an overview 20002004
Abstract number: p1032
van Hees B.C., Veldman-Ariesen M.J., Jongh B.M., Tersmette M., van Pelt W.
Campylobacter is the most frequent cause of bacterial gastroenteritis worldwide. We describe epidemiological features of culture-proven Campylobacter infections in the Netherlands over the years 20002004.
Data from two ongoing projects for surveillance of infectious diseases in the Netherlands were used, covering 3- and 8 million inhabitants respectively. Incidence and resistance rates were analysed over time, by region, by level of urbanization, for seasonal variation and for recent travel history.
The incidence of culture-proven Campylobacter infections showed an incidental decrease in the year 2003, in time related to an avian flu outbreak in poultry. Patients in age group 60 + were tested most frequently, but found positive in only 3%. Age group 1529 years had the highest percentage of positive cultures (12%). The incidence of Campylobacter infections was highest in the southern part of the Netherlands; 55.7 per 100.000 in the south versus an average of 39.1 per 100.000 in the other parts of the Netherlands. The incidence was much lower in the rural than the urban areas. High stable rates of resistance were observed for fluoroquinolones (35%). Resistance to erythromycin was low but increasing over the years. Highest resistance rates to erythromycine were found in the south of the Netherlands. Resistance rates increased with increasing urbanization level. An inverse relation was observed between the incidence of infection (high in summer, low in winter) and resistance to both fluoroquinolones and macrolides (relatively high rates during winter). Resistance to predominantly fluoroquinolones was considerably higher in travel- related infections (54%), as compared to endemic ones (33%).
We found regional differences in incidence and resistance rates, both being highest in the south of the Netherlands. Furthermore we found an inverse relationship between resistance rates to fluoroquinolones and macrolides and the incidence of campylobacteriosis. An explanation could be that during winter months poultry is the most important source for Campylobacter infections, while during summer isolates from other sources associated with a low rate of fluoroquinolone resistance become more important. The high resistance rates to fluoroquinolones warrant reconsideration of its use as drug of first choice in the empiric treatment of presumed Campylobacter infections.
|Session name:||XXIst ISTH Congress|
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