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Transmission of multidrug-resistant Campylobacter jejuni to children from different sources in Pakistan

Zobia Noreen¹, Fariha Siddiqui¹, Sundus Javed¹

¹Department of Biosciences, COMSATS University, Islamabad, Pakistan.

Journal of Global Antimicrobial Resistance

|July 27, 2019

Insights

Multidrug-resistant Campylobacter jejuni is common in Pakistani children with diarrhoea. Most strains resist common antibiotics, with livestock identified as a likely source, raising public health concerns.

Area of Science:

Microbiology
Infectious Diseases
Public Health

Background:

Campylobacter jejuni (C. jejuni) is a priority pathogen due to rising multidrug resistance.
Understanding its prevalence and resistance patterns in vulnerable populations is crucial.

Purpose of the Study:

To investigate the prevalence, antibiotic resistance, and sources of C. jejuni in children with diarrhoea in Pakistan.
To identify metallo-β-lactamase (MBL) producing strains and assess potential transmission routes.

Main Methods:

Culture, biochemical tests, and PCR were used to detect C. jejuni in 150 stool samples.
Antibiotic susceptibility testing (disc diffusion) and MBL gene detection (PCR) were performed.
Source tracking utilized source-predictive PCR to identify isolate origins.

Main Results:

C. jejuni was found in 54.6% of samples.
Over 80% of isolates showed resistance to seven of 12 antibiotics; high susceptibility was noted for imipenem and TGC.
Six isolates (7.3%) were MBL producers; 57.3% were linked to livestock, 42.8% to non-livestock/environmental sources.

Conclusions:

High prevalence of multidrug-resistant C. jejuni in paediatric diarrhoea cases in Pakistan.
Livestock-associated strains suggest food chain transmission, posing significant public health risks.
Imipenem-resistant, MBL-producing C. jejuni warrants urgent attention.

Read full analysis

Abstract

Objectives:

Due to the rapid emergence of multidrug-resistant isolates, Campylobacter jejuni (C. jejuni) has been classified as a member of the priority pathogens group. This study aimed to determine the prevalence, antibiotic resistance patterns and source tracking of clinical C. jejuni isolates from paediatric diarrhoeal patients in Pakistan.

Methods:

A total of 150 stool samples from children were processed for the presence of C. jejuni using culture, biochemical tests and species-specific PCR. Antibiotic susceptibility of the isolates was determined by the disc diffusion method, and metallo-β-lactamase (MBL) producers were detected using gene-specific PCR. Source tracking was performed using source-predictive PCR.

Results:

C. jejuni was present in 54.6% of the processed samples. More than 80% of the isolated strains were resistant to seven of 12 tested antibiotics. High levels of susceptibility were observed against imipenem (12.2%) and TGC (9.7%). Six isolates (7.3%) were MBL producers and positive for at least one of the five MBL genes. Source tracking showed that 57.3% of the isolates belonged to livestock-associated clusters (C1-C6) and 42.8% were assigned to non-livestock/environmental clusters (C7-C9). Isolates belonging to livestock clusters had a high Multiple Antibiotic Resistance (MAR) index (P < 0.001) as compared with non-livestock.

Conclusion:

A high prevalence of multidrug-resistant C. jejuni among paediatric diarrhoeal patients was observed. Moreover, the association of these isolates to livestock clades suggests transmission to human populations via the food chain. The presence of imipenem-resistant MBL-producing C. jejuni can lead to serious public health concerns.

Keywords:

Antibiotic resistance Campylobacter jejuni Imipenem Metallo-β-lactamase Source attribution

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