Antimicrobial Susceptibility of Campylobacter isolates in the Capital of North Macedonia.
BACKGROUND
Campylobacter infections are typically self-limited, but in cases with severe enteritis, immuno-compromised system and bacteremia, an appropriate antimicrobial treatment is demanding. Our study aim was to determine the isolation rate of Campylobacter among patients with acute enteritis in the capital of North Macedonia and its antimicrobial susceptibility.


MATERIAL AND METHODS
A total number of 3820 patients clinically diagnosed as acute enteritis, were included in the study. Stool samples were collected and Campylobacter was isolated and identified by classical microbiological methods. Antimicrobial susceptibility of all isolates to Ceftriaxone, Amoxicillin-clavulonic acid, Erythromycin, Ciprofloxacin, Tetracycline and Gentamicin was determined by disc-diffusion technique. Additionally, minimal inhibitory concentrations of all Campylobacter isolates against erythromycin, ciprofloxacin and tetracycline were determined by Epsilon gradient tests.


RESULTS
Campylobacter species was isolated in 97 patients. Although the mean isolation rate of Campylobacter spp. during the whole study period was 2.53%, a statistically significant increase was detected in 2016 and 2017, in comparison with the data from previous four years of the study. The isolation rate of Campylobacter spp. didn't reveal statistically significant difference between males and females (p > 0.05). 46.4 % of patients with Campylobacter enteritis were children at the age under 15 years. Forty-three C. jejuni isolates were susceptible to all six antibiotics, but the remaining 44 isolates revealed resistance to at least one antibiotic. C. coli isolates were resistant to 3 antibiotics simultaneously. Two C. coli isolates only, were susceptible to all 6 antibiotics. 40.90% of C. jejuni and 50% of C. coli isolates were resistant to beta-lactams, fluoroquinolones and tetracyclines, simultaneously.


CONCLUSION
The increase of the isolation rate of Campylobacter from patients with acute enteritis indicates the need for permanent isolation and identification of Campylobacter from every clinically diagnosed patient, as acute enteritis. Erythromicin is the most effective antibiotic for treatment of Campylobacter enteritis in our patients. The high level of Campylobacter resistance to beta-lactams, fluoroquinolones and tetracyclines requires more rational approach in the treatment of Campylobacter enteritis.
['Trajkovska-Dokic|Elena|E|', 'Mihajlov|Kiril|K|', 'Mirchevska|Gordana|G|', 'Kostovski|Marko|M|', 'Blazevska|Aneta|A|', 'Stojkovska|Snezana|S|']
D000208:Acute Disease D000293:Adolescent D000328:Adult D000368:Aged D000900:Anti-Bacterial Agents D000890:Anti-Infective Agents D002167:Campylobacter D002169:Campylobacter Infections D002648:Child D002675:Child, Preschool D002939:Ciprofloxacin D003430:Cross-Sectional Studies D024881:Drug Resistance, Bacterial D004751:Enteritis D004917:Erythromycin D005243:Feces D005260:Female D006801:Humans D007223:Infant D008297:Male D008826:Microbial Sensitivity Tests D008875:Middle Aged D018843:Republic of North Macedonia D013752:Tetracycline D055815:Young Adult
antimicrobial susceptibility Campylobacter acute enteritis