Determination of antibiotic susceptibility pattern in Campylobacter jejuni and Campylobacter coli isolated from children with acute diarrhea

Background: The emergence of antimicrobial resistant Campylobacter populations, which become an important consideration on the use of antimicrobial agents, especially in veterinary and human medicine, has become a serious concern worldwide. For monitoring the drug resistance, there is a need to develop reliable and reproducible laboratory techniques. There are several methods including disk diffusion, broth micro-dilution, agar dilution, and E-test to determine in-vitro susceptibility profiles of Campylobacter to a range of antimicrobial agents.

Objectives: Study the Campylobacter jejuni and Campylobacter coli from children with diarrhea and determine the antimicrobial susceptibilities of the isolates to clinically relevant antimicrobials.

Materials and methods: Two hundred twenty stool samples of children with diarrhea were cultured on Preston agar and the isolated campylobacter species were identified by further standard identification test. Susceptibility testing was carried out using Kirby-Bauer disk diffusion method and E-test.

Results: Fourteen Campylobacter strains were isolated (6.36%), of which nine (64.3%) were identified as C. jejuni and five (35.7%) as C. coli. Using disk diffusion, all the campylobacter isolates were fully resistant to cephalothin, oxacillin, and ampicillin followed by ceftazidime with resistance rate of 71.42%. Gentamicin and ciprofloxacin were the most effective antibiotics against both isolated campylobacter species. According to E-test results, Campylobacter isolates demonstrated the greatest resistance to cephalothin (92.85%), oxacillin (92.85%), and ampicillin (78.57%).

Conclusions: Our study reveals a high-level correlation between the E-test and agar disk diffusion method in evaluating the resistance of Campylobacter species to tested antimicrobial agents. This study also suggests disk diffusion is a reliable and cost effective technique for determining the prevalence of resistance among Campylobacter isolates.