Recherche en gérontologie et en gériatrie

Abstrait

Colitis Due to Campylobacter jejuni/coli: Ceftriaxone is Not Effective

Stephane Emonet *,Betim Redzepi ,Arnaud Riat ,Abdessalam Cherkaoui ,Benjamin A Lipsky ,Frederic Ris ,Jacques Schrenzel

Background: Ceftriaxone is often prescribed empirically for patients hospitalized with abdominal pain and fever. If stools culture from such a patient yields Campylobacter jejuni or Campylobacter coli (C. jejuni/coli), clinicians ask about its susceptibility to ceftriaxone, to which it is not routinely tested. We report a case of colitis that raised this question. As we couldn’t find the answer in the published literature, we investigated the sensitivity of strains of C. jejuni/coli to ceftriaxone in our hospital.

Methods: We conducted a retrospective study of all strains of C. jejuni and C. coli isolated from specimens of infected patients seen in our tertiary care university-affiliated hospital in Switzerland between March 2009 and December 2010. Campylobacter strains were identified to the species level with matrix-assisted laser desorption ionization - time of flight (MALDI-TOF) mass spectrometry and antimicrobial susceptibilities were determined by Etest.

Results: Among 108�C. jejuni and 14�C. coli isolates, only 1.6% were fully susceptible to ceftriaxone. Overall, 95.9% of our strains were susceptible to erythromycin but 52.5% of C. jejuni/coli were resistant to ciprofloxacin.

Conclusion: Our results suggest that ceftriaxone should be considered ineffective for the treatment of Campylobacter jejuni/coli infections, the major cause of gastro-enteritis in Europe. In the light of increasing resistance to fluoroquinolones, cases of severe Campylobacter colitis or bacteraemia may require a short course of macrolides.