Antibiotic Resistance of Diverse MLST Campylobacter from Pediatric Patients with Acute Diarrhea

Abstract

Abstract Background Campylobacter spp., as a zoonotic pathogen, has been one of the most common pathogens that causes human gastroenteritis in developing countries. The objective of this study was to determine the antibiotic resistance of Campylobacter in children. Methods Stool samples were collected from pediatric patients under 14 years of age who visited hospital for acute diarrhea between February 2018 and January 2019. Campylobacter was isolated from samples using selective enrichment and culture and confirmed by PCR, genotypes were characterized by multilocus sequencing, and antibiotic resistance was determined by susceptibility and resistance genes to antimicrobials of medical importance. Results The overall prevalence of Campylobacter in children with diarrhea was 4.4% (53/1197). Higher prevalence was observed in children under five-year-old and in spring and autumn. Approximately 80% (42/53) of confirmed isolates were C. jejuni and ~ 20% (11/53) isolates were C. coli. Among the 51 isolates successfully typed, 43 sequence types belonging to 13 clonal complexes were identified, of which 44.2% (19/43) sequence types were novel. The majority of the Campylobacter isolates (74%) exhibited multidrug resistance and the most common antimicrobials resistant to were ciprofloxacin, tetracycline and nalidixic acid. All isolates (53/53) were positive of the tet(O) gene that confers resistance to tetracycline and the gyrA gene that confers resistance to quinolones/fluoroquinolones, 81% (43/53) isolates were positive of the ermB gene that confers resistance to macrolides, and 19% (10/53) isolates were positive of the aadE-sat4-aphA gene that confers resistance to aminoglycosides, respectively. Conclusions Despite the low prevalence of Campylobacter in children in the subtropical Guangzhou metropolitan, the high multidrug resistance of diverse MLST of Campylobacter indicated the importance of preventive strategies including routine surveillance in order to minimize the infections of antibiotic resistant Campylobacter in children.