Dysentery caused by macrolide and fluoroquinolone resistant Campylobacter coli in central area of Iran

Background: Campylobacter genus is considered some of the most important agents of bacterial gastroenteritis worldwide. Campylobacter coli (C. coli) is accounted to at least 25% of all Campylobacter related diarrheal diseases moreover, C. coli infections can result in severe complications, such as bacteremia, sepsis, meningitis and spontaneous abortion. Finally, there is evidence that the frequency of antimicrobial resistance is higher in C. coli, when compared to C. jejuni. There is no data regarding the frequency and antibiotic resistance profile of C. jejuni isolated from human gastroenteritis samples. The present study aimed to determine the frequency and antibiotic resistance patterns of Campylobacter coli isolated from infectious diarrhea samples. Methods: In a descriptive cross-sectional study, 200 infectious diarrhea samples collected in Arak University of Medical Sciences Hospitals, Markazi Province, Iran, from May to November 2015 were subjected to the study. In order to identify C. coli modified Gram stain, modified charcoal-cefoperazone-deoxycholate agar (mCCDA) and Brucella agar media with filter and CeuE gene polymerase chain reaction (PCR) were accomplished. Antibiotic resistance against tetracycline, erythromycin, ciprofloxacin, ampicillin and gentamicin was evaluated phenotypically and genotypically. Results: In total, out of 200 modified gram stained samples, 2 cases (1%) of C. coli were identified. Cultivating methods using mCCDA medium found 2 isolates (1%), 3 isolates (1.5%) were grown on Brucella agar with filter and 5 cases (2.5%) were determined as C. coli using PCR assay. Antibiotic resistance was observed in 5 cases against tetracycline, erythromycin and ciprofloxacin (100%), in 4 cases against ampicillin (80%), in 2 cases against gentamicin (40%), in 5 cases with CmeB, 23srRNA mutation in, qnrS, tet (o) (100%), in 4 cases with gyrA4 (80%), in 3 cases with gyrA5 (60%), in 5 cases with gyrA6 (100%), in 4 cases with Oxa61 (60%) and in 1 case with aphA-3-1 (20%). Conclusion: In this present study C. coli with low prevalence and entire resistance to ciprofloxacin and erythromycin which are the first line antibiotic for the treatment of campylobacter gastroenteritis is introduced as a causative agent of gastroenteritis in patients at central part of Iran.