Transmission of Multidrug Resistant Campylobacter jejuni to Children from Different Sources in Pakistan.

OBJECTIVES: Campylobacter jejuni has been classified as a member of priority pathogens group due to the rapid emergence of multidrug resistant isolates. In the present study we planned to determine the prevalence, antibiotic resistance patterns and source tracking of clinical C. jejuni isolates from pediatric diarrheal patients in Pakistan.

METHODS: A total of 150 stool samples from children were processed for the presence of Campylobacter jejuni using culture, biochemical tests and by species specific PCR. Antibiotic susceptibility of the isolates was determined by disc diffusion method and metallo-beta-lactamase (MBL) producers were detected using gene specific PCR. Source tracking was done using source predictive PCR.

RESULTS: Campylobacter jejuni was present in 54.6% of the processed samples. More than 80% of the isolated strains were resistant to 7 out of 12 antibiotics tested. High level of susceptibility was observed against imipenem (12.2%) and tigecycline (9.7%). Six isolates (7.3%) were metallo-beta-lactamase producers and were positive for at least one of the five metallo-beta-lactamase genes. Source tracking showed that 57.3% of the isolates belonged to livestock associated cluster (C1 to C6) and 42.8% were assigned to non-livestock/environmental clusters (C7-C9). Isolates belonging to livestock cluster had high Multiple Antibiotic Resistance (MAR) index (p value<0.001) as compared to non-livestock.

CONCLUSION: High prevalence of multidrug resistant C. jejuni among pediatric diarrheal patients was observed. Moreover, association of these isolates to livestock clades suggest transmission to human population via food chain and presence of imipenem resistant MBL producing C. jejuni can lead to serious public health concerns.