Epidemiology and Infection

Original Papers

Risk factors for ciprofloxacin resistance in reported Campylobacter infections in southern Alberta

J. Y. M. JOHNSONa1a2, L. M. McMULLENa2, P. HASSELBACKa3, M. LOUIEa4, G. JHANGRIa1 and L. D. SAUNDERSa1 c1

a1 Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada

a2 Department of Agriculture, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada

a3 Interior Health Authority, Kelowna, British Columbia, Canada

a4 Provincial Laboratory for Public Health (Microbiology), Calgary, Alberta, Canada

Abstract

We conducted a case-control study examining risk factors for ciprofloxacin resistance in Campylobacter infections that were reported in 2004 and 2005 in two health regions in southern Alberta. The study questionnaire included questions about recent travel and antibiotic use, food consumption frequency, use of household and personal hygiene products with antibacterial agents, contact with animals, and potential misuse of antibiotics. Of the 210 patients who participated, 31·0% had ciprofloxacin-resistant Campylobacter infections. Foreign travel was the strongest predictor of resistance. Surprisingly, possession of antibiotics for future use was identified as a risk factor for resistance. We also examined the potential for participation bias and resistance misclassification to affect the resulting multivariable models. Participation bias appears to have had a substantial effect on the model results, but the estimated misclassification effect due to the use of different ciprofloxacin susceptibility testing methods was only slight.

(Accepted July 05 2007)

(Online publication August 03 2007)

Correspondence:

c1 Address for correspondence: Dr L. D. Saunders, Department of Public Health Sciences, 13-103 Clinical Sciences Building, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada. (Email: Duncan.Saunders@ualberta.ca)

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