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Letter
Antimicrobial Resistance in
Campylobacter
Nicole M. Iovine* and Martin J. Blaser*†
*New York University School of Medicine, New York, New York, USA; †New
York Harbor Department of Veterans Affairs Medical Center, New York, New
York, USA
Suggested citation
for this article:
Iovine NM, Blaser MJ. Antimicrobial resistance in Campylobacter
[letter]. Emerg Infect Dis [serial on the Internet]. 2004 Jul [date
cited]. Available from: http://www.cdc.gov/ncidod/EID/vol10no7/04-0580.htm
To the Editor: We wish to rectify several errors in our commentary,
Antibiotics in Animal Feed and Spread of Resistant Campylobacter
from Poultry to Humans (1). The fluoroquinolone enrofloxacin
was approved in 1996 for therapeutic use by addition to drinking water
upon the decision of a licensed veterinarian "for the control of
mortality in chickens associated with Escherichia coli organisms
and control of mortality in turkeys associated with E. coli and
Pasteurella multocida organisms" (2). This
therapeutic use was withdrawn (3) but is now under appeal.
Initial approval and subsequent efforts to withdraw use of enrofloxacin
in the United States parallel the earlier trend in Europe and specifically
Denmark, where the use of antimicrobial agents as growth promoters has
been banned (4).
Enrofloxacin is not approved for prophylactic or growth promotion use
in poultry feed as stated in our commentary and in the first section of
the flowchart (1). However, when enrofloxacin is added
to the drinking water of poultry, large numbers of both ill and healthy
animals are exposed to the agent (5). Although extra-label
use of enrofloxacin is prohibited, microbiologic culture of either of
the cited bacteria is not required before administration (2).
Despite the restrictions on enrofloxacin use, emergence of fluoroquinolone-resistant
Campylobacter species, with poultry as an important source, has
been documented in the United States (5,6). Thus the
decision to withdraw therapeutic use of enrofloxacin (3)
was warranted. Therefore, our conclusion remains: use of enrofloxacin
in poultry materially contributed to increase in human infection by fluoroquinolone-resistant
Campylobacter species. Given the above, our commentary should have
been entitled Use of Antibiotics in the Poultry Industry and Spread of
Resistant Campylobacter to Humans. We regret the errors and hope
we have clarified this issue.
References
- Iovine N, Blaser MJ. Antibiotics in animal feed and
spread of resistant Campylobacter from poultry to humans. Emerg
Infect Dis. 2004 Jun [cited 14 Jun 2004]. Available from: http://www.cdc.gov/ncidod/eid/vol10no6/04-0403.htm
- Sundlof S. Enrofloxacin for Poultry; Opportunity for Hearing. Department
of Health and Human Services, Food and Drug Administration, Center for
Veterinary Medicine. Fed Register. 2000;65:64954–65.
- Davidson D. In the matter of enrofloxacin for poultry: withdrawal
of approval of Bayer Corporation's new animal drug application 1 (NADA)
140-828 (Baytril). FDA Docket No 00N-1571 2004.
- DANMAP 2002. Use of antimicrobial agents and occurrence of antimicrobial
resistance in bacteria from food animals, foods and humans in Denmark.
Copenhagen Danish Zoonosis Center, Danish Veterinary Institute. 2003.
- Gupta A, Nelson JM, Barrett TJ, Tauxe RV, Rossiter SP, Friedman CR,
et al. Antimicrobial
resistance among Campylobacter strains, United States, 1997–2001.
Emerg Infect Dis. 2004;10:1102–9.
- Smith KE, Besser JM, Hedberg CW, Leano FT, Bender JB, Wicklund JH,
et al. Quinolone-resistant
Campylobacter jejuni infections in Minnesota, 1992-1998. Investigation
Team. N Engl J Med. 1999;340:1525-32.
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