Correlation Between Flagellin A (flaA) Genotypes and Antimicrobial Susceptibility Patterns of Campylobacter jejuni Strains Isolated from Children with Gastroenteritis in Athens, Greece

Background and Objective: Campylobacter jejuni is one of the most common enteric pathogens worldwide. The bacterium is transmitted to humans via contaminated food and water. In the majority of cases the disease is self-limiting, but treatment is indicated in immunocompromised patents, in severe cases with septicemia, and in children. The subtyping of clinical, animal, and food C. jejuni isolates is very important for epidemiological studies. In the present Study, 192 Campylobacter jejuni isolates characterized by pulsed-field gel electrophoresis (PFGE) of SmaI digested genomic DNA were further examined with respect to their antimicrobial resistance and their flagellin A (flaA) genotypes in order to disclose any correlation between a certain flaA type and a specific antimicrobial susceptibility pattern. Methods: C. jejuni clinical isolates were collected from infected children up to 14 years of age from five general hospitals in the area of Attica, Greece, during the period 2004-7. C. jejuni strain isolation and identification from stool samples were performed by conventional bacteriological methods. Sinal restriction fragments were prepared as described previously for the PFGE analysis. Antimicrobial susceptibility was tested and interpreted by determination of the minimal inhibitory concentration (MIC) by use of the agar dilution method as described by the Clinical Laboratory Standards Institute. flaA typing was performed by PCR amplification of the corresponding gene, and the product was digested with DdeI and visualized by agarose gel electrophoresis. Data were analyzed using the software Gene Profiler 1-D Gel Analysis and Data Basing for Windows (R). Results: A statistically significant correlation between certain flaA genotypes (flaA 17 Greece [GR], flaA 19 GR and flaA 39 GR) and resistance to some antimicrobial agents (ampicillin, amoxicillin/clavulinic acid [co-amoxiclav], erythromycin, nalidixic acid, and ciprofloxacin) was detected in C. jejuni strains isolated from infected children. Conclusions: Further investigations on a molecular basis are warranted in order to clarify whether certain C. jejuni flaA types are associated with specific antimicrobial resistance attributes.