Prevalence, antimicrobial resistance and risk factors for campylobacteriosis in Lebanon

Abstract

Introduction: The rapid increase in Campylobacter strains resistant to antibiotics represents a major problem for public health. In Lebanon, campylobacteriosis is underdiagnosed since bacteria detection in stool samples is not performed routinely. This study aims to evaluate the prevalence, sources and routes of transmission, risk factors and antimicrobial susceptibility patterns of Campylobacter spp. in Lebanon.

Methodology: Stool samples collected from 1000 Lebanese patients with diarrhea, and 150 meat samples taken from supermarkets and slaughterhouses were subjected to Campylobacter detection. Colonies were identified by Gram staining, oxidase and catalase activities. They were then differentiated at the species level by hippurate test and PCR. Susceptibility of Campylobacter spp. to antibiotics was studied by the disc diffusion standard method.

Results: Campylobacter spp. were detected in 21.5% of stool samples; the main isolated species being C. jejuni (83.2%) and C. coli (13.9%). The highest Campylobacter infection rates were detected among children (41.8%) and during summer (31.6%). Consumption of contaminated meat and salads, and contact with animals represented the major risk factors for campylobacteriosis, with poultry carcasses and bovine cuts identified as the main bacteria reservoirs. Neither demographic determinants nor season had a major effect on the prevalence of campylobacteriosis. Erythromycin was the most active agent against Campylobacter spp. A multi-resistance rate was observed in 35.9% of isolates.

Conclusions: Campylobacteriosis is a major public health concern in Lebanon. Bacteria detection in stool culture should be performed routinely to allow an early diagnosis and a better monitoring of the disease and its burden.