Clinical manifestations of Campylobacter jejuni infection in adolescents and adults, and change in antibiotic resistance of the pathogen over the past 16 years.

Background: Campylobacter jejuni infection, traditionally a paediatric illness, is now seen more frequently in adolescents and adults in northern China. Published surveillance reports on C. jejuni infection in these patients are rare. We aimed to characterize (1) the clinical manifestations of this infection in adolescents and adults, and (2) changes in antibiotic resistance of the pathogen. Methods: We retrospectively examined 492 cases of C. jejuni infection in patients aged >= 14 y treated at the Peking University First Hospital, Beijing, China, for the period January 1994 to December 2010. Results: The disease was more common in patients aged 14-24 y and in men (57.9%; p < 0.0001 vs women). The peak incidence was seen between May and October. The infection manifested with acute diarrhoea (<10 bowel movements per day, loose or mucous stool), fever (mostly low grade), and abdominal cramps and pain. Faecal leukocytes and erythrocytes were demonstrated in, respectively, 90.9% and 79.3% of stool specimens, while leukocytes >10 per high-power field were detected in 70.3%. In 1994-1998, 44.5% of C. jejuni strains were resistant to fluoroquinolone, 0% to gentamicin, and 0% to cefuroxime; in 2005-2010, resistance increased significantly to 97.9%, 16.7%, and 93.0%, respectively (p < 0.0001). The resistance to erythromycin did not change significantly (3% vs 6.4%, p = 0.4). Conclusions: Manifestations of C. jejuni infection in adolescent and adult patients are similar to those in children. Over the 16-y study period, resistance of C. jejuni to fluoroquinolones, gentamicin, and cefuroxime significantly increased.