The antimicrobial susceptibility patterns of 146 Campylobacter spp.isolated from diarrheal patients admitted to hospitals in Azad Kashmir Pakistan were analyzed to determine their changing trends in response to fifteen antibiotics. Campylobacter isolates were identified as C. jejuni (66.4%) and C. coli (33.6%). An over whelming majority of isolates were recovered from children (72%), 52 % were from male patients. The highest number of strains was isolated in summer (30.8 %) followed by in autumn (25.3 %) and in spring (22.6 %). The lowest number of strains was isolated in winter (21.2 %). The isolates showed highest resistance against carbenicillin followed by ampicillin, co-trimoxazole, streptomycin, amoxicillin, amikacin, ceftizoxime, tetracycline, erythromycin and nalidixic acid. The isolates showed least resistance against ceftriaxone followed by chloramphenicol and gentamicin. All Campylobacter isolates were sensitive to cefixime and ciprofloxacin. Multiple drug resistance was observed in this study ranging from three to eight drugs. 36 % were resistant to three or more antibiotics at 25µg/ml, 34 % were resistant to three or more antibiotics at 50µg/ml, 18 % were resistant to three or more antibiotics at 100µg/ml and 8 % were resistant to three or more antibiotics at 300µg/ml. The most common pattern of antibiotic resistance was Carbenicillin+ampicillin+co-trimoxazole. The plasmids were observed in 15.1 % MDR strains of Campylobacter spp. which were found resistant to three or more antibiotics. Allthe strains contained a heterogeneouspopulation of plasmids ranging between 23.1 kb to 2.0 kb. grouped into seven different plasmid patterns. The plasmids (23.1 Kb) could only confer tetracycline resistance to the competent cells of drug sensitive and plasmid-less Campylobacter strains. A plasmid-borne tet(O) gene were the main resistance mechanisms for tetracycline.
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