Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Linda Niccolai

Abstract

Antibiotics are helpful for limiting duration and complications of Salmonella andCampylobacter isolates in selected age groups and people who are immunosuppressed. However, antibiotic-resistant (AR) foodborne pathogens have been on the rise in the United States over the past 10 years and are often linked to international travel (IT). Long-term trends on AR have not been examined in Connecticut (CT). This study evaluates trends in AR among nontyphoidal Salmonella and Campylobacter isolates in CT from 2010 to 2023 and examines the association between AR and IT. Data from submission of annual systematic samples of CT Salmonella and Campylobacter isolates to the CDC’s National Antimicrobial Resistance Monitoring System (NARMS) for standardized AR testing against a panel of 31 antibiotics each and IT and demographic information from the CT Electronic Disease Surveillance System (CTEDSS) were merged. AR trends were assessed using JoinPoint regression analysis. Pearson’s Chi-Square and Fisher’s Exact Test were used to determine associations between AR and IT. Between 2010 – 2023, 424 Salmonella and 1,223 Campylobacter isolates were tested for first-line AR. Among Salmonella, 59 of 424 had IT. Among Campylobacter, 276 of 1,223 had IT. Although there was fluctuation from year to year, there were no distinct trends in overall AR or in specific antibiotics commonly used to treat salmonellosis. Among Campylobacter, AR to azithromycin and erythromycin increased up to 2015 (15%), then decreased until 2023 (2%). Resistance to ciprofloxacin increased (36% to 68%). A significant association was found between IT and higher percentage in overall AR for both pathogens. By antibiotics, a statistically significant association was found for two antibiotics historically used to treat campylobacteriosis (tetracycline, 62.3% vs 41.3%, and ciprofloxacin, 73.9% vs 21.4%). Annual fluctuations in resistance to commonly used antibiotics for severe Salmonella and Campylobacter infections emphasize the need for ongoing surveillance and periodically evaluating trends.

Comments

This is an Open Access Thesis.

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