Risk factors for ciprofloxacin-resistant Campylobacter infection in Wales.

OBJECTIVES To identify risk factors for ciprofloxacin resistance in both travel-related and domestically acquired Campylobacter infection. METHODS Case-comparison study of patients with ciprofloxacin-resistant and ciprofloxacin-susceptible Campylobacter infection conducted in Wales during 2003 and 2004. RESULTS Foreign travel was the major risk factor for ciprofloxacin-resistant infection [adjusted odds ratio (adjOR) 24.0, 95% confidence interval (95% CI) 12.6-45.9]. Among travellers, case patients were five times more likely to drink still bottled water (adjOR 4.7, 95% CI 1.0-21.7), whilst among non-travellers, case patients were three times more likely to drink sparkling bottled water (adjOR 3.3, 95% CI 1.5-7.4). There was no increased risk associated with eating poultry or prior quinolone use. CONCLUSIONS Foreign travel remains the most important risk factor for ciprofloxacin-resistant Campylobacter infection. The possible association of both domestic- and travel-related ciprofloxacin-resistant Campylobacter infection with bottled water needs to be further explored.