High rates of fluoroquinolone-resistant Campylobacter in Portugal--need for surveillance.

Introduction Gastrointestinal infections caused by Campylobacter spp. can manifest as self-limited gastroenteritis or more severe diarrhoea. They can also cause secondary complications, such as reactive arthritis and Guillian-Barré syndrome. Recent publications have indicated that Campylobacter is a leading cause of food-borne diseases in many countries in Europe, clearly surpassing former frontrunners, such as nontyphoidal Salmonella [1,2]. Furthermore, recent studies from Europe have reported a worrying rise in resistance to fluoroquinolones among Campylobacter strains [2,3]. However, few data on Campylobacter are available from Portugal. A report from 2003 singled out Portugal as the only country among 18 European states that had no existing surveillance system for Campylobacter infections in 2000 [4]. A PubMed search in February 2008, using the terms Campylobacter and Portugal, retrieved just seven publications. Only one of these reported results collected on the national level, but it was published in 1992 [5]. Official notification reports in Portugal do not include many food-borne diseases; among the bacterial infections, only cholera, salmonellosis, shigellosis and botulism are reported [6]. Furthermore, stool cultures for Campylobacter are not routinely performed in all Portuguese laboratories.