• CDC, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) are investigating a multistate outbreak of multidrug-resistant Campylobacter infections.
  • Campylobacter bacteria isolated from clinical samples from people sickened in this outbreak were found to be resistant to commonly recommended, first-line antibiotics. This antibiotic resistance means it may be difficult to treat infections with the outbreak strain with the antibiotics usually prescribed for Campylobacter infections.
  • Since the last update on October 3, 2017, 12 more ill people have been reported from 8 states. The most recent illness began on October 14, 2017.
  • As of October 23, 2017, a total of 67 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection have been linked to this outbreak. Illnesses have been reported from 15 states.
    • Of 62 ill people with available information, 17 (27%) have been hospitalized. No deaths have been reported.
    • Illnesses started on dates ranging from September 15, 2016 to October 14, 2017.
  • Epidemiologic and laboratory investigations linked this outbreak to contact with pet store puppies.
    • Of the 67 ill people in this outbreak, 62 (93%) have an epidemiological link to puppies at or from a Petland store.
      • Eighteen patients were Petland employees.
      • Forty- four people either recently purchased a puppy from Petland, visited a Petland store, or live in or visited a home with a puppy sold by Petland before their illness began.
      • Of the other five ill people, four reported contact with puppies from other sources and one had a laboratory-confirmed infection and did not report any puppy exposure.
    • Whole genome sequencing (WGS) showed that the Campylobacter isolates from ill people and from puppies were closely related genetically.
    • WGS provides additional evidence that the source of human illness in this outbreak is contact with puppies from Petland.
  • Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients.
    • WGS has identified multiple antimicrobial resistance genes and mutations in outbreak-associated isolates from 13 ill people and 8 puppies. This finding matches results from standard antibiotic resistance testing methods used by CDC’s National Antimicrobial Resistance Monitoring System (NARMS)laboratory on 10 clinical isolates from 4 ill people and 6 puppies in this outbreak.
    • The 10 isolates tested by standard methods were resistant to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline. In addition, 8 of these isolates were resistant to gentamicin, and 2 of these isolates were resistant to florfenicol.