Biological Warfare in the 17th Century

in this study and in previous studies (1,8). The presence of a strong β-lactamase with resistance to ampicillin was also a marker in this study; epidemic C. jejuni and C. coli isolates were β-lactamase negative with susceptibility to ampicillin in previous outbreaks in MSM (1,8). Higher proportions of C. coli isolates are erythromycinand multidrug-resistant than are C. jejuni isolates (4,6). When indicated, the proper antimicrobial treatment of enteric erythromycinand ciprofloxacin-resistant Campylobacter spp. is not known because no clinical studies have been done for infections with such isolates, but tetracycline or amoxicillin/clavulanic acid can be used if isolates are susceptible in vitro (1,8; this study). MSM should be counseled about preventing STIs, including enteric infections. Barriers should be used during genital, oral, and anal sex, and genital and hand washing before and after sex should be done (9,10). Our study increases evidence of clusters of Campylobacter STIs in MSM (1,8).