臺灣曲狀桿菌監測之挑戰：臨床診斷缺口與抗藥性演進

Surveillance Gaps of Campylobacter in Taiwan: Clinical Detection, Antimicrobial Resistance, and Policy Progress

本文探討臺灣曲狀桿菌監測面臨的挑戰，涵蓋臨床診斷、抗藥性演進及食品鏈風險。透過彙整全基因體定序與親緣演化分析資料，本文解析了氟喹諾酮類抗藥性近乎飽和的成因，並提示攜帶erm(B)基因之多重抗藥基因島的擴散風險。相關資料反映出人源株與禽源株具高度相似遺傳背景，顯示食品供應鏈是傳播的核心路徑。本文主張，監測模式應轉型為以全基因體定序為核心，以破解傳統培養法的檢測盲點。落實整合人畜數據的「健康一體」框架，方能精準引導用藥選擇並強化防疫控管措施，有效遏制多重抗藥菌的威脅。

This review evaluates the diagnostic gaps and antimicrobial resistance (AMR) trends of Campylobacter in Taiwan. By integrating data from whole-genome sequencing (WGS), MLST, and phylogenetic analysis, the study elucidates the genetic mechanisms driving near-saturated fluoroquinolone resistance and the emergence of novel multidrug resistance genomic islands (MDR-GIs) harboring erm(B). Besides extreme resistance, high genetic relatedness persists between human clinical isolates and poultry reservoirs. The findings emphasize that transitioning to WGS-based routine surveillance is critical to overcome traditional culture-based limitations. Implementing a One Health framework that integrates human and animal genomic data is essential for informing empiric therapy and developing precise public health interventions to mitigate the burden of multidrug-resistant Campylobacter prevalence.