Enhancing Surveillance of Foodborne Bacteria and Antimicrobial Resistance Using a Large Centralized Laboratory Database: Case Study of Campylobacter and Non-Typhoidal Salmonella in Peru

BACKGROUND: Rising antimicrobial resistance of foodborne pathogens threatens effective treatment. In LMICs, surveillance systems fail to capture diagnostic data generated by private laboratories. We assessed the value of private laboratory data to characterize the epidemiology, seasonality, and AMR profiles of Campylobacter and non-typhoidal Salmonella in Peru. METHODS: A retrospective analysis was performed on stool culture data between 2020 and 2024. Positivity and resistance proportions were summarized by age group, sex, and hospitalization status. Seasonal trends were evaluated using generalized additive models, with interaction terms to assess age-specific seasonal effects. RESULTS: Campylobacter and NTS were isolated in 4.1% and 2.2% of samples (N=47,724). Infants had over 20-fold higher odds of Campylobacter positivity compared to individuals ≥5 years. Ciprofloxacin resistance exceeded 95% in both C. jejuni and C. coli, while azithromycin resistance reached 8.2% and 38.9%, respectively. NTS positivity was highest in children under 5 years, remaining stable across older age groups. Resistance was observed to ceftriaxone (40.6%), ciprofloxacin (32.6%), and azithromycin (11.3%). Campylobacter exhibited significant, age-dependent seasonal patterns, with peak positivity between July and October. CONCLUSION: Despite limitations in the availability of clinical data and harmonization of methods, private laboratories can provide timely information on pathogen burden, AMR, and seasonality that supports national surveillance. The use of this system may contribute to health security as reporting is significantly accelerated using automated laboratory data systems relative to passive centralized reporting systems.