INTRODUCTION:
Campylobacter species are a leading global cause of bacterial gastroenteritis, primarily transmitted to humans through poultry. Antimicrobial resistance (AMR) in these pathogens critically exacerbates this pathway, driving the spread of multidrug-resistant (MDR) strains and complicating outbreak management. This study assessed the AMR profile of Campylobacter isolates from poultry waste in an agricultural facility in South Africa's Eastern Cape Province to evaluate the direct public health threat.

METHODS:
Campylobacter isolates were recovered from poultry waste samples. Phenotypic AMR profiling was conducted against a panel of antibiotics, and the multiple antibiotic resistance index (MARI) was calculated. Molecular analysis was performed to detect the presence of 20 specific antimicrobial resistance genes (ARGs).

RESULTS:
From 110 presumptive isolates, we observed a high prevalence of MDR, with 85% exhibiting an MARI between 0.24 and 1.0. Resistance was widespread across seven antibiotic classes, most alarmingly to erythromycin (92.73%), chloramphenicol (81.82%), tetracycline (80%), and ciprofloxacin (70%)—drugs vital for human therapy. Molecular analysis detected 17 of the 20 tested ARGs, including genes conferring resistance to aminoglycosides (strA, aadA), chloramphenicol (catI, catII), and tetracyclines (tetB, tetD).

CONCLUSIONS:
The high burden of MDR Campylobacter and associated ARGs in poultry waste represents a significant reservoir for environmental contamination and zoonotic transmission. These findings underscore an urgent public health risk, as improper handling of waste or consumption of contaminated poultry products can facilitate the spread of resistant infections, diminish treatment efficacy, and increase the severity of campylobacteriosis in communities.