Campylobacter Infections

Key Features

• Microaerophilic, motile, gram-negative rods

• Two species infect humans

  • Campylobacter jejuni, an important cause of diarrheal disease

  • Campylobacter fetus subsp fetus, typically causes systemic infection and not diarrhea

• Dairy cattle and poultry are important reservoirs

Clinical Findings

• Campylobacter gastroenteritis

  • Fever

  • Abdominal pain

  • Diarrhea characterized by loose, watery, or bloody stools

  • Disease is self-limited, but its duration can be shortened with antimicrobial therapy

• C fetus

  • Causes systemic infections that can be fatal, including primary bacteremia, endocarditis, meningitis, and focal abscesses

  • Infrequently causes gastroenteritis

  • Infected patients are often elderly, debilitated, or immunocompromised

  • Closely related species, collectively termed "Campylobacter-like organisms," cause bacteremia in HIV-infected individuals

Diagnosis

• Blood culture

• Stool culture

Treatment

• Either azithromycin, 1 g orally as single dose, or ciprofloxacin, 500 mg twice daily orally for 3 days, is effective

• However, C jejuni isolates may be resistant to fluoroquinolones, particularly in Southeast Asia, and susceptibility testing should be routinely performed

• C fetus

  • Systemic infections respond to therapy with gentamicin, chloramphenicol, ceftriaxone, or ciprofloxacin

  • Ceftriaxone or chloramphenicol should be used to treat CNS infections because of their ability to penetrate the blood-brain barrier