Campylobacteriosis
Encyclopedia
Campylobacteriosis is an infection
by the Campylobacter
bacterium, most commonly C. jejuni. It is among the most common bacterial infections of human
s, often a foodborne illness
. It produces an inflammatory, sometimes bloody, diarrhea
or dysentery
syndrome, mostly including cramps, fever and pain.
Campylobacteriosis is caused by Campylobacter organisms. These are curved or spiral, motile, non–spore-forming, Gram-negative
rods. This is most commonly caused by C. jejuni, a spiral and comma shaped bacterium normally found in cattle, swine, and birds, where it is nonpathogenic, but the illness can also be caused by C. coli (also found in cattle, swine, and birds), C. upsaliensis
(found in cats and dogs) and C. lari (present in seabirds in particular).
One effect of campylobacteriosis is tissue injury in the gut
. The sites of tissue injury include the jejunum
, the ileum
, and the colon
. C jejuni appears to achieve this by invading and destroying epithelial cells.
C. jejuni can also cause a latent autoimmune effect on the nerves of the legs, which is usually seen several weeks after a surgical procedure of the adomen. The effect is known as an acute idiopathic demyelinating polyneuropathy (AIDP), i.e. Guillain-Barre syndrome
, in which one sees symptoms of ascending paralysis, dysaesthesias usually below the waist, and, in the later stages, respiratory failure.
Some strains of C jejuni produce a cholera
-like enterotoxin, which is important in the watery diarrhea observed in infections. The organism produces diffuse, bloody, edematous, and exudative enteritis. In a small number of cases, the infection may be associated with hemolytic uremic syndrome and thrombotic thrombocytopenic purpura
through a poorly understood mechanism.
and undercooked or poorly handled poultry
), and waterborne (i.e., through contaminated drinking water
). Contact with contaminated poultry, livestock, or household pets, especially puppies, can also cause disease. Animals farmed for meat are the main source of campylobacteriosis. A study published in PLoS Genetics (September 26, 2008) by researchers from Lancashire, England, and Chicago, IL, found that 97 percent of campylobacteriosis cases sampled in Lancashire were caused by bacteria typically found in chicken and livestock. In 57 percent of cases, the bacteria could be traced to chicken, and in 35 percent to cattle. Wild animal and environmental sources were accountable for just three percent of disease.
The infectious dose is 1000-10,000 bacteria (although ten to five hundred bacteria can be enough to infect humans). Campylobacter species are sensitive to hydrochloric acid
in the stomach
, and acid reduction treatment can reduce the amount of inoculum needed to cause disease.
Exposure to bacteria is often more common during travelling, and therefore campylobacteriosis is a common form of travelers' diarrhea.
. For instance, an estimated 2 million cases of Campylobacter
enteritis
occur annually in the U.S.
, accounting for 5-7% of cases of gastroenteritis
. Furthermore, in the United Kingdom
during 2000, Campylobacter jejuni
was involved in 77.3% in all cases of foodborne illness
. About 15 of every 100,000 people are diagnosed with campylobacteriosis every year, and with many cases going unreported, up to 0.5% of the general population may unknowingly harbor Campylobacter in their gut.
A large animal reservoir is present as well, with up to 100% of poultry, including chicken
s, turkey
s, and waterfowl, having asymptomatic infections in their intestinal tracts. Infected chicken
feces may contain up to 109 bacteria per 25 grams, and due to the installations, the bacteria are rapidly spread to other chicken
s. This vastly exceeds the infectious dose of 1000-10,000 bacteria for humans.
is fever, headache, and myalgias, lasting as long as 24 hours. The actual latent period is 2–5 days (sometimes 1–6 days). In other words, it typically takes 1–2 days until actual symptoms develop. These are diarrhea
(as many as 10 watery, frequently bloody, bowel movements per day) or dysentery
, cramps, abdominal pain
, and fever
as high as 40°C (104°F). In most people, the illness lasts for 2–10 days. This is classified as invasive/inflammatory diarrhea, also known as bloody diarrhea or dysentry.
Symptoms may also depend on route of transmission. In participants of anal intercourse, campylobacteriosis is more localized to the distal end of the colon
and may be termed a proctocolitis
.
There are other diseases showing similar symptoms. For instance, abdominal pain and tenderness may be very localized, mimicking acute appendicitis. Furthermore, Helicobacter pylori
is closely related to Campylobacter
and causes peptic ulcer disease.
, infections may be more frequent, may cause prolonged bouts of dirty brown diarrhea, and may be more commonly associated with bacteremia
and antibiotic resistance. The severity and persistence of infection in patients with AIDS and hypogammaglobulinemia
indicates that both cell-mediated and humoral immunity are important in preventing and terminating infection.
or PCR
.
Erythromycin
can be used in children, and tetracycline in adults. Some studies show, however, that erythromycin
rapidly eliminates Campylobacter from the stool without affecting the duration of illness. Nevertheless, children with dysentery
due to C. jejuni benefit from early treatment with erythromycin. Treatment with antibiotics, therefore, depends on the severity of symptoms. Quinolone
s are effective if the organism is sensitive, but high rates of quinolone use in livestock means that quinolones are now largely ineffective. Antimotility agents, such as loperamide
, can lead to prolonged illness or intestinal perforation in any invasive diarrhea, and should be avoided. Trimethoprim
-sulfamethoxazole and ampicillin
are ineffective against Campylobacter.
and sarafloxacin
for single instances of infection. The FDA banned this practice, as it promoted the development of fluoroquinolone-resistant populations.
A major broad-spectrum fluoroquinolone used in humans is ciprofloxacin
.
Currently growing resistance of the Campylobacter to fluoroquinolones and macrolides is of a major concern.
, in which the nerves that join the spinal cord and brain to the rest of the body are damaged, sometimes permanently. This occurs only with infection of C. jejuni and C. upsaliensis.
Other complications include toxic megacolon
, dehydration
and sepsis
. Such complications generally form in little children (< 1 year of age) and immunocompromised people. A chronic course of the disease is possible; such form of the process is likely to develop without a distinct acute phase. Chronic campylobacteriosis features long period of sub-febrile temperature and asthenia; eye damage, arthritis
, endocarditis
may develop if infection is untreated.
Occasional deaths occur in young, previously healthy individuals because of blood volume depletion, and in persons who are elderly or immunocompromised.
A mysterious paralysis can attack people who just had mild symptoms of campylobacteriosis years earlier.
Following are recommendations of the World Health Organization.
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
by the Campylobacter
Campylobacter
Campylobacter is a genus of bacteria that are Gram-negative, spiral, and microaerophilic. Motile, with either unipolar or bipolar flagella, the organisms have a characteristic spiral/corkscrew appearance and are oxidase-positive. Campylobacter jejuni is now recognized as one of the main causes...
bacterium, most commonly C. jejuni. It is among the most common bacterial infections of human
Human
Humans are the only living species in the Homo genus...
s, often a foodborne illness
Foodborne illness
Foodborne illness is any illness resulting from the consumption of contaminated food, pathogenic bacteria, viruses, or parasites that contaminate food, as well as chemical or natural toxins such as poisonous mushrooms.-Causes:Foodborne illness usually arises from improper handling, preparation, or...
. It produces an inflammatory, sometimes bloody, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
or dysentery
Dysentery
Dysentery is an inflammatory disorder of the intestine, especially of the colon, that results in severe diarrhea containing mucus and/or blood in the faeces with fever and abdominal pain. If left untreated, dysentery can be fatal.There are differences between dysentery and normal bloody diarrhoea...
syndrome, mostly including cramps, fever and pain.
Cause
Campylobacteriosis is caused by Campylobacter organisms. These are curved or spiral, motile, non–spore-forming, Gram-negative
Gram-negative
Gram-negative bacteria are bacteria that do not retain crystal violet dye in the Gram staining protocol. In a Gram stain test, a counterstain is added after the crystal violet, coloring all Gram-negative bacteria with a red or pink color...
rods. This is most commonly caused by C. jejuni, a spiral and comma shaped bacterium normally found in cattle, swine, and birds, where it is nonpathogenic, but the illness can also be caused by C. coli (also found in cattle, swine, and birds), C. upsaliensis
Campylobacter upsaliensis
Campylobacter upsaliensis is a species of campylobacter. It can be found in cats and dogs.-Etymology:Campylobacter upsaliensis is named after Uppsala, Sweden, where it was first discovered.- Pathogenesis :...
(found in cats and dogs) and C. lari (present in seabirds in particular).
One effect of campylobacteriosis is tissue injury in the gut
Gut (zoology)
In zoology, the gut, also known as the alimentary canal or alimentary tract, is a tube by which bilaterian animals transfer food to the digestion organs. In large bilaterians the gut generally also has an exit, the anus, by which the animal disposes of solid wastes...
. The sites of tissue injury include the jejunum
Jejunum
The jejunum is the middle section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms middle intestine or mid-gut may be used instead of jejunum.The jejunum lies between the duodenum...
, the ileum
Ileum
The ileum is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may be used instead of ileum.The ileum follows the duodenum...
, and the colon
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...
. C jejuni appears to achieve this by invading and destroying epithelial cells.
C. jejuni can also cause a latent autoimmune effect on the nerves of the legs, which is usually seen several weeks after a surgical procedure of the adomen. The effect is known as an acute idiopathic demyelinating polyneuropathy (AIDP), i.e. Guillain-Barre syndrome
Guillain-Barré syndrome
Guillain–Barré syndrome , sometimes called Landry's paralysis, is an acute inflammatory demyelinating polyneuropathy , a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom...
, in which one sees symptoms of ascending paralysis, dysaesthesias usually below the waist, and, in the later stages, respiratory failure.
Some strains of C jejuni produce a cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...
-like enterotoxin, which is important in the watery diarrhea observed in infections. The organism produces diffuse, bloody, edematous, and exudative enteritis. In a small number of cases, the infection may be associated with hemolytic uremic syndrome and thrombotic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura is a rare disorder of the blood-coagulation system, causing extensive microscopic thromboses to form in small blood vessels throughout the body...
through a poorly understood mechanism.
Transmission
The common routes of transmission for the disease-causing bacteria are fecal-oral, person-to-person sexual contact, ingestion of contaminated food (generally unpasteurized (raw) milkMilk
Milk is a white liquid produced by the mammary glands of mammals. It is the primary source of nutrition for young mammals before they are able to digest other types of food. Early-lactation milk contains colostrum, which carries the mother's antibodies to the baby and can reduce the risk of many...
and undercooked or poorly handled poultry
Poultry
Poultry are domesticated birds kept by humans for the purpose of producing eggs, meat, and/or feathers. These most typically are members of the superorder Galloanserae , especially the order Galliformes and the family Anatidae , commonly known as "waterfowl"...
), and waterborne (i.e., through contaminated drinking water
Drinking water
Drinking water or potable water is water pure enough to be consumed or used with low risk of immediate or long term harm. In most developed countries, the water supplied to households, commerce and industry is all of drinking water standard, even though only a very small proportion is actually...
). Contact with contaminated poultry, livestock, or household pets, especially puppies, can also cause disease. Animals farmed for meat are the main source of campylobacteriosis. A study published in PLoS Genetics (September 26, 2008) by researchers from Lancashire, England, and Chicago, IL, found that 97 percent of campylobacteriosis cases sampled in Lancashire were caused by bacteria typically found in chicken and livestock. In 57 percent of cases, the bacteria could be traced to chicken, and in 35 percent to cattle. Wild animal and environmental sources were accountable for just three percent of disease.
The infectious dose is 1000-10,000 bacteria (although ten to five hundred bacteria can be enough to infect humans). Campylobacter species are sensitive to hydrochloric acid
Hydrochloric acid
Hydrochloric acid is a solution of hydrogen chloride in water, that is a highly corrosive, strong mineral acid with many industrial uses. It is found naturally in gastric acid....
in the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
, and acid reduction treatment can reduce the amount of inoculum needed to cause disease.
Exposure to bacteria is often more common during travelling, and therefore campylobacteriosis is a common form of travelers' diarrhea.
Epidemiology
Infection with a Campylobacter species is one of the most common causes of human bacterial gastroenteritisGastroenteritis
Gastroenteritis is marked by severe inflammation of the gastrointestinal tract involving both the stomach and small intestine resulting in acute diarrhea and vomiting. It can be transferred by contact with contaminated food and water...
. For instance, an estimated 2 million cases of Campylobacter
Campylobacter
Campylobacter is a genus of bacteria that are Gram-negative, spiral, and microaerophilic. Motile, with either unipolar or bipolar flagella, the organisms have a characteristic spiral/corkscrew appearance and are oxidase-positive. Campylobacter jejuni is now recognized as one of the main causes...
enteritis
Enteritis
In medicine, enteritis, from Greek words enteron and suffix -itis , refers to inflammation of the small intestine. It is most commonly caused by the ingestion of substances contaminated with pathogenic microorganisms. Symptoms include abdominal pain, cramping, diarrhea, dehydration and fever...
occur annually in the U.S.
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, accounting for 5-7% of cases of gastroenteritis
Gastroenteritis
Gastroenteritis is marked by severe inflammation of the gastrointestinal tract involving both the stomach and small intestine resulting in acute diarrhea and vomiting. It can be transferred by contact with contaminated food and water...
. Furthermore, in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
during 2000, Campylobacter jejuni
Campylobacter jejuni
Campylobacter jejuni is a species of curved, helical-shaped, non-spore forming, Gram-negative, microaerophilic bacteria commonly found in animal feces. It is one of the most common causes of human gastroenteritis in the world. Food poisoning caused by Campylobacter species can be severely...
was involved in 77.3% in all cases of foodborne illness
Foodborne illness
Foodborne illness is any illness resulting from the consumption of contaminated food, pathogenic bacteria, viruses, or parasites that contaminate food, as well as chemical or natural toxins such as poisonous mushrooms.-Causes:Foodborne illness usually arises from improper handling, preparation, or...
. About 15 of every 100,000 people are diagnosed with campylobacteriosis every year, and with many cases going unreported, up to 0.5% of the general population may unknowingly harbor Campylobacter in their gut.
A large animal reservoir is present as well, with up to 100% of poultry, including chicken
Chicken
The chicken is a domesticated fowl, a subspecies of the Red Junglefowl. As one of the most common and widespread domestic animals, and with a population of more than 24 billion in 2003, there are more chickens in the world than any other species of bird...
s, turkey
Turkey
Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...
s, and waterfowl, having asymptomatic infections in their intestinal tracts. Infected chicken
Chicken
The chicken is a domesticated fowl, a subspecies of the Red Junglefowl. As one of the most common and widespread domestic animals, and with a population of more than 24 billion in 2003, there are more chickens in the world than any other species of bird...
feces may contain up to 109 bacteria per 25 grams, and due to the installations, the bacteria are rapidly spread to other chicken
Chicken
The chicken is a domesticated fowl, a subspecies of the Red Junglefowl. As one of the most common and widespread domestic animals, and with a population of more than 24 billion in 2003, there are more chickens in the world than any other species of bird...
s. This vastly exceeds the infectious dose of 1000-10,000 bacteria for humans.
Symptoms
The prodromeProdrome
In medicine, a prodrome is an early symptom that might indicate the start of a disease before specific symptoms occur. It is derived from the Greek word prodromos or precursor...
is fever, headache, and myalgias, lasting as long as 24 hours. The actual latent period is 2–5 days (sometimes 1–6 days). In other words, it typically takes 1–2 days until actual symptoms develop. These are diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
(as many as 10 watery, frequently bloody, bowel movements per day) or dysentery
Dysentery
Dysentery is an inflammatory disorder of the intestine, especially of the colon, that results in severe diarrhea containing mucus and/or blood in the faeces with fever and abdominal pain. If left untreated, dysentery can be fatal.There are differences between dysentery and normal bloody diarrhoea...
, cramps, abdominal pain
Abdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
, and fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
as high as 40°C (104°F). In most people, the illness lasts for 2–10 days. This is classified as invasive/inflammatory diarrhea, also known as bloody diarrhea or dysentry.
Symptoms may also depend on route of transmission. In participants of anal intercourse, campylobacteriosis is more localized to the distal end of the colon
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...
and may be termed a proctocolitis
Proctocolitis
Proctocolitis is a general term for inflammation of the rectum and colon.-Etiology:Common etiologic agents of proctocolitis include Chlamydia trachomatis, Neisseria gonorrhoeae, HSV, and Campylobacter species....
.
There are other diseases showing similar symptoms. For instance, abdominal pain and tenderness may be very localized, mimicking acute appendicitis. Furthermore, Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...
is closely related to Campylobacter
Campylobacter
Campylobacter is a genus of bacteria that are Gram-negative, spiral, and microaerophilic. Motile, with either unipolar or bipolar flagella, the organisms have a characteristic spiral/corkscrew appearance and are oxidase-positive. Campylobacter jejuni is now recognized as one of the main causes...
and causes peptic ulcer disease.
Other factors
In patients with HIVHIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
, infections may be more frequent, may cause prolonged bouts of dirty brown diarrhea, and may be more commonly associated with bacteremia
Bacteremia
Bacteremia is the presence of bacteria in the blood. The blood is normally a sterile environment, so the detection of bacteria in the blood is always abnormal....
and antibiotic resistance. The severity and persistence of infection in patients with AIDS and hypogammaglobulinemia
Hypogammaglobulinemia
Hypogammaglobulinemia is a type of immune disorder characterized by a reduction in all types of gamma globulins.Hypogammaglobulinemia is a characteristic of common variable immunodeficiency.-Terminology:...
indicates that both cell-mediated and humoral immunity are important in preventing and terminating infection.
Diagnosis
Campylobacter organisms can be detected by performing a Gram stain of a stool sample with high specificity and a sensitivity of ~60%, but are most often diagnosed by stool culture. Fecal leukocytes should be present and indicate the diarrhea to be inflammatory in nature. Methods currently being developed to detect the presence of campylobacter organisms include antigen testing via an EIAELISA
Enzyme-linked immunosorbent assay , is a popular format of a "wet-lab" type analytic biochemistry assay that uses one sub-type of heterogeneous, solid-phase enzyme immunoassay to detect the presence of a substance in a liquid sample."Wet lab" analytic biochemistry assays involves detection of an...
or PCR
Polymerase chain reaction
The polymerase chain reaction is a scientific technique in molecular biology to amplify a single or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence....
.
Treatment
The infection is usually self-limiting, and in most cases, symptomatic treatment by liquid and electrolyte replacement is enough in human infections.Antibiotics
Antibiotic treatment is controversial, and has only a marginal benefit (1.32 days) on the duration of symptoms, and should not be used routinely.Erythromycin
Erythromycin
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and...
can be used in children, and tetracycline in adults. Some studies show, however, that erythromycin
Erythromycin
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and...
rapidly eliminates Campylobacter from the stool without affecting the duration of illness. Nevertheless, children with dysentery
Dysentery
Dysentery is an inflammatory disorder of the intestine, especially of the colon, that results in severe diarrhea containing mucus and/or blood in the faeces with fever and abdominal pain. If left untreated, dysentery can be fatal.There are differences between dysentery and normal bloody diarrhoea...
due to C. jejuni benefit from early treatment with erythromycin. Treatment with antibiotics, therefore, depends on the severity of symptoms. Quinolone
Quinolone
The quinolones are a family of synthetic broad-spectrum antibiotics. The term quinolone refers to potent synthetic chemotherapeutic antibacterials....
s are effective if the organism is sensitive, but high rates of quinolone use in livestock means that quinolones are now largely ineffective. Antimotility agents, such as loperamide
Loperamide
Loperamide , a synthetic piperidine derivative, is an opioid drug used against diarrhea resulting from gastroenteritis or inflammatory bowel disease. In most countries it is available generically and under brand names such as Lopex, Imodium, Dimor, Fortasec, and Pepto Diarrhea Control...
, can lead to prolonged illness or intestinal perforation in any invasive diarrhea, and should be avoided. Trimethoprim
Trimethoprim
Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections.It belongs to the class of chemotherapeutic agents known as dihydrofolate reductase inhibitors...
-sulfamethoxazole and ampicillin
Ampicillin
Ampicillin is a beta-lactam antibiotic that has been used extensively to treat bacterial infections since 1961. Until the introduction of ampicillin by the British company Beecham, penicillin therapies had only been effective against Gram-positive organisms such as staphylococci and streptococci...
are ineffective against Campylobacter.
In animals
In the past, poultry infections were often treated by mass administration of enrofloxacinEnrofloxacin
Enrofloxacin is a fluoroquinolone antibiotic sold by the Bayer Corporation under the trade name Baytril. Enrofloxacin is currently FDA-approved for treatment of individual pets and domestic animals in the United States...
and sarafloxacin
Sarafloxacin
Sarafloxacin is a quinolone antibiotic drug, which was removed from clinical use by the manufacturer April 30, 2001....
for single instances of infection. The FDA banned this practice, as it promoted the development of fluoroquinolone-resistant populations.
A major broad-spectrum fluoroquinolone used in humans is ciprofloxacin
Ciprofloxacin
Ciprofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class.It is a second-generation fluoroquinolone antibacterial. It kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops synthesis of DNA and of...
.
Currently growing resistance of the Campylobacter to fluoroquinolones and macrolides is of a major concern.
Prognosis
Campylobacteriosis is usually self-limited without any mortality. However, there are several possible complications.Complications
Some (1-2 in 100,000 cases) individuals develop Guillain-Barré syndromeGuillain-Barré syndrome
Guillain–Barré syndrome , sometimes called Landry's paralysis, is an acute inflammatory demyelinating polyneuropathy , a disorder affecting the peripheral nervous system. Ascending paralysis, weakness beginning in the feet and hands and migrating towards the trunk, is the most typical symptom...
, in which the nerves that join the spinal cord and brain to the rest of the body are damaged, sometimes permanently. This occurs only with infection of C. jejuni and C. upsaliensis.
Other complications include toxic megacolon
Toxic megacolon
Toxic megacolon is an acute form of colonic distension. It is characterized by a very dilated colon , accompanied by abdominal distension , and sometimes fever, abdominal pain, or shock....
, dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...
and sepsis
Sepsis
Sepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...
. Such complications generally form in little children (< 1 year of age) and immunocompromised people. A chronic course of the disease is possible; such form of the process is likely to develop without a distinct acute phase. Chronic campylobacteriosis features long period of sub-febrile temperature and asthenia; eye damage, arthritis
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
, endocarditis
Endocarditis
Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or even on intracardiac devices...
may develop if infection is untreated.
Occasional deaths occur in young, previously healthy individuals because of blood volume depletion, and in persons who are elderly or immunocompromised.
A mysterious paralysis can attack people who just had mild symptoms of campylobacteriosis years earlier.
Prevention
- Pasteurization of milk and chlorination of drinking water destroy the organism.
- Treatment with antibiotics can reduce fecal excretion.
- Infected health care workers should not provide direct patient care.
- Separate cutting boards should be used for foods of animal origin and other foods. After preparing raw food of animal origin, all cutting boards and countertops should be carefully cleaned with soap and hot water.
- Contact with pet saliva and feces should be avoided.
Following are recommendations of the World Health Organization.
- Recommendations for the public and travellers - |
Your food should be properly cooked and hot when served. |
Consume only pasteurized or boiled milk and milk products, never raw milk products. |
Make sure that ice is from safe water. |
If you are not sure of the safety of drinking water, boil it, or disinfect it with chemical disinfectant. |
Wash hands thoroughly and frequently with soap, especially after using the toilet and after contact with pets and farm animals. |
Wash fruits and vegetables thoroughly, especially if they are to be eaten raw. Peel fruits and vegetables whenever possible. |
- Recommendations for food handlers - |
Food handlers, professionals and at home, should observe hygenic rules during food preparation. |
Professional food handlers should immediately report to their employer any fever, diarrhoea, vomiting or visible infected skin lesions. |
External links
- Campylobacter jejuni genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID