Campylobacter

• Gram-negative bacillus that is a common cause of foodborne illness, especially associated with undercooked poultry

Background

Microbiology

• Genus of oxidase positive, catalase positive, curved, Gram-negative bacilli
• Includes Campylobacter jejuni and Campylobacter coli

Growth Temp (ºC)			Nitrate	H2S		Hippurate Hydrolysis	Susceptibility		C-19 FA Reduction	Species
25	37	42		TSI	Lead Acetate Paper		Cephalothin	Nalidixic Acid
–	+	+	+	–	+	+	R	S	+	Campylobacter jejuni
–	+	+	+	v	+	–	R	S	+	Campylobacter coli
–	+	+	+	–	+	–	R	R	+	Campylobacter lari
+	+	v	+	–	v	–	S	R	–	Campylobacter fetus subsp. fetus
v	+	v	+	+	+	–	S	R	+	Campylobacter hyointestinalis
–	+	–	+	–	+	–	S	S	–	Campylobacter cinaedi
–	+	+	+	–	+	–	S	S	–	Campylobacter upsaliensis
–	+	–	–	–	+	–	S	S	–	Helicobacter fennelliae

Clinical Manifestations

• Enteric disease, with acute blood gastroenteritis, is most common with Campylobacter jejuni
  • Also seen with Campylobacter coli, Campylobacter lari, Campylobacter fetus, Helicobacter fennelliae, Helicobacter cinaedi, Campylobacter upsaliensis, Arcobacter butzleri, Arcobacter skirrowi, and Arcobacter cryaerophilus
• Extraintestinal disease, with bacteremia and endovascular infection, is most common with Campylobacter fetus subspecies fetus
  • Also seen with Campylobacter jejuni, Campylobacter coli, Campylobacter lari, Helicobacter fennelliae, Helicobacter cinaedi, Campylobacter sputorum, Campylobacter hyointestinalis, and Helicobacter rappini

	Campylobacter jejuni	Campylobacter fetus subsp. fetus
Reservoir	birds, food animal	cattle and sheep
Epidemiology	healthy hosts of all ages, often cluster	debilitated hosts, rarely clusters
Culture From	feces	bloodstream
Clinical Manifestations	acute gastroenteritis, colitis	bacteremia, meningitis, endovascular infection, abscess, gastroenteritis
Diarrhea	common	uncommon
Prognosis	self-limited	can be fatal

Complications

• Guillain-Barré syndrome (GBS)
• MALT lymphoma

Management

Enteric Disease

• Supportive care
• Illness lasts on average 1.3 days
• No antibiotics needed if stable; treatment suggested if high fever, bloody diarrhea, more than 8 stools per daily, prolonged illness ≥7 days
• If requiring antibiotics, use ciprofloxacin or azithomycin for 5 days, or clarithromycin for 7 days

Extraintestinal Disease

• Bacteremia with Campylobacter fetus should be treated with antibiotics, usually for at least 2 weeks
  • Options include ampicillin, imipenem, chloramphenicol, gentamicin, fluoroquinolones if not resistant
• Endovascular infections often treated for 4 or more weeks
• Meningitis treated for 2 to 3 weeks