What is the significance of a fecal lab result indicating the presence of Campylobacter (C.) coli, C. jejuni, and C. upsaliensis in a 2-year-old child?

From the Guidelines

Campylobacter infection in a 2-year-old requires prompt treatment with antibiotics, specifically azithromycin, to reduce the duration of symptoms and prevent complications. According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1, the recommended treatment for Campylobacter infection is azithromycin at a dose of 10 mg/kg once daily for 3 days (maximum 500 mg per day).

• Key points to consider in the management of Campylobacter infection in a 2-year-old include:
  • Ensuring the child stays well-hydrated with frequent small amounts of clear fluids to prevent dehydration from diarrhea
  • Watching for signs of dehydration including decreased urination, dry mouth, no tears when crying, and unusual sleepiness
  • Practicing strict handwashing after diaper changes and before food preparation to prevent spread to other family members
  • Keeping the child out of daycare until diarrhea has resolved
• The three species mentioned (C. coli, C. jejuni, and C. upsaliensis) are all treated with the same approach, as they are all bacterial infections typically acquired from contaminated food (especially undercooked poultry), water, or contact with infected animals 1.
• It is essential to note that while most cases resolve within a week, antibiotics in young children can reduce the duration of symptoms and prevent complications, such as hemolytic uremic syndrome (HUS) due to STEC and Guillain-Barré syndrome following Campylobacter infection 1.

From the Research

Campylobacter Infection in Children

• Campylobacter is one of the most common causes of foodborne illness in the United States, commonly occurring in children younger than 5 years of age 2.
• The most common species of Campylobacter associated with human illness is Campylobacter jejuni, but other Campylobacter species such as Campylobacter coli and Campylobacter upsaliensis can also cause human infections 3.

Symptoms and Diagnosis

• Campylobacter species can cause a wide range of syndromes, from asymptomatic infections to severe systemic infections 2.
• Infection with Campylobacter causes a spectrum of diseases including acute enteritis, extraintestinal infections, and postinfectious complications 3.
• Laboratory detection of Campylobacter can be done through various methods, including multiplex PCR, which can identify the species of Campylobacter 4.

Antibiotic Resistance and Virulence

• Campylobacter jejuni and Campylobacter coli have been found to have high resistance rates to certain antibiotics, such as trimethoprim/sulfamethoxazole and ciprofloxacin 4.
• The presence of virulence genes such as cdtA, virB11, and cadF can contribute to the pathogenicity of Campylobacter species 4.
• The evolution of Campylobacter jejuni and Campylobacter coli is influenced by factors such as mutation, lateral gene transfer, and recombination, which can lead to the emergence of new lineages and antibiotic resistance 5.

Transmission and Prevention

• Campylobacter is typically transmitted through the consumption of contaminated food products, especially poultry meat 3, 5.
• Proper hygiene and food handling practices can help prevent the transmission of Campylobacter 4.
• Education and training of food handlers and processors are crucial in preventing the spread of Campylobacter 4.