What is Campylobacter?
Campylobacter is a bacterial pathogen that causes infectious diarrhea and is one of the most common causes of bacterial gastroenteritis worldwide. 1, 2
Microbiology and Classification
Campylobacter is a genus of bacteria that includes multiple species, with Campylobacter jejuni being the most common species causing human illness, followed by Campylobacter coli. 1, 3 These organisms are commensal inhabitants of the gastrointestinal tract of many animals including poultry, cattle, pigs, wild birds, and companion animals. 4
Clinical Manifestations
Gastrointestinal Disease
The typical presentation includes diarrheal illness of variable severity, characterized by watery, mucoid, or bloody diarrhea, abdominal pain, fever, and nausea. 1 Key clinical features include:
- Abdominal pain tends to be particularly severe in Campylobacter enteritis and may mimic appendicitis. 1
- Visible blood in stool is a common finding. 1
- Most infections are acute and self-limited, resolving within 3-5 days without specific antimicrobial treatment. 5, 2
Extraintestinal Manifestations
Campylobacter can cause bacteremia and systemic infections, particularly in immunocompromised patients. 1, 3
Post-Infectious Complications
Campylobacter infection has been associated with several serious late complications: 1, 6
- Guillain-Barré syndrome (GBS) - occurring in approximately 1 in 1000 infections 2
- Reactive arthritis (REA) 1, 4
- Miller Fisher syndrome 6
- Irritable bowel syndrome (IBS) 4
Epidemiology and Transmission
In industrialized countries, Campylobacter is the most commonly recognized cause of bacterial gastroenteritis and has been the most frequently notified foodborne disease in Europe since 2005. 2, 4
The primary transmission routes include: 2, 7, 4
- Consumption of contaminated poultry meat - the most important source in industrialized countries
- Handling of raw poultry products
- Inadequately treated water
- Contact with farm animals or infected pets
- Travel to endemic areas
The incidence peaks during infancy and again in young adults aged 15-44 years in industrialized countries. 2 In developing countries, the disease is primarily confined to young children. 2
Laboratory Diagnosis
Laboratory confirmation requires isolation of Campylobacter from any clinical specimen, most commonly stool. 1 The introduction of selective media has made diagnosis straightforward. 2 Culture-independent diagnostic testing including multiplex molecular panels can also detect Campylobacter DNA. 1
Public Health Significance
The Centers for Disease Control and Prevention has identified antibiotic resistance in Campylobacter as a 'significant public health threat.' 6 Fluoroquinolone resistance has increased dramatically worldwide, exceeding 90% in some regions like Southeast Asia, largely due to fluoroquinolone use in food production animals. 5, 2 Macrolide resistance remains relatively low at approximately 4% for travel-related infections. 5