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Campylobacter species are among the most common pathogens in humans and are commensal in birds, swine, and cattle. It is the most common cause of culture-proven bacterial gastroenteritis in developed and developing countries, responsible for 400 to 500 million cases of diarrhea each year.1,2 Although diarrhea is the most frequent clinical manifestation, a broad clinical spectrum is associated with this infection, from asymptomatic carriage to systemic illness. Guillain-Barrè syndrome (GBS), occurs as an immunoreactive complication.

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Campylobacter organisms are motile, comma-shaped, gram-negative bacilli that derive their name from the Greek words meaning “curved rod.” Campylobacter has been recognized as a pathogen of many animal species including humans. There are 21 species of the genus Campylobacter, but only 13 are responsible for illness in humans. The species most frequently associated with acute infectious diarrhea are C jejuni and C coli. Campylobacter jejuni is a leading cause of bacterial enteritis. Campylobacter upsaliensis, C lari, C hyointestinalis, and C jejuni subspecies doylei are associated with diarrhea, abdominal pain, fever, and vomiting. Campylobacter fetus is an infrequent cause of bacteremia and occasionally of meningitis in debilitated and immunocompromised individuals, including neonates.

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Epidemiology

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Campylobacter jejuni is found in the intestinal tract of turkeys, chickens, sheep, cattle, and other farm animals and birds, all of which serve as reservoirs of infection. Contamination of meat, especially chickens, during slaughter may be the way bacteria enter the human food chain. The main source of C jejuni and C coli infection in humans is poultry, although unpasteurized milk, water, dogs, cats, hamsters, and ferrets are potential sources. In the United States, an estimated 2 million cases of campylobacteriosis occur each year. It is the most common bacterial cause of food-borne illness.1 The overall incidence of laboratory-confirmed Campylobacter infection in 2007 in the United States was 12.7 cases per 100,000 population, representing a 31% decrease since 1996.3-5 However, the incidence of symptomatic Campylobacter species infection has been estimated at 760 to 1100 cases per 100,000 populations.2,3 Age-specific rates of Campylobacter jejuni isolation in patients with diarrhea differ among countries. In industrialized countries, C jejuni is isolated from 5% to 16% of children with diarrhea, with a prevalence of infection in healthy children of up to 1.5%.1 The disease occurs in all ages but is more common in children less than 5 years of age, with a second peak at 15 to 29 years of age. In children under 5 years of age, the incidence of laboratory-confirmed Campylobacter species infection is 43.4 cases per 100,000 person-years (up to 54.3 cases per 100,000 person-years in children < 1 year of age), and the associated male-to-female ratio is 1.34:1.6 It is the third most common cause of hospitalization for gastroenteritis after rotavirus and Salmonella species infection, with a hospitalization rate of 10.8% for all Campylobacter species infections.7-9 Studies of the disease burden of Campylobacter species infection in the Netherlands have estimated that intestinal infection in general accounts for 67,000 disability-adjusted life years ...

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