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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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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 ...