Bacteraemia and pericarditis from Campylobacter infection.
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We report 10 cases of Campylobacter fetus infection, isolated during a 7-month period, which were all sensitive to erythromycin. The aetiology and epidemiology are discussed.
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Campylobacter fetus ss. jejuni has recently been recognised as a human enteric pathogen. Five cases of campylobacter enteritis are described. All five patients had abdominal pain and diarrhoea. Two of the five patients had bloody diarrhoea and relapses. All the patients had been in contact with young dogs which had had diarrhoea. Campylobacter fetus ss. jejuni was isolated from these dogs or from their litter-mates. Canine infection with Campylobacter fetus ss. jejuni may be an important source of infection causing diarrhoea in man.
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Within a three week period, four cases of Campylobacter fetus infection were identified in a hospital in Los Angeles County. Three of the four patients had drunk large quantities of an identical brand of commercially available certified raw milk. Campylobacter fetus subspecies jejuni was isolated from the blood of these three patients. The fourth patient, who did not drink raw milk, had Campylobacter fetus subspecies intestinalis isolated from his blood. A telephone survey comparing cases and controls for possible risk factors associated with Campylobacter fetus infection confirmed the association with raw milk (P = 0.003). In a serologic survey, evidence suggested that Campylobacter fetus infection was associated with raw milk consumption.
There has been a gradual accumulation of reported Campylobacter fetus human infections since the first description in 1947. The taxonomy of these fastidious and morphologically confusing organisms has been recently revised and, in the past few years, through the use of selective culture medium for stool isolation C fetus has been implicated as a frequent paghogen in children. There are three relatively distinct patterns of human C fetus infection. The first, most frequent, pattern of disease is enteritis which is usually uncomplicated and due to C fetus subsp jejuni. A second form of disease consists of focal infections, often associated with vasculitis and/or chronic bacteremia. These infections, due to C fetus subsp intestinalis, are seen most often in older, debilitated, or chronically ill men. The third pattern, perinatal infections causing abortion, prematurity, and neonatal meningitis, is the least frequent, but these infections are usually fetal to the fetus or infant and are also due to C fetus subsp intestinalis.
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Increasing attention has focused on health outcomes of Campylobacter infections among children younger than 5 years in low-resource settings. Recent evidence suggests that colonization by Campylobacter species contributes to environmental enteric dysfunction, malnutrition, and growth faltering in young children. Campylobacter species are zoonotic, and factors from humans, animals, and the environment are involved in transmission. Few studies have assessed geospatial effects of environmental factors along with human and animal factors on Campylobacter infections. Here, we leveraged Campylobacter Genomics and Environmental Enteric Dysfunction project data to model multiple socioenvironmental factors on Campylobacter burden among infants in eastern Ethiopia. Stool samples from 106 infants were collected monthly from birth through the first year of life (December 2020-June 2022). Genus-specific TaqMan real-time polymerase chain reaction was performed to detect and quantify Campylobacter spp. and calculate cumulative Campylobacter burden for each child as the outcome variable. Thirteen regional environmental covariates describing topography, climate, vegetation, soil, and human population density were combined with household demographics, livelihoods/wealth, livestock ownership, and child-animal interactions as explanatory variables. We dichotomized continuous outcome and explanatory variables and built logistic regression models for the first and second halves of the infant's first year of life. Infants being female, living in households with cattle, reported to have physical contact with animals, or reported to have mouthed soil or animal feces had increased odds of higher cumulative Campylobacter burden. Future interventions should focus on infant-specific transmission pathways and create adequate separation of domestic animals from humans to prevent potential fecal exposures.
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Campylobacter spp. were the organisms isolated most frequently from 29 consecutive patients admitted with acute diarrhoea to an infectious disease unit. Rectal biopsies taken from 21 of the patients were abnormal in all but four, and in the patients with campylobacter infection there was a characteristic proctocolitis in each case. The histopathology was similar to that described for salmonella and shigella infections but clearly different from typical ulcerative colitis and Crohn's disease. Therefore in patients with acute diarrhoea we suggest that selective culture for Campylobacter spp. should be made a routine and that rectal biopsy has an important diagnostic role, particularly in patients with negative cultures.