Campylobacter

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A genus of pathogenic organisms which are the most commonly reported cause of gastro-enteritis in the UK, although it is not known what proportion of cases are foodborne. Campylobacteriosis has been associated with the consumption of undercooked meats, milk that has been inadequately pasteurized or contaminated by birds, and contaminated water.

Although campylobacter was first identified in 1909 as an animal pathogen, due to better isolation methodology in recent years it is now recognized as one of the leading causes of diarrhea in humans. They are small nonsporing, gramnegative motile bacteria with spiral or S-shaped morphology and can only grow under conditions of reduced oxygen tension. Campylobacter organisms are sensitive to drying or freezing, but they can survive in the environment in cold ground-water, soil, and in refrigerated food for weeks. Campylobacters are found in the gastrointestinal tract of domestic and wild animals and can cause human infections through direct contact or through food or water vehicles. Poultry, cattle, swine, and sheep are the main reservoirs, and campylobacters can cause abortions and diarrhea in these animals.

Two main species affect humans, C. jejuni and C. coli, with most cases attributed to the former. Virulence factors include rapid motility, outer membrane protein for adherence, and possibly enterotoxin. The diarrhea caused by campylobacter is often mild, but may be marked by profuse, foul-smelling stools with blood or mucus, accompanied by abdominal cramping. Symptoms can be severe enough to mimic appendicitis, although death is rare. Sequelae such as reactive arthritis may follow, but the most serious of these is Guillain-Barré syndrome. For these reasons, the costs for campylobacteriosis are high (up to $1.4 billion annually in the United States). Immunocompromised people are susceptible, and young adults also appear to be a high-risk group, possibly due to inadequate understanding of food safety and undercooking of poultry. Based on routine surveillance, children under five years of age have the highest incidence.

Most campylobacteriosis cases are sporadic, peaking in the summer months. The estimated annual incidence of campylobacteriosis in the United States and United Kingdom is about the same, between 1,000 and 1,100 cases per 100,000 persons. In developing countries the rate is believed to be higher, especially in children under five. Risk factors include direct contact with farm animals, animal carcasses, or household pets— especially puppies and kittens with diarrhea. Person-to-person transmission occurs within families. Perinatal transmission is rare. Unlike Salmonella and other food-borne disease organisms, Campylobacter subspecies tend not to multiply in food, but they can be found in large numbers in raw sewage and fecally contaminated surface waters. Raw chicken is the food most commonly associated with campylobacteriosis. Because of the low infective dose, it is possible to transfer sufficient organisms to the mouth by direct contact with the chicken or its drip waters to cause illness.

In addition, consumption of untreated water and milk has been associated with large outbreaks— 500 joggers in Switzerland became ill after drinking a raw milk beverage, and 2,500 school children aged 2 to 7 were infected by raw milk in England. In Sweden, between 1992 and 1996, six waterborne outbreaks were recorded, affecting about 6,000 persons. Water treatment, pasteurization of milk, and proper hygiene by the public are the most important strategies for reducing incidence of the disease.

(SEE ALSO: Food-Borne Diseases; Waterborne Diseases)

Bibliography

Advisory Committee on the Microbiological Safety of Food (1993). "Interim Report on Campylobacter." London, UK: Her Majesty's Stationery Office.

Center for Food Safety and Applied Nutrition (2001). "Campylobacter jejuni." In Bad Bug Book (Foodborne Pathogenic Microorganisms and Natural Toxins Handbook). Washington, DC: U.S. Food and Drug Administration. Available at http://vm.cfsan.fda.gov/~mow/chap4.html.

Farber, J. M., and Todd, E. C. D., eds. (2000). Safe Handling of Foods. New York: Marcel Dekker.

— EWEN TODD

A genus of bacteria, family Spirillaceae, made up of gram-negative, non-spore-forming, motile, comma-shaped rods, which are microaerophilic to anaerobic. Members of the genus were previously classified as Vibrio spp. and many of the diseases caused by these species are still referred to as vibriosis.

• C. coli — a commensal of the gastrointestinal tract of poulty, pigs and humans; can cause enteritis in pigs and humans.
• C. fetus subsp. fetus — causes ovine genital campylobacteriosis and abortion in sheep and cattle.
• C. fetus subsp. venerealis — causes bovine vibriosis, also known as epizootic bovine infertility.
• C. hyointestinalis, C. mucosalis — associated with the porcine intestinal adenomatosis complex, proliferative hemorrhagic enteropathy, necrotic enteritis.
• C. jejuni — causes abortion in sheep and enteritis in dogs, cats and other animals. An important food-borne cause of enteritis in humans, and the cause of avian vibrionic hepatitis.
• C. sputorum subsp. bubulus, C. sputorum biovar fecalis — found in cattle and sheep, but not known to cause disease.
• C. upsaliensis — may be associated with diarrhea in dogs and humans.

A microorganism associated with progressive periodontal destruction and refractory forms of periodontitis.

Campylobacter
Campylobacter bacteria
Scientific classification
Kingdom:	Bacteria
Phylum:	Proteobacteria
Class:	Epsilonproteobacteria
Order:	Campylobacterales
Family:	Campylobacteraceae
Genus:	Campylobacter Sebald and Véron 1963
Species
C. coli C. concisus C. curvus C. fetus C. gracilis C. helveticus C. hominis C. hyointestinalis C. insulaenigrae C. jejuni C. lanienae C. lari C. mucosalis C. rectus C. showae C. sputorum C. upsaliensis

Campylobacter (meaning 'twisted bacteria') is a genus of bacteria that are Gram-negative, spiral, and microaerophilic. Motile, with either unipolar or bipolar flagella, the organisms have a characteristic spiral/corkscrew appearance (see photo) and are oxidase-positive.^[1] Campylobacter jejuni is now recognized as one of the main causes of bacterial foodborne disease in many developed countries.^[2] At least a dozen species of Campylobacter have been implicated in human disease, with C. jejuni and C. coli the most common.^[1] C. fetus is a cause of spontaneous abortions in cattle and sheep, as well as an opportunistic pathogen in humans.^[3]

Contents 1 Genome 2 Pathogenesis 2.1 Cause 2.2 Treatment 3 History 4 See also 5 References 6 External links

Genome

The genomes of several Campylobacter species have been sequenced, providing insights into their mechanisms of pathogenesis.^[4] The first Campylobacter genome to be sequenced was C. jejuni, in 2000.^[5]

Campylobacter species contain two flagellin genes in tandem for motility, flaA and flaB. These genes undergo intergenic recombination, further contributing to their virulence.^[6] Nonmotile mutants do not colonize.

Pathogenesis

Main article: Campylobacteriosis

Campylobacteriosis is an infection by Campylobacter.^[7] The common routes of transmission are fecal-oral, ingestion of contaminated food or water, and the eating of raw meat. It produces an inflammatory, sometimes bloody, diarrhea, periodontitis^[8] or dysentery syndrome, mostly including cramps, fever and pain. The infection is usually self-limiting and in most cases, symptomatic treatment by liquid and electrolyte replacement is enough in human infections. The use of antibiotics, on the other hand, is controversial. Symptoms typically last for five to seven days.

Cause

The sites of tissue injury include the jejunum, the ileum, and the colon. Most strains of C jejuni produce a toxin (cytolethal distending toxin) that hinders the cells from dividing and activating the immune system. This helps the bacteria to evade the immune system and survive for a limited time in the cells. It was thought previously that a cholera-like enterotoxin was also made, but this appears not to be the case. The organism produces diffuse, bloody, edematous, and exudative enteritis. Although rarely the infection has been considered a cause of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, no unequivocal case reports exist. In some cases a campylobacter infection can be the underlying cause of Guillain-Barre syndrome. Gastrointestinal perforation is a rare complication of ileal infection ^[9]

Treatment

Diagnosis of the illness is made by testing a specimen of faeces (bowel motion).

• Quinolone antibiotics, as Cipro or Levaquin, are effective therapy for Campylobacter enteritis, shortening the clinical course by days, with a rapid improvement in patient well being
• Dehydrated children may require intravenous (by vein) fluid treatment in a hospital.
• The illness is contagious, and children must be kept at home until they have been clear of symptoms for at least two days
• Good hygiene is important to avoid contracting the illness or spreading it to others.
• Intestinal perforation is very rare; increased abdominal pain and collapse require immediate medical attention.

History

The symptoms of Campylobacter infections were described in 1886 in infants by Theodor Escherich.^[10] These infections were named cholera infantum,^[10] or summer complaint.^[11] The genus was first discovered in 1963;^[12] however, the organism was not isolated until 1972.^[10]

See also

• Periodontitis

References

1. ^ ^{a b} Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 378–80. ISBN 0-8385-8529-9. 
2. ^ Moore JE, et al. (2005). "Campylobacter". Vet Res 36 (3): 351–82. doi:10.1051/vetres:2005012. PMID 15845230. 
3. ^ Sauerwein R, Bisseling J, Horrevorts A (1993). "Septic abortion associated with Campylobacter fetus subspecies fetus infection: case report and review of the literature". Infection 21 (5): 331–3. doi:10.1007/BF01712458. PMID 8300253. 
4. ^ Fouts DE et al. (2005). "Major Structural Differences and Novel Potential Virulence Mechanisms from the Genomes of Multiple Campylobacter Species". PLoS Biol 3 (1): e15. doi:10.1371/journal.pbio.0030015. PMC 539331. PMID 15660156. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=539331. 
5. ^ Parkhill et al.; Wren, BW; Mungall, K; Ketley, JM; Churcher, C; Basham, D; Chillingworth, T; Davies, RM et al (2000). "The genome sequence of the food-borne pathogen Campylobacter jejuni reveals hypervariable sequences". Nature 403 (6770): 665–668. doi:10.1038/35001088. PMID 10688204. 
6. ^ Grant C, Konkel M, Cieplak W, Tompkins L (1993). "Role of flagella in adherence, internalization, and translocation of Campylobacter jejuni in nonpolarized and polarized epithelial cell cultures". Infect Immun 61 (5): 1764–71. PMC 280763. PMID 8478066. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=280763. 
7. ^ cdc.gov
8. ^ Humphrey, Tom et al.; O'Brien, S; Madsen, M (2007). "Campylobacters as zoonotic pathogens: A food production perspective <internet>". International Journal of Food Microbiology 117 (3): 237–57. doi:10.1016/j.ijfoodmicro.2007.01.006. PMID 17368847. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-4N0PPRG-1&_user=10&_coverDate=07%2F15%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=74b7c07635a1873ca815b3139b56d2e0. 
9. ^ Jassim SS, Malik A, Aldridge A (2011). "Small bowel perforation: An unusual cause". Grand Rounds 11: 17–19. doi:10.1102/1470-5206.2011.0006. http://www.grandrounds-e-med.com/articles/gr110006.htm. 
10. ^ ^{a b c} Samie A, Obi CL, Barrett LJ, Powell SM, Guerrant RL (June 2007). "Prevalence of Campylobacter species, Helicobacter pylori and Arcobacter species in stool samples from the Venda region, Limpopo, South Africa: studies using molecular diagnostic methods". J. Infect. 54 (6): 558–66. doi:10.1016/j.jinf.2006.10.047. PMID 17145081. 
11. ^ "Defining and Managing Infant Mortality: A Case Study of Philadelphia, 1870-1920 -- Condran and Murphy 32 (4): 473 -- Social Science History". http://ssh.dukejournals.org/cgi/content/abstract/32/4/473. 
12. ^ Nachmankin I; Szymanski CM; Blaser J (editors) (2008). Campylobacter (3rd ed.). ASM Press. pp. 3–25. ISBN 978-1-55581-437-3. 

External links

• Campylobacter genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID
• Campylobacter info from the CDC

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