Campylobacter enteritis in childhood

Bacteriological examinations of faecal samples, obtained from 321 infants and children with acute enteritis, were carried out in the pediatric clinic of the University of Occupational and Environmental Health, Japan from January 1983 to December 1985. Campylobacter jejuni were isolated in 48 infants and children (15%), while Salmonella species in 6 (1.9%), and enteropathogenic Escherichia coli in 11 (3.4%). Of 48 infants and children with Campylobacter enteritis (C. enteritis), 20 cases (42%) were under 2 years old, 17 (35%) from 2 to 6 years old, 8 (17%) from 7 to 12 years old, and 3 (6%) above 13 years old, suggesting the higher incidence in the younger infants and children. There were 30 males and 18 females, male:female ratio of 5:3. No seasonal variations in the frequency of C. enteritis were noticed. Major symptoms were diarrhea (94%), fever (50%), bleeding in stools (44%), abdominal pain (31%), and vomiting (10%). All strains of C. jejuni were highly sensitive to gentamicin, amikacin, kanamycin, erythromycin, josamycin, and chloramphenicol. We also report two typically mild cases of C. enteritis, a newborn infant with monosymptomatic bleeding in stools and diarrhea, and another 11-month-old, Wiskott-Aldrich syndrome infant with asymptomatic bloody stools.     

Campylobacter enteritis in Saudi Arabia.

A 12-month survey on the incidence of campylobacter infection in 1217 patients with diarrhoea was carried out in Jeddah, Saudi Arabia. Campylobacters were isolated from 55 (4.5%) patients, second in prevalence to salmonellas (6.2%). Shigellas were isolated from 4.2% of patients. Campylobacter isolation rates were high in children of all ages, as well as in young adults (36.5% of all isolates were from adults aged 20-39 years). Isolation rates peaked in September and November. Analysis of the results showed that 69% were Campylobacter jejuni (mostly biotype IV) and 31% C. coli. Serogroups 5 and 23 (Penner scheme) and phage type 125 (Preston scheme) were most frequently isolated. Resistance to erythromycin and tetracycline was observed in 7.3 and 32.7% of the isolates. Campylobacters are an important cause of bacterial enteritis in Saudi Arabia, both in adults and in children, and should be sought routinely.     

Campylobacter enteritis in general practice.

The incidence and clinical features of campylobacter enteritis were studied in a defined general practice population over a period of three years. Specimens of faeces were cultured from a representative sample of patients suffering from acute enteritis. Of 168 patients submitting a specimen to the laboratory 34 (20.2%) were positive for thermophilic Campylobacter species. The projected campylobacter infection rate varied from 5.4% per annum in infancy to 0.3% per annum in the 5- to 14-year-olds with a mean of 1.1% per annum for the whole study population. During the same period campylobacters were isolated from 484 (14.9%) of 3250 patients suffering from acute enteritis whose general practitioners had sent faecal specimens to the laboratory, confirming the importance of this organism in the aetiology of acute enteritis in the community.     

Campylobacter jejuni enteritis in honolulu,hawaii

The incidence of Campylobacter jejuni in patients with acute diarrhoea was studied in Honolulu, Hawaii. C. jejuni was recovered from 8·7% of diarrhoeal stools, compared to isolation rates of 4·2% for Salmonella and 3·8% for Shigella. C. jejuni occurred mainly in the summer and autumn, and in all age and racial groups. There was a significantly higher incidence of abdominal pain, fever history, bloody stools and faecal leucocytes in patients with Campylobacter enteritis.     

pVir and bloody diarrhea in Campylobacter jejuni enteritis

The plasmid pVir may play a role in the virulence of Campylobacter jejuni, a leading cause of bacterial gastroenteritis. The pVir plasmid was identified in 17% of 104 C. jejuni clinical isolates studied and was significantly associated with the occurrence of blood in patient stool, a marker of invasive infection. The pVir plasmid was not associated with greater occurrence of diarrhea, fever, pain, vomiting, or need for patient hospitalization. Isolates containing pVir were also associated with the presence of a tetracycline-resistance plasmid, but pVir did not transfer with tetracycline-resistance plasmids to recipient strains of C. jejuni. The association of pVir and bloody stool suggests that pVir may be clinically relevant in C. jejuni infections.     

Campylobacter enteritis associated with undercooked barbecued chicken

An outbreak of Campylobacter enteritis occurred in 1982 among 11 of 15 members and friends of an extended family gathering in Colorado. Median onset for illness, characterized by diarrhea, abdominal cramps, fever and headache, was four days after the party. Illness was associated with eating undercooked chicken. Two ill persons had stool specimens positive for C. jejuni. Eight of ten ill persons tested had Immunoglobulin-M-specific indirect fluorescent antibody (IFA) titers to C. jejuni greater than or equal to 32. IFA titers to C. jejuni peaked within three weeks of exposure and decreased to control levels within three months after exposure. Inadequate cooking of poultry may increase the risk of these infections.     

Epidemiological aspects of Campylobacter jejuni enteritis.

An epidemiological study on Campylobacter jejuni enterocolitis was performed in an urban Swedish community. The study included 55 patients gathered during a six-month period. Forty-one of the 55 patients (75%) were infected outside Sweden. Campylobacter enterocolitis was rare among children within the country. Patients infected in Sweden had eaten chicken significantly more often than a corresponding control group. Seven out of nine chicken consuming campylobacter patients also had prepared the fresh chicken alone, and none of their family members became ill. Thus the preparation of food contaminated with Campylobacter seems to elevate the risk for contracting the disease. Sick household pets transmitted the campylobacter infection to two patients. Forty-six of the patients had a total of 85 close household members. Three definite secondary cases were found. There was no evidence of transmission of Campylobacter by food prepared by two cooks who were working while still being asymptomatic excreters. Clinical reinfection with Campylobacter was observed in one patient. No patients became long-term carriers of Campylobacter.     

Guillain-Barré syndrome following Campylobacter jejuni enteritis

A 7-year-old boy nine days before onset of a Guillain-Barré-syndrome had had enteritis caused by Campylobacter jejuni. The clinical signs were restricted to minor motor and sensory deficits in the limbs; 5 weeks after the onset of the syndrome, recovery was complete. So far, 16 cases of Guillain-Barré syndrome after a Campylobacter enteritis have been reported in the literature.     

Campylobacter jejuni enteritis mistaken for ulcerative colitis.

Campylobacter jejuni is the most common bacterial cause of gastroenteritis and is often missed by routine stool cultures. Patients may present with a clinical syndrome and endoscopic findings that are similar to acute ulcerative colitis. Ciprofloxacin is currently the recommended antibiotic therapy.     

Campylobacter jejuni enteritis associated with raw goat's milk

During a three-week period in July 1983, six cases of Campylobacter jejuni enteritis in King County, Washington were associated with a dairy that produced raw goat's milk. Four patients consumed the dairy's milk, and the other two patients comprised an employee of the dairy and her infant son. Two case-control studies confirmed that, at the time the cases occurred, consumption of the dairy's milk was a risk factor for C. jejuni enteritis in King County. C. jejuni was isolated from the intestinal tract of three of the dairy's goats. Two of the three isolates, as well as those from five of the patients (all of those tested), were Lior serotype 36. That serotype was not encountered among 14 other C. jejuni isolates from King County during the period of the outbreak, including three isolates from goats at another inspected dairy. The study shows that raw goat's milk may transmit C. jejuni infection from animals to humans, as other investigators have shown for unpasteurized cow's milk.     

Campylobacter enteritis in Portugal: Epidemiological features and biological markers

From 1984 to 1989, stool samples from 2811 gastroenteritis cases were examined for the presence ofCampylobacter jejuni andC. Coli, Salmonella, Shigella andYersinia species. Isolation rates were:Campylobacter jejuni andC. Coli, 5.3%,Salmonella spp., 14.8%,Shigella spp., 4.6% andYersinia enterocolitica, 1.1%. Age group distribution analysis shows a higherCampylobacter isolation rate in children under one year of age. Seasonal distribution revealed a peak incidence in winter as in other Meditteranean countries. Predominant biotypes wereC. jejuni I (51%),C. jejuni II (21.5%) andC. coli I (18.8%). Antimicrobial susceptibility testing did not reveal resistance to erythromycin. Thirty of the strains harboured plasmids with 7 different profiles.     

Campylobacter jejuni enteritis associated with consumption of raw milk

An outbreak of Campylobacter jejuni enteritis occurred among people who had attended a meal where raw milk was served. A case control study was conducted using instances of illness as cases; those who attended the event but did not become ill served as controls. Thirteen of 20 people who had attended the meal became ill. C. jejuni was cultured from five of six stools that were submitted. Raw milk consumption was strongly associated with illness (p = .0072, Fisher exact test). Although C. jejuni outbreaks associated with milk can be prevented with pasteurization, they still occur in association with raw milk consumption.     

The role of poultry and meats in the etiology of Campylobacter jejuni/coli enteritis.

To determine the role of meats as possible sources of infection leading to Campylobacter jejuni/coli (CJC) enteritis, 218 cases and 526 controls were selected from the King County Group Health Cooperative (GHC) population from April 1982 through September 1983. All subjects were interviewed regarding food consumption one week prior to case onset. Consumption of chicken and cornish game hen were both associated with more than a doubling of the risk of CJC enteritis: for chicken (relative risk = 2.4, 95% CI = 1.6-3.6), and for game hen, (RR = 3.3, 95% CI = 1.1-9.8). The consumption of raw or rare chicken was even more strongly associated (RR = 7.6, 95% CI = 2.1-27.6). Strains of CJC bearing R factors for tetracycline were equally as likely as tetracycline-susceptible strains to have been acquired from chicken and game hens. Processed turkey sandwich meats (RR = 1.7, 95% CI = 1.0-2.9) raw or rare fish (RR = 4.0, 95% CI = 1.1-14.5) and shellfish (RR = 1.5, 95% CI = 1.1-2.1) were the only other meats reported to have been eaten significantly (p less than .05) more often by cases than by controls. These data along with the results of bacteriologic sampling of meats from King County retail food markets during the same period suggest that ingestion of contaminated chicken is a primary source of CJC enteritis, contributing to approximately half of the cases.