Bacteremia Due to Campylobacter Species: Clinical Findings and Antimicrobial Susceptibility Patterns

Abstract

From 1979 to 1996, 58 patients (mean age, 39.4 years) were treated for bacteremia due to Campylobacter species at the Hospitals Vall d'Hebron in Barcelona, Spain. Bacteremia was considered to be hospital acquired in 30% of these patients. Almost all the patients (93%) had underlying conditions; liver cirrhosis was the most frequent (34% of patients), and neoplasia, immunosuppressive therapy, and human immunodeficiency virus disease were also common. Of the 58 Campylobacter strains isolated, 81% were C. jejuni, 10% were Campylobacter species, 7% were C. fetus, and one (2%) was C. coli. Resistance rates were: cephalothin, 82%; co-trimoxazole, 79%; quinolones, 54%; ampicillin, 20%; amoxicillin/clavulanate, 4%; erythromycin, 7%; gentamicin, 0; and tetracyclines, 0. Even though the majority of patients were immunocompromised, mortality was low (10.5%), and only one patient relapsed. Because of the high level of resistance to the quinolones in Campylobacter species, these drugs should not be used as empirical treatment, at least in Spain. Although the macrolides remain the antibiotics of choice, amoxicillin/clavulanate may be an effective alternative therapy.

Campylobacter bacteremia in London: A 44-year single-center study

“…We were unable to estimate the incidence of the Campylobacter bacteraemia as our study was hospital-based in a single centre. However our findings are consistent with studies published in the literature, in particular the predisposition among men, for those with HIV, a high proportion of extraintestinal or unknown foci of infection, and the predominance of C. jejuni bacteraemia [17]. Furthermore, studies from France and Israel highlighted the higher proportion of Campylobacter bacteraemia among patients with malignancy and liver disease, which is consistent with our findings [36,37].…”

Clinical Features of Bacteremia due to <i>Campylobacter jejuni</i>

“…Previous studies have consistently shown chronic liver diseases (mainly liver cirrhosis), malignancies, immunosuppressed states (including human immunodeficiency virus infection), and alcoholism to be risk factors for C. jejuni bacteremia (3)(4)(5)(6)(7)(8)(9). Hypogammaglobulinemia has also been reported to be associated with a higher risk of developing C. jejuni bacteremia as well as greater severity and greater likelihood of recurrence and secondary soft tissue infection (3,8,14).…”

“…Bacteremia due to Campylobacter species has been considered rare; it was detected in less than 1% of patients with gastroenteritis due to these species (2). Therefore, the clinical features of bacteremia due to Campylobacter species have been the focus of several investigators and have yet to be fully elucidated (2)(3)(4)(5)(6)(7)(8)(9)(10). Most previous reports are from European countries and included data obtained from cases of bacteremia due to not only C. jejuni but also other Campylobacter species.…”

Campylobacterbacteremia: A rare and under-reported event?

“…However, in Finland there were only four cases of C. fetus-related bacteremia reported in a 10-year surveillance study [55], suggesting that there may be geographical differences in C. fetus-related bacteremia. In fact, in the majority of clinical studies, C. jejuni and C. coli have been the predominant Campylobacter species isolated from Campylobacter-related bacteremia, and the risk of death has been higher in those patients that did not receive appropriate antibiotic therapy, or were prescribed a thirdgeneration cephalosporin [58][59][60][61][62].…”