Campylobacter gastroenteritis in children in north-eastern Israel comparison with other common pathogens

Abstract

Gastroenteritis is common among children. Campylobacter jejuni is one of the main causative bacterial pathogens, together with Shigella, Salmonella and invasive Escherichia coli. campylobacteriosis is a zoonotic, usually self-limited disease that does not always require antibiotic treatment. In cases of protracted diarrhoea in healthy children or immunocompromised patients, antibiotic treatment is recommended, and the drug of choice is still macrolides, with very low resistance rates in Campylobacter species. However, it is crucial to isolate the causative organism, because some cases, such as Shigella encephalitis, call for initiation of empiric antibiotic treatment. In this study, we compared the incidence, epidemiology, clinical findings and laboratory results of gastroenteritis with dysentery caused by these organisms in children in our area. C. jejuni was found to be the leading pathogen in children hospitalized with bacterial gastroenteritis, followed by Shigella and Salmonella. Macrolides were the drug of choice for Campylobacter, and ceftriaxone and ciprofloxacin were the best empiric treatments for Shigella and Salmonella, respectively. Acute bacterial gastroenteritis is a common disease in infants and children. The clinical presentation includes fever, diarrhoea, bloody stool, vomiting, dehydration and abdominal pain. Campylobacter species, Shigella, Salmonella and invasive Escherichia coli are the main bacterial organisms causing acute infection in the gastrointestinal tract 1. Campylobacter organisms are thin curved Gram-negative non-spore-forming rods. The Campylobacter group includes 26 species: the most frequent types that cause disease in humans are Campylobacter jejuni, Campylobacter coli and Campylobacter fetus 2 , these are also the most common types in Israel 3. Campylobacteriosis is a zoonotic disease, with wild birds, poultry and domestic pets as the main reservoirs. Outbreaks are often linked to contaminated water, unpasteurized milk products, consumption of under-cooked chicken, environmental exposure and contact with farm animals 4. It is difficult to differentiate acute gastroenteritis caused by Campylobacter from gastroenteritis caused by Shigella or Salmonella based only on clinical signs or routine blood analysis; stool culture provides the definitive diagnosis of the causative organism. In cases of severe dehydration, toxic appearance, signs of sepsis and gastroenteritis caused by Shigella or Salmonella, initiation of empiric antibiotic treatment, such as third-generation cephalosporin, is required; in cases suspected of Shigella encephalitis, empiric treatment is also recommended. Third-generation cephalosporin has no effect against Campylobacter 4. Campylobacter is considered the causative organism in most cases of bacterial gastroenteritis in young children. It is usually a self-limited disease and does not always require antibiotic treatment. In cases of protracted diarrhoea in healthy children, or infection in immunocompromised patients, antibiotic treatment is recommended, and ...

Campylobacteriosis, Shigellosis and Salmonellosis in Hospitalized Children with Acute Inflammatory Diarrhea in Georgia

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“…However, fever was more common in the case of Shigella -positive children compared to Shigella -negative children. It was probably due to mild, often self-limiting Campylobacter infections that needed only supportive treatment 12 . This observation was similar to a study conducted in the north of Israel 12 .…”

“…It was probably due to mild, often self-limiting Campylobacter infections that needed only supportive treatment 12 . This observation was similar to a study conducted in the north of Israel 12 . Henceforth, fever on admission associated with dysentery will be helpful for the clinicians to differentiate between shigellosis and Campylobacter infections among under-5 children.…”

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