Do patients with recurrent episodes of campylobacteriosis differ from those with a single disease event?

Abstract

BackgroundAlthough Campylobacter is the leading cause of reported bacterial gastro-enteritis in industrialized countries, little is known on its recurrence. The objective of this study is to describe the risk and the patient characteristics of recurrent episodes of human campylobacteriosis reported in Quebec.MethodsLaboratory-confirmed cases of campylobacteriosis reported in the province of Quebec, Canada, through ongoing surveillance between 1996 and 2006 were analyzed. The risk of having a recurrent episode of campylobacteriosis was described using life table estimates. Logistic regression was used to assess if gender, age and patient residential location were associated with an increased risk of recurrence.ResultsCompared to the baseline risk, the risk for a recurrent disease event was higher for a period of four years and followed a decreasing trend. This increased risk of a recurrent event was similar across gender, but higher for people from rural areas and lower for children under four years of age.ConclusionsThese results may suggest the absence of durable immunity or clinical resilience following a first episode of campylobacteriosis and periodical re-exposure, at least among cases reported through the surveillance system.

The second study of infectious intestinal disease (IID2): increased rates of recurrent diarrhoea in individuals aged 65 years and above

“…We are not aware of previous evidence from observational studies for such strong clustering effects in adult age groups. In an analysis of surveillance data on laboratory-confirmed campylobacteriosis in Québec, Canada, Arsenault et al found that, over a period of 11 years, a second episode of Campylobacter IID was more likely to be reported among those aged 15 years and above compared with children under 5 years [15]. …”

Campylobacteriosis in returning travellers and potential secondary transmission of exotic strains

“…Although core-genome (as described by MLST) is not necessarily related to antigens, and cross-protection is expected to develop for strains sharing similar antigenic properties, the higher risk of campylobacteriosis in travellers does not appear to be limited just to higher levels of exposure in developing countries, but also to the possible presence of 'new' Campylobacter strains, endemic in the different regions to which travellers have rarely been exposed before [14]. It follows that, probabilistically, these new strains are more likely to be associated with regionally untested antigens than widespread strains, and acquired protection may be ineffective when exposed to uncommon strains, as evidenced by a Canadian study [15].…”

Potential Use of Fosfomycin-Tromethamine for Treatment of Recurrent Campylobacter Species Enteritis

“…The disease can have a protracted course but can also present as an acute and potentially life-threatening infection (5), as occurred in one of our patients. Certain conditions, such as chronic intestinal diseases, diabetes, liver disease, metastatic cancers, and AIDS, as well as hypogammaglobulinemia and the use of proton-pump inhibitors, may be associated with a higher risk of acquiring the infection (9). Humoral immunity plays a crucial role against Campylobacter spp., and recurrent infection has been reported in patients with conditions associated with impaired humoral immunity (5), as was the case of both our patients.…”