Multicenter Retrospective Study of Vascular Infections and Endocarditis Caused by Campylobacter spp., France

Abstract

The incidence of campylobacteriosis has substantially increased over the past decade, notably in France. Secondary localizations complicating invasive infections are poorly described. We aimed to describe vascular infection or endocarditis caused by Campylobacter spp. We included 57 patients from a nationwide 5-year retrospective study on Campylobacter spp. bacteremia conducted in France; 44 patients had vascular infections, 12 had endocarditis, and 1 had both conditions. Campylobacter fetus was the most frequently involved species (83%). Antibiotic treatment involved a β-lactam monotherapy (54%) or was combined with a fluoroquinolone or an aminoglycoside (44%). The mortality rate was 25%. Relapse occurred in 8% of cases and was associated with delayed initiation of an efficient antimicrobial therapy after the first symptoms, diabetes, and coexistence of an osteoarticular location. Cardiovascular Campylobacter spp. infections are associated with a high mortality rate. Systematically searching for those localizations in cases of C. fetus bacteremia may be warranted.

Campylobacter coli enteritis associated with Campylobacter fetus bacteremia, spondylodiscitis, and late CIED-related endocarditis, a case report

“…Relapse (defined by > 1 new positive blood culture with Campylobacter spp. after clinical sign resolution and apyrexia or negative control blood culture) occurred in 8 % of cases and was associated with delayed initiation of an efficient antimicrobial therapy, diabetes, and coexistence of an osteoarticular location [ 8 ]. In our patient, relapse seems indeed to be the most likely hypothesis to explain the secondary CIED infection, although we cannot completely rule out reinfection as strain sequencing could not have been performed.…”

Campylobacter fetus Invasive Infections and Risks for Death, France, 2000–2021

“…The most commonly detected cause of Campylobacter bacteremia is C. fetus ( 5 , 6 ). However, cohorts or large case series exclusively involving patients with C. fetus bacteremia remain scarce.…”

“…Among patients with C. fetus bacteremia, one third exhibited secondary localizations with a predilection for vascular infections. A recent multicenter study in France (252 patients with C. fetus bacteremia) found that 11.5% patients had vascular localization and 4.4% had endocarditis ( 6 ). In our study population, we found more vascular localizations but less endocarditis.…”

“…In our study, TTE and 18 F-FDG PET/CT were each performed for only 14% of patients with bacteremia, which is a major limitation. We suggest performing those radiologic examinations early for patients with C. fetus bacteremia ( 6 , 23 ). Late radiologic examination may partially explain the high mortality rate among patients with aneurysm rupture or endocarditis.…”

“…No strain was resistant to amoxicillin/clavulanic acid, aminoglycoside, or imipenem. The initial empiric treatment should be dual antimicrobial therapy (including amoxicillin/clavulanic acid or imipenem with an aminoglycoside) ( 6 , 22 , 24 ). In our cohort, all dual-therapy regimens consisted of amoxicillin/clavulanic acid (7/8 [88%]) or imipenem (1/8 [12%]) with a second agent.…”