Short-term and medium-term clinical outcomes of Campylobacter concisus infection

Abstract

Clin Microbiol Infect 2012; 18: E459–E465 Abstract There are only sparse data on the short‐term and medium‐term clinical impacts of Campylobacter concisus infection. A clinical study was performed during a 2‐year period to determine the clinical manifestations in C. concisus‐positive adult patients. A case patient was defined as an adult patient (≥18 years) with a C. concisus‐positive stool sample during the study period. Clinical data were obtained with use of a questionnaire supplemented with the patients’ medical records, if any. The short‐term and medium‐term clinical manifestations in these patients were compared with those of patients with Campylobacter jejuni/Campylobacter coli infection. One hundred and seventy‐four C. concisus patients and 196 C. jejuni/C. coli patients participated in the study. Patients with pre‐existing inflammatory bowel disease or microscopic colitis or enteric co‐infection were excluded from review of the clinical manifestations. Comparison of the short‐term clinical manifestations in 139 C. concisus patients with those in 187 C. jejuni/C. coli patients showed a significantly lower prevalence of fever, chills, mucus and blood in stools, and weight loss. However, 80% of C. concisus patients, but only 32% of C. jejuni/C. coli patients, had diarrhoea for >2 weeks. After a 6‐month follow‐up period, 12% of C. concisus patients were diagnosed with microscopic colitis, whereas no C. jejuni/C. coli patients were diagnosed with non‐infective colitis. Irritable bowel symptoms were common in both groups at follow‐up. C. concisus infection seems to cause a milder course of acute gastroenteritis than C. jejuni/C. coli infection, but is associated with more prolonged diarrhoea.

Isolation of Campylobacter Species from Stool Samples by Use of a Filtration Method: Assessment from a United States-Based Population

“…In a questionnaire survey of patients with C. concisus isolated from fecal samples, Nielsen et al concluded that the patients had a milder course of infection compared with patients who had C. jejuni/C. coli isolated from stool samples but were more likely to have prolonged symptoms (12). The role of other species in gastrointestinal infection such as C. ureolyticus isolated from 3 patients in our survey is less certain (13).…”

Campylobacter concisus pathotypes are present at significant levels in patients with gastroenteritis

“…In support of this, our results provide further evidence as to the possible involvement of Campylobacter concisus in cases of gastroenteritis and the need for diagnostic laboratories to employ identification protocols for Campylobacter concisus and other emerging Campylobacter species, in order to reduce the number of undiagnosed cases of gastroenteritis. Given that following symptoms of gastroenteritis, patients with Campylobacter concisus have been reported to later develop more chronic sequelae (Nielsen et al, 2012(Nielsen et al, , 2013b(Nielsen et al, , 2014, and the association of this bacterium with IBD (Kaakoush et al, 2014b), clinical follow-up studies in patients presenting with high levels of this bacterium in the intestinal tract are urgently needed. In particular, a prospective population-based study examining the long-term effects of Campylobacter concisus infection, as was elegantly performed for Campylobacter jejuni by Gradel et al (2009), would be of significant clinical importance.…”

“…Further, the threshold established for clinical relevance of Campylobacter concisus levels is preliminary in nature and requires confirmation. Given that Campylobacter concisus presents with a milder but more prolonged form of the disease as compared with Campylobacter jejuni (Nielsen et al, 2012(Nielsen et al, , 2013b, bacterial levels that may be considered clinically relevant may differ between the two species. Moreover, exotoxin 9 and ZOT are only putative indicators of Campylobacter concisus pathotypes, and these genes have been reported in other organisms.…”

“…While most cases of gastroenteritis are self-limiting, it has recently been reported that Campylobacter concisusassociated gastroenteritis is more prolonged in nature (Nielsen et al, 2012(Nielsen et al, , 2013b. Furthermore, 25 and 12.5% of patients with gastroenteritis resulting from Campylobacter concisus infection go on to develop microscopic colitis and irritable bowel syndrome, respectively (Nielsen et al, 2012(Nielsen et al, , 2013a(Nielsen et al, , b, 2014.…”

“…Furthermore, 25 and 12.5% of patients with gastroenteritis resulting from Campylobacter concisus infection go on to develop microscopic colitis and irritable bowel syndrome, respectively (Nielsen et al, 2012(Nielsen et al, , 2013a(Nielsen et al, , b, 2014. These findings highlight the need to further investigate the role of Campylobacter concisus in the aetiology of acute gastroenteritis.…”