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Microbiology, pathogenesis, and epidemiology of Campylobacter infection

INTRODUCTION

Campylobacters are small gram-negative bacteria first recognized as causes of abortion in cattle and sheep in the early twentieth century [1]. A few decades later, the organism (originally called Vibrio) was reported as an occasional cause of illness in humans [2]. In 1973, a new genus, Campylobacter, was designated [3]. It was not until the 1980s that the full impact of Campylobacter infections on human health began to be appreciated; they are now known to be a leading cause of acute diarrhea and systemic illness worldwide. (See "Epidemiology and causes of acute diarrhea in developed countries".)

Campylobacter spp are common commensals in the gastrointestinal tract of animals, especially poultry; thus, animal-to-human transmission of infections occurs frequently. The microbiology, pathogenesis, and epidemiology of Campylobacter infection will be reviewed here. The clinical features and treatment of Campylobacter infection are discussed separately. (See "Clinical manifestations, diagnosis, and treatment of Campylobacter infection".)

MICROBIOLOGY

Campylobacters belong to a distinct group of specialized gram-negative bacteria designated rRNA superfamily VI [4]. Apart from the genus Campylobacter, the group also contains Arcobacter and Helicobacter. Arcobacters are closely related to campylobacters, and some cause intestinal infection in humans. Helicobacter pylori is well known as a cause of gastritis and peptic ulcer disease, but there are other Helicobacter species that cause infection of the human gut. (See "Infection with less common Campylobacter species and related bacteria" and "Pathophysiology of and immune response to Helicobacter pylori infection".)

A feature common to all these bacteria is that they are adapted to colonize the surface of the mucous membranes of the alimentary and reproductive tracts. This adaptation is reflected in their morphology. The combination of spiral shape and long polar flagella leads to rapid motility that enables the organisms to "corkscrew" their way through mucus with a facility denied to conventional bacteria (picture 1).

Most members of this group are microaerophilic, or partially anaerobic, and most undergo transformation into coccoid forms when exposed to adverse conditions, especially oxidation [5]. These appear to be degenerative forms, but some believe they are potentially dormant forms capable of long survival [6]. Although some campylobacters can survive in cold water for several weeks, even months, they are not necessarily in coccal form. In general, these bacteria are fragile and easily destroyed by heat, desiccation, acidity, irradiation, and disinfectants.

                  

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Literature review current through: Nov 2014. | This topic last updated: Jun 20, 2014.
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References
Top
  1. MacFadyean F, Stockman S. Report of the department committee appointed by the board of agriculture and fisheries to inquire into epizoonotic abortion, Vol 3. London HMSO. Abstract 1909.
  2. Vinzent R, Dumas J, Picard N. Septicemie grave au cours de la grossesse due a un vibrion: avortement consectuvie. Bull Acad Nat'l Med 1947; 131:90.
  3. Vernon M, Chatlain R. Taxonomic study of the genus Campylobacter and designation of the neotype strain for the type species. Int J Syst Bacteriol 1973; 23:122.
  4. Vandamme P, Falsen E, Rossau R, et al. Revision of Campylobacter, Helicobacter, and Wolinella taxonomy: emendation of generic descriptions and proposal of Arcobacter gen. nov. Int J Syst Bacteriol 1991; 41:88.
  5. Moran AP, Upton ME. Factors affecting production of coccoid forms by Campylobacter jejuni on solid media during incubation. J Appl Bacteriol 1987; 62:527.
  6. Rollins DM, Colwell RR. Viable but nonculturable stage of Campylobacter jejuni and its role in survival in the natural aquatic environment. Appl Environ Microbiol 1986; 52:531.
  7. Lastovica AJ, Skirrow MB. Clinical significance of Campylobacter and related species other than Campylobacter jejuni and C. coli. In: Campylobacter, 2nd Ed, Nachamkin I, Blaser MJ (Eds), ASM Press, Washington, DC 2000. p.89.
  8. Paisley JW, Mirrett S, Lauer BA, et al. Dark-field microscopy of human feces for presumptive diagnosis of Campylobacter fetus subsp. jejuni enteritis. J Clin Microbiol 1982; 15:61.
  9. Blaser MJ, Berkowitz ID, LaForce FM, et al. Campylobacter enteritis: clinical and epidemiologic features. Ann Intern Med 1979; 91:179.
  10. Friedman CR, Neimann J, Wegener HC, Tauxe RV. Epidemiology of Campylobacter jejuni infections in the United States and other industrialized nations. In: Campylobacter, 2nd Ed, Nachamkin I, Blaser MJ (Eds), ASM Press, Washington, DC 2000. p.121.
  11. Nachamkin I. Campylobacter, Heliobacter and related spiral bacteria. In: Manual of Clinical Microbiology, 6th Ed, ASM Press, Washington, DC p.402.
  12. Wassenaar TM, Newell DG. Genotyping of Campylobacter spp. Appl Environ Microbiol 2000; 66:1.
  13. Kulkarni SP, Lever S, Logan JM, et al. Detection of campylobacter species: a comparison of culture and polymerase chain reaction based methods. J Clin Pathol 2002; 55:749.
  14. Persson S, Petersen HM, Jespersgaard C, Olsen KE. Real-time TaqMan polymerase chain reaction-based genus-identification and pyrosequencing-based species identification of Campylobacter jejuni, C. coli, C. lari, C. upsaliensis, and C. fetus directly on stool samples. Diagn Microbiol Infect Dis 2012; 74:6.
  15. Ugarte-Ruiz M, Gómez-Barrero S, Porrero MC, et al. Evaluation of four protocols for the detection and isolation of thermophilic Campylobacter from different matrices. J Appl Microbiol 2012; 113:200.
  16. Poly F, Guerry P. Pathogenesis of Campylobacter. Curr Opin Gastroenterol 2008; 24:27.
  17. Robinson DA. Infective dose of Campylobacter jejuni in milk. Br Med J (Clin Res Ed) 1981; 282:1584.
  18. Black RE, Levine MM, Clements ML, et al. Experimental Campylobacter jejuni infection in humans. J Infect Dis 1988; 157:472.
  19. Doorduyn Y, Van Pelt W, Siezen CL, et al. Novel insight in the association between salmonellosis or campylobacteriosis and chronic illness, and the role of host genetics in susceptibility to these diseases. Epidemiol Infect 2008; 136:1225.
  20. Neal KR, Scott HM, Slack RC, Logan RF. Omeprazole as a risk factor for campylobacter gastroenteritis: case-control study. BMJ 1996; 312:414.
  21. Caldwell MB, Guerry P, Lee EC, et al. Reversible expression of flagella in Campylobacter jejuni. Infect Immun 1985; 50:941.
  22. Grant CC, Konkel ME, Cieplak W Jr, Tompkins LS. Role of flagella in adherence, internalization, and translocation of Campylobacter jejuni in nonpolarized and polarized epithelial cell cultures. Infect Immun 1993; 61:1764.
  23. Yao R, Burr DH, Doig P, et al. Isolation of motile and non-motile insertional mutants of Campylobacter jejuni: the role of motility in adherence and invasion of eukaryotic cells. Mol Microbiol 1994; 14:883.
  24. Bacon DJ, Alm RA, Burr DH, et al. Involvement of a plasmid in virulence of Campylobacter jejuni 81-176. Infect Immun 2000; 68:4384.
  25. Pei Z, Burucoa C, Grignon B, et al. Mutation in the peb1A locus of Campylobacter jejuni reduces interactions with epithelial cells and intestinal colonization of mice. Infect Immun 1998; 66:938.
  26. Yao R, Burr DH, Guerry P. CheY-mediated modulation of Campylobacter jejuni virulence. Mol Microbiol 1997; 23:1021.
  27. Dolg P, Yao R, Burr DH, et al. An environmentally regulated pilus-like appendage involved in Campylobacter pathogenesis. Mol Microbiol 1996; 20:885.
  28. Wassenaar TM, Blaser MJ. Pathophysiology of Campylobacter jejuni infections of humans. Microbes Infect 1999; 1:1023.
  29. Gaynor EC, Ghori N, Falkow S. Bile-induced 'pili' in Campylobacter jejuni are bacteria-independent artifacts of the culture medium. Mol Microbiol 2001; 39:1546.
  30. Konkel ME, Klena JD, Rivera-Amill V, et al. Secretion of virulence proteins from Campylobacter jejuni is dependent on a functional flagellar export apparatus. J Bacteriol 2004; 186:3296.
  31. de Zoete MR, Keestra AM, Wagenaar JA, van Putten JP. Reconstitution of a functional Toll-like receptor 5 binding site in Campylobacter jejuni flagellin. J Biol Chem 2010; 285:12149.
  32. Rivera-Amill V, Konkel ME. Secretion of Campylobacter jejuni Cia proteins is contact dependent. In: Mechanisms in the Pathogenesis of Enteric Diseases 2, Paul PS, Francis DH (Eds), Plenum, New York 1999. p.225.
  33. Konkel ME, Kim BJ, Rivera-Amill V, Garvis SG. Bacterial secreted proteins are required for the internaliztion of Campylobacter jejuni into cultured mammalian cells. Mol Microbiol 1999; 32:691.
  34. Bacon DJ, Alm RA, Hu L, et al. DNA sequence and mutational analyses of the pVir plasmid of Campylobacter jejuni 81-176. Infect Immun 2002; 70:6242.
  35. Tracz DM, Keelan M, Ahmed-Bentley J, et al. pVir and bloody diarrhea in Campylobacter jejuni enteritis. Emerg Infect Dis 2005; 11:838.
  36. Fauchere JL, Rosenau A, Veron M, et al. Association with HeLa cells of Campylobacter jejuni and Campylobacter coli isolated from human feces. Infect Immun 1986; 54:283.
  37. Jin S, Song YC, Emili A, et al. JlpA of Campylobacter jejuni interacts with surface-exposed heat shock protein 90alpha and triggers signalling pathways leading to the activation of NF-kappaB and p38 MAP kinase in epithelial cells. Cell Microbiol 2003; 5:165.
  38. Konkel ME, Garvis SG, Tipton SL, et al. Identification and molecular cloning of a gene encoding a fibronectin-binding protein (CadF) from Campylobacter jejuni. Mol Microbiol 1997; 24:953.
  39. Wassenaar TM. Toxin production by Campylobacter spp. Clin Microbiol Rev 1997; 10:466.
  40. Whitehouse CA, Balbo PB, Pesci EC, et al. Campylobacter jejuni cytolethal distending toxin causes a G2-phase cell cycle block. Infect Immun 1998; 66:1934.
  41. Pickett CL, Pesci EC, Cottle DL, et al. Prevalence of cytolethal distending toxin production in Campylobacter jejuni and relatedness of Campylobacter sp. cdtB gene. Infect Immun 1996; 64:2070.
  42. Hickey TE, Majam G, Guerry P. Intracellular survival of Campylobacter jejuni in human monocytic cells and induction of apoptotic death by cytholethal distending toxin. Infect Immun 2005; 73:5194.
  43. Shenker BJ, Besack D, McKay T, et al. Induction of cell cycle arrest in lymphocytes by Actinobacillus actinomycetemcomitans cytolethal distending toxin requires three subunits for maximum activity. J Immunol 2005; 174:2228.
  44. Blaser MJ, Duncan DJ. Human serum antibody response to Campylobacter jejuni infection as measured in an enzyme-linked immunosorbent assay. Infect Immun 1984; 44:292.
  45. Melamed I, Bujanover Y, Igra YS, et al. Campylobacter enteritis in normal and immunodeficient children. Am J Dis Child 1983; 137:752.
  46. Sorvillo FJ, Lieb LE, Waterman SH. Incidence of campylobacteriosis among patients with AIDS in Los Angeles County. J Acquir Immune Defic Syndr 1991; 4:598.
  47. Tee W, Mijch A. Campylobacter jejuni bacteremia in human immunodeficiency virus (HIV)-infected and non-HIV-infected patients: comparison of clinical features and review. Clin Infect Dis 1998; 26:91.
  48. Centers for Disease Control and Prevention (CDC). Preliminary FoodNet data on the incidence of infection with pathogens transmitted commonly through food--10 States, United States, 2005. MMWR Morb Mortal Wkly Rep 2006; 55:392.
  49. Centers for Disease Control and Prevention (CDC). Incidence and trends of infection with pathogens transmitted commonly through food - foodborne diseases active surveillance network, 10 U.S. sites, 1996-2012. MMWR Morb Mortal Wkly Rep 2013; 62:283.
  50. Buzby JC, Allos BM, Roberts T. The economic burden of Campylobacter-associated Guillain-Barré syndrome. J Infect Dis 1997; 176 Suppl 2:S192.
  51. Skirrow MB. A demographic survey of campylobacter, salmonella and shigella infections in England. A Public Health Laboratory Service Survey. Epidemiol Infect 1987; 99:647.
  52. Blaser MJ, Taylor DN, Echeverria P. Immune response to Campylobacter jejuni in a rural community in Thailand. J Infect Dis 1986; 153:249.
  53. Calva JJ, Ruiz-Palacios GM, Lopez-Vidal AB, et al. Cohort study of intestinal infection with campylobacter in Mexican children. Lancet 1988; 1:503.
  54. Gardner TJ, Fitzgerald C, Xavier C, et al. Outbreak of campylobacteriosis associated with consumption of raw peas. Clin Infect Dis 2011; 53:26.
  55. Jacobs-Reitsma W. Campylobacter in the food supply. In: Campylobacter, 2nd Ed, Nachamkin I, Blaser MJ (Eds), ASM Press, Washington, DC 2000. p.467.
  56. Stern NJ, Hernandez MP, Blankenship L, et al. Prevalence and distribution of Campylobacter jejuni and Campylobacter coli in retail meats. J Food Protect 1985; 48:595.
  57. Bolton FJ, Dawkins HC, Hutchinson DN. Biotypes and serotypes of thermophilic campylobacters isolated from cattle, sheep and pig offal and other red meats. J Hyg (Lond) 1985; 95:1.
  58. Jones FT, Axtell RC, Rives DV, et al. A survey of Campylobacter jejuni contamination in modern broiler production and processing systems. J Food Protect 1991; 54:259.
  59. Hood AM, Pearson AD, Shahamat M. The extent of surface contamination of retailed chickens with Campylobacter jejuni serogroups. Epidemiol Infect 1988; 100:17.
  60. Harris NV, Weiss NS, Nolan CM. The role of poultry and meats in the etiology of Campylobacter jejuni/coli enteritis. Am J Public Health 1986; 76:407.
  61. Neal KR, Slack RC. The autumn peak in campylobacter gastro-enteritis. Are the risk factors the same for travel- and UK-acquired campylobacter infections? J Public Health Med 1995; 17:98.
  62. Denno DM, Keene WE, Hutter CM, et al. Tri-county comprehensive assessment of risk factors for sporadic reportable bacterial enteric infection in children. J Infect Dis 2009; 199:467.
  63. Danis K, Di Renzi M, O'Neill W, et al. Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study. Euro Surveill 2009; 14.
  64. Stafford RJ, Schluter PJ, Wilson AJ, et al. Population-attributable risk estimates for risk factors associated with Campylobacter infection, australia. Emerg Infect Dis 2008; 14:895.
  65. Smith KE, Besser JM, Hedberg CW, et al. Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998. Investigation Team. N Engl J Med 1999; 340:1525.
  66. Brown P, Kidd D, Riordan T, Barrell RA. An outbreak of food-borne Campylobacter jejuni infection and the possible role of cross-contamination. J Infect 1988; 17:171.
  67. Saeed AM, Harris NV, DiGiacomo RF. The role of exposure to animals in the etiology of Campylobacter jejuni/coli enteritis. Am J Epidemiol 1993; 137:108.
  68. Vogt RL, Sours HE, Barrett T, et al. Campylobacter enteritis associated with contaminated water. Ann Intern Med 1982; 96:292.
  69. Mentzing LO. Waterborne outbreaks of campylobacter enteritis in central Sweden. Lancet 1981; 2:352.
  70. Sacks JJ, Lieb S, Baldy LM, et al. Epidemic campylobacteriosis associated with a community water supply. Am J Public Health 1986; 76:424.
  71. Robinson DA, Jones DM. Milk-borne campylobacter infection. Br Med J (Clin Res Ed) 1981; 282:1374.
  72. Wood RC, MacDonald KL, Osterholm MT. Campylobacter enteritis outbreaks associated with drinking raw milk during youth activities. A 10-year review of outbreaks in the United States. JAMA 1992; 268:3228.
  73. Richardson G, Thomas DR, Smith RM, et al. A community outbreak of Campylobacter jejuni infection from a chlorinated public water supply. Epidemiol Infect 2007; 135:1151.
  74. Centers for Disease Control and Prevention (CDC). Campylobacter jejuni infection associated with unpasteurized milk and cheese--Kansas, 2007. MMWR Morb Mortal Wkly Rep 2009; 57:1377.
  75. Centers for Disease Control and Prevention (CDC). Recurrent outbreak of Campylobacter jejuni infections associated with a raw milk dairy--Pennsylvania, April-May 2013. MMWR Morb Mortal Wkly Rep 2013; 62:702.
  76. Longenberger AH, Palumbo AJ, Chu AK, et al. Campylobacter jejuni infections associated with unpasteurized milk--multiple States, 2012. Clin Infect Dis 2013; 57:263.
  77. Fullerton KE, Ingram LA, Jones TF, et al. Sporadic campylobacter infection in infants: a population-based surveillance case-control study. Pediatr Infect Dis J 2007; 26:19.