In August 2021, three students with diarrhea from the same school visited a local hospital in the S district of Beijing. An epidemic investigation showed that there were more students with diarrhea in the same school and they had one meal together. Campylobacter jejuni was isolated from both patients with diarrhea and asymptomatic food handlers; however, the latter also carried Campylobacter coli. Phylogenomic analysis showed that there was a campylobacteriosis outbreak among the students, and the asymptomatic food handler may have been the source of the infection. Routine inspection and surveillance for Campylobacter is needed for the food producing staff, particularly those cooking in the cafeteria in schools or other public food services.
Humans ; Campylobacter Infections/epidemiology* ; Gastroenteritis ; Diarrhea ; Campylobacter ; Disease Outbreaks

Campylobacter is a worldwide foodborne pathogen, associated with human gastroenteritis. The efficient translocation of Campylobacter and its ability to secrete toxins into host cells are the 2 key features of Campylobacter pathophysiology which trigger inflammation in intestinal cells and contribute to the development of gastrointestinal symptoms, particularly diarrhoea, in humans. The purpose of conducting this literature review is to summarise the current understanding of: i) the human immune responses involved in the elimination of Campylobacter infection and ii) the resistance potential in Campylobacter against these immune responses. This review has highlighted that the intestinal epithelial cells are the preliminary cells which sense Campylobacter cells by means of their cell-surface and cytosolic receptors, activate various receptors-dependent signalling pathways, and recruit the innate immune cells to the site of inflammation. The innate immune system, adaptive immune system, and networking between these systems play a crucial role in bacterial clearance. Different cellular constituents of Campylobacter, mainly cell membrane lipooligosaccharides, capsule, and toxins, provide protection to Campylobacter against the human immune system mediated killing. This review has also identified gaps in knowledge, which are related to the activation of following during Campylobacter infection: i) cathelicidins, bactericidal permeability-increasing proteins, chemokines, and inflammasomes in intestinal epithelial cells; ii) siglec-7 receptors in dendritic cell; iii) acute phase proteins in serum; and iv) T-cell subsets in lymphoid nodules. This review evaluates the existing literature to improve the understanding of human immunity against Campylobacter infection and identify some of the knowledge gaps for future research.
Acute-Phase Proteins ; Antigen-Presenting Cells ; Campylobacter Infections ; Campylobacter ; Cathelicidins ; Cell Membrane ; Chemokines ; Cytosol ; Dendritic Cells ; Epithelial Cells ; Gastroenteritis ; Guillain-Barre Syndrome ; Homicide ; Humans ; Immune System ; Inflammasomes ; Inflammation ; T-Lymphocyte Subsets ; Toll-Like Receptors

PURPOSE: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent. METHODS: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with Campylobacter spp. (25 patients), Salmonella spp. (18 patients), and Clostridium perfringens (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was 84.0±54.8 months, and the mean hospital stay was 4.6±1.7 days. RESULTS: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with Campylobacter infection were significantly older (P=0.00). C-reactive protein (CRP) levels in patients with Campylobacter infection were higher than those in the other 2 groups, at 9.6±6.1 mg/dL. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ≥103.5 months (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ≥4.55 mg/dL (sensitivity, 80%; specificity, 69%). CONCLUSION: Age (≥103.5 months) and higher CRP level (≥4.55 mg/dL) were good predictors of Campylobacter enterocolitis. If neither criterion was met, Campylobacter enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, Campylobacter enterocolitis was highly likely.
Bacteria ; Bacterial Infections ; C-Reactive Protein ; Campylobacter Infections ; Campylobacter* ; Child* ; Clostridium perfringens ; Diarrhea ; Enteritis* ; Enterocolitis ; Hematologic Tests ; Humans ; Length of Stay ; Multiplex Polymerase Chain Reaction ; Pediatrics ; Salmonella ; Sensitivity and Specificity

Recurrent Guillain-Barré syndrome (GBS) is a rare, immune-mediated disease of the peripheral nervous system. It has been reported to occur at intervals ranging from four months to 10 years; published case studies suggest that 1%–6% of patients who have had GBS will experience recurrent attacks. The most commonly identified infections coinciding with GBS are Campylobacter jejuni, Haemophilus influenzae, Mycoplasma pneumonia, and cytomegalovirus, while an antecedent infection with Escherichia coli is very uncommon. In this case report, we present a rare episode of recurrent GBS, which followed a urinary tract infection (UTI) by E. coli, and an accompanying literature review. A 75-year-old woman with a prior history of acute motor axonal neuropathy (AMAN), a subtype of GBS, presented with subsequent weakness of limbs and areflexia following 10 days of fever, frequency, and dysuria. Base on nerve conduction studies, cerebrospinal fluid analysis and other clinical investigation, we diagnosed the patient with recurrent GBS caused by E. coli. The patient recovered with mild subjective weakness following treatment of intravenous immunoglobulin with ceftriaxone. We suggest that E. coli causes UTI could be one of the diverse trigger factors involved in recurrent GBS.
Aged ; Axons ; Campylobacter jejuni ; Ceftriaxone ; Cerebrospinal Fluid ; Cytomegalovirus ; Dysuria ; Escherichia coli ; Escherichia ; Extremities ; Female ; Fever ; Guillain-Barre Syndrome ; Haemophilus influenzae ; Humans ; Immunoglobulins ; Neural Conduction ; Peripheral Nervous System ; Pneumonia, Mycoplasma ; Polyneuropathies ; Urinary Tract Infections ; Urinary Tract ; Uropathogenic Escherichia coli

We investigated recent epidemiologic trends regarding campylobacteriosis vs. nontyphoidal salmonellosis (NTS), a previously known leading cause of bacterial enterocolitis in Korean children. Among 363 hospitalized children with acute inflammatory diarrhea, Campylobacter (18.7%) was the most frequently detected pathogen using multiplex polymerase chain reaction tests followed by Salmonella (15.4%). Children with campylobacteriosis were older than children with NTS (112.6 months [interquartile range (IQR) 66.0–160.1] vs. 53 months [IQR 31.0–124.0], P < 0.001) and had higher prevalences of abdominal cramping and stool hemoglobin. Campylobacteriosis may be suspected as a primary cause of acute inflammatory diarrhea in hospitalized school-aged Korean children and adolescents.
Adolescent ; Age Distribution* ; Campylobacter ; Child* ; Child, Hospitalized ; Colic ; Diarrhea* ; Enterocolitis ; Humans ; Multiplex Polymerase Chain Reaction ; Prevalence ; Salmonella ; Salmonella Infections*

PURPOSE: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. METHODS: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. RESULTS: Twenty-four patients (70.6%) were male. The mean age of the patients was 8.5±6.2 (range, 1.1–17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p<0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. CONCLUSION: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.
Abdominal Pain ; Bacteria ; C-Reactive Protein ; Campylobacter ; Campylobacter Infections ; Child* ; Clostridium difficile ; Colon ; Diagnosis ; Enterocolitis* ; Humans ; Ileum ; Male ; Medical Records ; Multiplex Polymerase Chain Reaction ; Retrospective Studies ; Salmonella ; Shiga-Toxigenic Escherichia coli ; Shigella ; Staphylococcus aureus ; Ultrasonography

Campylobacter infection causes gastrointestinal symptoms such as abdominal pain or diarrhea. Occasionally, Campylobacter bacteremia affects immunocompromised patients; however, serious outcomes are known to be rare. Here, we present a case of a patient with Campylobacter bacteremia who had underlying liver cirrhosis. The patient had fever and diarrhea. These symptoms subsided after treatment with cefotaxime. Campylobacter jejuni was isolated in the blood culture after 10 days. In addition, previously reported cases of Campylobacter bacteremia in Asian countries were reviewed with respect to antimicrobial sensitivities.
Abdominal Pain ; Asian Continental Ancestry Group ; Bacteremia* ; Campylobacter Infections ; Campylobacter jejuni* ; Campylobacter* ; Cefotaxime ; Diarrhea ; Fever ; Humans ; Immunocompromised Host ; Liver Cirrhosis* ; Liver*

Bacterial Typing Techniques ; Campylobacter Infections ; microbiology ; Campylobacter fetus ; classification ; isolation & purification ; Humans ; Multilocus Sequence Typing

OBJECTIVETo understand the occurrence and distribution of Campylobacter jejuni in chicken in China, assess its health risk to the Chinese population, and provide recommendations for effective risk control.

METHODSData from the National Food Safety Risk Surveillance Network on Campylobacter jejuni between 2007 and 2010 and from published articles were analyzed. Eleven parameters were used based on the whole chicken preparation process and prevalence of Campylobacter jejuni for risk assessment by using the Ross-Sumner Method.

RESULTSThe detection rates of Campylobacter jejuni in raw chicken were between 0.29% and 2.28% during 2007-2010 in China (more than 20 provinces). The probability of illness caused by Campylobacter jejuni due to chicken consumption was around six out of one million consumers per day in urban areas and around one out of one million consumers per day in rural areas. Total predicted illnesses per year was about 736 000, accounting for 1.6‰ of the general population in urban areas and about 301 000, accounting for 0.37‰ of the total population in rural areas. The risk rankings of Campylobacter jejuni in chicken were 52 and 49 in urban and rural areas, respectively.

CONCLUSIONA high risk score for Campylobacter jejuni in chicken was obtained in China. This result may contribute to development of food safety management strategies. Key efforts should be made to control the risk of Campylobacter jejuni in chicken in China, especially in chick breeding and chicken preparation processes.

Animals ; Campylobacter Infections ; epidemiology ; veterinary ; Campylobacter jejuni ; Chickens ; China ; epidemiology ; Diet ; Food Handling ; Food Microbiology ; Poultry Diseases ; epidemiology ; Prevalence ; Risk Assessment ; Transportation

The occupations involved in food animal production have long been recognized to carry significant health risks for workers, with special attention to injuries. However, risk of pathogen exposure in these occupations has been less extensively considered. Pathogens are a food safety issue and are known to be present throughout the food animal production chain. Workers employed at farms and slaughterhouses are at risk of pathogen exposure and bacterial infections. The industrialization of animal farming and the use of antimicrobials in animal feed to promote growth have increased the development of antimicrobial resistance. The changed nature of these pathogens exposes workers in this industry to new strains, thus modifying the risks and health consequences for these workers. These risks are not yet recognized by any work-related health and safety agency in the world.
Abattoirs ; Farmers ; Animal Feed ; Animals ; Bacterial Infections ; Campylobacter jejuni ; Drug Resistance, Microbial ; Food Safety ; Methicillin-Resistant Staphylococcus aureus ; Occupational Diseases ; Occupations