GI IMPACT Study

The Diarrhea Study

Campylobacter - Information for Clinicians

Type of infection

Motile, comma-shaped gram-negative bacilli, including Campylobacter jejuni, C. upsaliensis, C. coli and C. fetus. All except C. fetus are detected by the FilmArray GI panel.

Sources of infection

  1. Major reservoir is the GI tract of domestic poultry and wild birds. Can also colonize the GI tract of cats, dogs, and hamsters.
  2. Campylobacter infects persons of all ages but the peak age-specific incidence is in preschool aged children and young adults.
  3. Infection usually comes from eating improperly cooked food, particularly chicken, handling raw chicken, or from drinking untreated water or unpasteurized milk. Campylobacter is associated with travel.
  4. Most cases are sporadic and person to person spread is relatively uncommon.

Usual symptoms

  1. Illness usually starts 2-4 days after exposure.
  2. Diarrhea, stomach pain or cramps, headache, and fever.
  3. Diarrhea may have blood or WBCs.

Complications

  1. Bacteremia is uncommon but can be seen in infants and the immunocompromised.
  2. Rare complications include Guillain Barre syndrom, Miller Fisher syndrome, reactive arthritis, Reiter syndrome, and erythema nodosum.

Duration of illness

  1. Typically 5-7 days. Prolonged or relapsing disease in 10-20%.

Treatment

  1. Most people will recover without treatment. Hydration may be appropriate for mild cases. Antibiotics should be considered for moderate to severe cases or for prolonged disease in immunocompromised hosts.
  2. Macrolides shorten the duration of illness and shedding. Azithromycin 10 mg/kg/day for 3 days for C. jejuni. Alternative is fluoroquinolones but resistance is seen in ~25% of US isolates and can be higher in other settings.

Comments

  1. Hand washing is the best way to prevent the spread of infection.
  2. Always wash hands after handling raw poultry. Wash cutting boards with soap and water after contact with raw poultry, avoid letting fruits or vegetables contact the juice of raw poultry and cook poultry thoroughly.
  3. Practice hand hygiene after cleaning up dog or cat feces.
  4. People with diarrhea should not prepare food.

Resources

  1. Redbook