Campylobacter

Definition | Aetiology | Pathophysiology | Risk Factors | Signs and Symptoms | Investigations | Management | References

Definition

Campylobacter infection, also known as campylobacteriosis, is a common bacterial infection that affects the gastrointestinal tract. It is one of the leading causes of foodborne illness worldwide.

Aetiology

Campylobacter infection is caused by bacteria of the genus Campylobacter, with Campylobacter jejuni being the most common species responsible for human infections. The bacteria are usually transmitted through:

• Consumption of contaminated food or water (especially undercooked poultry)
• Contact with infected animals or animal products
• Person-to-person transmission, although less common

Pathophysiology

The pathophysiology of Campylobacter infection involves:

• The bacteria invade and colonise the intestinal mucosa, causing inflammation and damage to the epithelial cells.
• This leads to an inflammatory response, resulting in diarrhoea, abdominal pain, and other gastrointestinal symptoms.
• In severe cases, the bacteria can enter the bloodstream, causing systemic infection and complications.

Risk Factors

• Consumption of undercooked or contaminated poultry
• Drinking untreated water
• Contact with infected animals, particularly farm animals and pets
• Poor hygiene and food handling practices
• Travel to areas with poor sanitation
• Immunocompromised individuals

Signs and Symptoms

The signs and symptoms of Campylobacter infection include:

• Diarrhoea (often bloody)
• Abdominal pain and cramping
• Fever
• Nausea and vomiting
• Malaise

Investigations

Specific investigations to diagnose Campylobacter infection include:

• Stool culture: To isolate and identify Campylobacter species.
• Polymerase Chain Reaction (PCR): To detect Campylobacter DNA in stool samples.
• Blood tests: Full blood count (FBC) to check for signs of infection and inflammation.
• Serology: Occasionally used to detect antibodies against Campylobacter, but less commonly performed.

Management

Primary Care Management

• Rehydration: Oral rehydration solutions to prevent dehydration from diarrhoea.
• Antidiarrhoeal medications: Such as loperamide may be used in non-severe cases, but generally avoided to allow the infection to clear.
• Antibiotics: Typically not required for mild cases, but may be considered for severe or prolonged infections, or in immunocompromised individuals. Common antibiotics include azithromycin or ciprofloxacin.
• Hygiene advice: Emphasising hand washing and safe food handling practices to prevent spread and reinfection.

Specialist Management

• Hospitalisation: For severe cases, especially if dehydration, sepsis, or complications arise.
• Intravenous fluids: To manage severe dehydration and maintain electrolyte balance.
• Further investigations: In cases of complications such as Guillain-Barré syndrome or reactive arthritis, specialist referral and further investigations may be necessary.
• Public health measures: Reporting cases to public health authorities to monitor and prevent outbreaks.

References

1. NHS (2024) Campylobacter infection. Available at: https://www.nhs.uk/conditions/campylobacter-infection/ (Accessed: 24 June 2024).
2. Centers for Disease Control and Prevention (2024) Campylobacter (Campylobacteriosis). Available at: https://www.cdc.gov/campylobacter/index.html (Accessed: 24 June 2024).
3. World Health Organization (2024) Campylobacter. Available at: https://www.who.int/news-room/fact-sheets/detail/campylobacter (Accessed: 24 June 2024).
4. British Medical Journal (2024) Campylobacter: clinical features, diagnosis, and management. Available at: https://www.bmj.com/content/350/bmj.h1952 (Accessed: 24 June 2024).

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