Campylobacter

Campylobacter
Campylobacter jejuni
Scientific classification
Kingdom:	Bacteria
Phylum:	Proteobacteria
Class:	Epsilonproteobacteria
Order:	Campylobacterales
Family:	Campylobacteraceae
Genus:	Campylobacter Sebald & Véron, 1963
Species
C. avium C. butzleri C. canadensis C. cinaedi C. coli C. concisus C. corcagiensis C. cryaerophilus C. cuniculorum C. curvus C. fennelliae C. fetus C. gracilis C. helveticus C. hominis C. hyoilei C. hyointestinalis C. insulaenigrae C. jejuni C. lanienae C. lari C. mucosalis C. mustelae C. nitrofigilis C. peloridis C. pylori C. rectus C. showae C. sputorum C. subantarcticus C. upsaliensis C. ureolyticus C. volucris

Campylobacter (meaning "curved bacteria") is a genus of Gram-negative, microaerophilic, oxidase-positive, catalase-positive, nonfermentative bacteria.^[1] Campylobacter species are typically spiral-shaped and able to move via unipolar or bipolar flagella.^[1] Most Campylobacter species are cause for disease and can infect humans and other animals. The bacterium's main reservoir is poultry;^[2] humans can contract the disease from contaminated food. Another source of infection is contact with infected animals such as kittens and puppies; most colonized animals -including chickens- develop a lifelong carrier state.^[3] At least a dozen species of Campylobacter have been implicated in human disease, with C. jejuni and C. coli being the most common.^[4] C. jejuni is now recognized as one of the main causes of bacterial foodborne disease in many developed countries.^[4][5] C. jejuni infection can also result in serious bacteremia in individuals with AIDS, while C. lari is a known cause of recurrent diarrhea in children.^[3] C. fetus is a cause of spontaneous abortions in cattle and sheep, as well as an opportunistic pathogen in humans.^[6]

History

The symptoms of Campylobacter infections were described in 1886 in infants by Theodor Escherich.^[7] These infections were named cholera infantum,^[7] or summer complaint.^[8] The genus was first described in 1963;^[9] however, the organism was not isolated until 1972.^[7]

Genome and proteome

The genomes of several Campylobacter species have been sequenced.^[10] The first Campylobacter genome to be sequenced was C. jejuni, in 2000.^[11]

Campylobacter species contain two flagellin genes in tandem for motility, flaA and flaB. These genes undergo intergenic recombination, further contributing to their virulence.^[12] Nonmotile mutants do not colonize.

Sequence features: Comparative genomic analysis has led to the identification of 15 proteins which are uniquely found in members of the genus Campylobacter and serve as molecular markers for the genus. Eighteen other proteins were also found which were present in all species except C. fetus, which is the deepest-branching Campylobacter species. A conserved insertion has also been identified which is present in all Campylobacter species except C. fetus. Additionally, 28 proteins have been identified present only in C. jejuni and C. coli, indicating a close relationship between these two species. Five other proteins have also been identified which are only found in C. jejuni and serve as molecular markers for the species.^[13]

Bacteriophage

The confusing taxonomy of Campylobacter over the past decades make it difficult to identify the earliest reports of Campylobacter bacteriophages. Bacteriophages specific to the species now known as C. coli and C. fetus (previously Vibrio coli and V. fetus), were isolated from cattle and pigs during the 1960s.^{[14][15][16][17]}

Pathogenesis

Campylobacteriosis, a gastrointestinal infection caused by Campylobacter, is characterized by inflammatory, sometimes bloody diarrhea or dysentery syndrome, mostly including cramps, fever, and pain.^[18][19] The most common routes of transmission are fecal-oral, ingestion of contaminated food or water, and the eating of raw meat. Foods implicated in campylobacteriosis include raw or under-cooked poultry, raw dairy products, and contaminated produce.^[20] Campylobacter is sensitive to the stomach's normal production of hydrochloric acid: as a result, the infectious dose is relatively high, and the bacteria rarely cause illness when a person is exposed to less 10,000 organisms.^[3] Nevertheless, people taking antacid medication (e. g. people with gastritis or stomach ulcers) are at higher risk of contracting disease from a smaller amount of organisms, since this type of medication inhibits normal gastric acid. The infection is usually self-limiting and, in most cases, symptomatic treatment by liquid and electrolyte replacement is enough in human infections. The use of antibiotics, though, is controversial. Symptoms typically last five to seven days.^[20]

The sites of tissue injury include the jejunum, the ileum, and the colon. Most strains of C jejuni produce a toxin (cytolethal distending toxin) that hinders the cells from dividing and activating the immune system. This helps the bacteria to evade the immune system and survive for a limited time in the cells. A cholera-like enterotoxin was once thought to be also made, but this appears not to be the case. The organism produces diffuse, bloody, edematous, and exudative enteritis. Although rarely has the infection been considered a cause of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, no unequivocal case reports exist. In some cases, a Campylobacter infection can be the underlying cause of Guillain–Barré syndrome. Gastrointestinal perforation is a rare complication of ileal infection.^[21]

Campylobacter has also been associated with periodontitis.^[18]

Treatment

Diagnosis of the illness is made by testing a specimen of feces.

• Standard treatment is now azithromycin, a macrolide antibiotic, especially for Campylobacter infections in children,^[22] although other antibiotics, such as macrolides, quinolones, and tetracycline are sometimes used to treat gastrointestinal Campylobacter infections in adults.^[23] In case of systemic infections, other bactericidal antibiotics are used, such as ampicillin, amoxicillin/clavulanic acid, or aminoglycosides. Fluoroquinolone antibiotics, such as ciprofloxacin or levofloxacin, may no longer be effective in some cases due to resistance.^[24]
• Dehydrated children may require intravenous fluid treatment in a hospital.
• The illness is contagious, and children must be kept at home until they have been clear of symptoms for at least two days.
• Good hygiene is important to avoid contracting the illness or spreading it to others.
• Intestinal perforation is very rare; increased abdominal pain and collapse require immediate medical attention.

Epidemiology

Campylobacter infections increased 14% in the United States in 2012 compared to the period from 2006 to 2008. This represents the highest reported number of infections since 2000.^[20]

UK

In January 2013, the UK's Food Standards Agency warned that two-thirds of all raw chicken bought from UK shops was contaminated with Campylobacter, affecting an estimated half a million people annually and killing about 100.^[25] In June 2014, the Food Standards Agency started a campaign against washing raw chicken, as washing can spread germs by splashing.^[26] In May 2015, cumulative results for samples taken from fresh chickens between February 2014 and February 2015 were published as official statistics by the FSA, including results presented by major retailers.

The results for the full year show:

• 19% of chickens tested positive for Campylobacter within the highest band of contamination.
• 73% of chickens tested positive for the presence of Campylobacter.
• 0.1% (five samples) of packaging tested positive at the highest band of contamination.
• 7% of packaging tested positive for the presence of Campylobacter.^[27]

USA

Larger prevalence of Campylobacter (40% or more) has been reported in raw chicken meat in retail stores in the USA.^[28] The reported prevalence in retail chicken meat is higher than the reported prevalence by the microbiology performance standard testing collected by the U. S. Department of Agriculture, and the last quarterly progress report on Salmonella and Campylobacter testing of meat and poultry for July–September 2014, published by the Food Safety and Inspection Service of the U. S. Department of Agriculture, shows a low prevalence of Campylobacter spp. in ground chicken meat, but a larger prevalence (20%) in mechanically separated chicken meat (which is sold only for further processing).^[29]

Canada

FoodNet Canada conducts surveillance at 3 different sites on behalf of Public Health Agency of Canada. In the 2014 Short Report of FoodNet Canada,^[30] they reported:

• "In 2014, Campylobacter and Salmonella remained the most common causes of human enteric illness in the sentinel sites" [3 sites for 2014],
• "Campylobacter was the most prevalent pathogen found on skinless chicken breast in all sites with close to one-half of all samples testing positive.";
• "In turkey in the BC site, Campylobacter was again the most common pathogen found in 2014, as in 2013. Campylobacter was also commonly found in beef and dairy manure samples in the ON site, as in previous years. Campylobacter prevalence in broiler chickens was variable across the sites, ranging from 8.7% - 22%.";
• "...the 2014 FoodNet Canada sampling year have demonstrated that retail meat products, particularly chicken products, remain an important source of human enteric pathogens."

References

1. Vandamme, Peter; Dewhirst, Floyd E.; Paster, Bruce J.; On, Stephen L.W. (2006). Garrity, George; Brenner, Don J.; Staley, James T.; Krieg, Noel R.; Boone, David R.; DeVos, Paul; Goodfellow, Michael; Rainey, Fred A.; Schleifer, Karl-Heinz, eds. Bergey's Manual of Systematic Bacteriology: Volume Two: The Proteobacteria (Part C) (2nd ed.). Springer Science & Business Media. pp. 1147–1160. ISBN 978-0-387-29298-4.
2. "Infectious disease Campylobacter clinical Foodborne illnesses | CDC". www.cdc.gov. Retrieved 2016-02-14.
3. "Campylobacter Infections: Background, Pathophysiology, Epidemiology".
4. Ryan, Kenneth James; Ray, C. George, eds. (2004). Sherris Medical Microbiology: An Introduction to Infectious Diseases (4th ed.). McGraw Hill. pp. 378–80. ISBN 978-0-8385-8529-0.
5. Moore, John E.; Corcoran, Deborah; Dooley, James S.G.; Fanning, Séamus; Lucey, Brigid; Matsuda, Motoo; McDowell, David A.; Mégraud, Francis; Millar, B.; O'Mahony, Rebecca; O'Riordan, Lisa; O'Rourke, Michele; Rao, Juluri R.; Rooney, Paul J.; Sails, Andrew; Whyte, Paul (2005). "Campylobacter". Veterinary Research 36 (3): 351–82. doi:10.1051/vetres:2005012. PMID 15845230.
6. Sauerwein, R. W.; Horrevorts, A. M.; Bisseling, J. (1993). "Septic abortion associated with Campylobacter fetus subspecies fetus infection: Case report and review of the literature". Infection 21 (5): 331–3. doi:10.1007/BF01712458. PMID 8300253.
7. Samie, A.; Obi, C.L.; Barrett, L.J.; Powell, S.M.; Guerrant, R.L. (2007). "Prevalence of Campylobacter species, Helicobacter pylori and Arcobacter species in stool samples from the Venda region, Limpopo, South Africa: Studies using molecular diagnostic methods". Journal of Infection 54 (6): 558–66. doi:10.1016/j.jinf.2006.10.047. PMID 17145081.
8. Condran, Gretchen A.; Murphy, Jennifer (2008). "Defining and Managing Infant Mortality: A Case Study of Philadelphia, 1870-1920". Social Science History 32 (4): 473–513. doi:10.1215/01455532-2008-006.
9. Debruyne, Lies; Gevers, Dirk; Vandamme, Peter (2008). "Taxonomy of the Family Campylobacteraceae". In Nachamkin, Irving; Szymanski, Christine M.; Blaser, Martin J. Campylobacter (3rd ed.). ASM Press. pp. 3–25. ISBN 978-1-55581-437-3. hdl:1854/LU-680725.
10. Relman, David A.; Fouts, Derrick E; Mongodin, Emmanuel F; Mandrell, Robert E; Miller, William G; Rasko, David A; Ravel, Jacques; Brinkac, Lauren M; DeBoy, Robert T; Parker, Craig T; Daugherty, Sean C; Dodson, Robert J; Durkin, A. Scott; Madupu, Ramana; Sullivan, Steven A; Shetty, Jyoti U; Ayodeji, Mobolanle A; Shvartsbeyn, Alla; Schatz, Michael C; Badger, Jonathan H; Fraser, Claire M; Nelson, Karen E (2005). "Major Structural Differences and Novel Potential Virulence Mechanisms from the Genomes of Multiple Campylobacter Species". PLoS Biology 3 (1): e15. doi:10.1371/journal.pbio.0030015. PMC 539331. PMID 15660156.
11. Parkhill, J.; Wren, B. W.; Mungall, K.; Ketley, J. M.; Churcher, C.; Basham, D.; Chillingworth, T.; Davies, R. M.; Feltwell, T.; Holroyd, S.; Jagels, K.; Karlyshev, A. V.; Moule, S.; Pallen, M. J.; Penn, C. W.; Quail, M. A.; Rajandream, M-A.; Rutherford, K. M.; van Vliet, A. H. M.; Whitehead, S.; Barrell, B. G. (2000). "The genome sequence of the food-borne pathogen Campylobacter jejuni reveals hypervariable sequences". Nature 403 (6770): 665–8. doi:10.1038/35001088. PMID 10688204.
12. Grant, Christopher C. R.; Konkel, Michael E.; Cieplak, Witold; Tompkins, Lucy S. (1993). "Role of flagella in adherence, internalization, and translocation of Campylobacter jejuni in nonpolarized and polarized epithelial cell cultures". Infection and Immunity 61 (5): 1764–71. PMC 280763. PMID 8478066.
13. Gupta, Radhey S (2006). "Molecular signatures (unique proteins and conserved indels) that are specific for the epsilon proteobacteria (Campylobacterales)". BMC Genomics 7: 167. doi:10.1186/1471-2164-7-167. PMC 1557499. PMID 16817973.
14. Firehammer, BD; Border, M (1968). "Isolation of temperate bacteriophages from Vibrio fetus". American Journal of Veterinary Research 29 (11): 2229–35. PMID 5693467.
15. Fletcher, R. D. (1965). "Activity and morphology of Vibrio coli phage". American Journal of Veterinary Research 26 (111): 361–4.
16. Fletcher, R. D.; Bertschinger, H. U. (2010). "A Method of Isolation ofVibrio colifrom Swine Fecal Material by Selective Filtration". Zentralblatt für Veterinarmedizin. Reihe B 11 (6): 469–74. doi:10.1111/j.1439-0450.1964.tb01075.x.
17. Connerton, P.L.; Timms, A.R.; Connerton, I.F. (2011). "Campylobacter bacteriophages and bacteriophage therapy". Journal of Applied Microbiology 111 (2): 255–65. doi:10.1111/j.1365-2672.2011.05012.x. PMID 21447013.
18. Humphrey, Tom; O'Brien, Sarah; Madsen, Mogens (2007). "Campylobacters as zoonotic pathogens: A food production perspective". International Journal of Food Microbiology 117 (3): 237–57. doi:10.1016/j.ijfoodmicro.2007.01.006. PMID 17368847.
19. "Infections from some foodborne germs increased, while others remained unchanged in 2012" (Press release). CDC. April 18, 2013. Retrieved October 22, 2015.
20. "Infections from some foodborne germs increased, while others remained unchanged in 2012". Centers for Disease Control. April 18, 2013. Retrieved April 19, 2013.
21. Jassim, S.S.; Malik, A.; Aldridge, A. (2011). "Small bowel perforation: an unusual cause". Grand Rounds 11 (1): 17–9. doi:10.1102/1470-5206.2011.0006.
22. Vukelic, Dalibor; Trkulja, Vladimir; Salkovic-Petrisic, Melita (2010). "Single Oral Dose of Azithromycin Versus 5 Days of Oral Erythromycin or No Antibiotic in Treatment of Campylobacter Enterocolitis in Children: A Prospective Randomized Assessor-Blind Study". Journal of Pediatric Gastroenterology and Nutrition 50 (4): 404–10. doi:10.1097/MPG.0b013e3181a87104. PMID 19881393.
23. Gendrel, D.; Cohen, R. (2008). "Diarrhées bactériennes et antibiotiques : les recommandations européennes" [Bacterial diarrheas and antibiotics: European recommendations]. Archives de Pédiatrie (in French) 15 (Suppl 2): S93–6. doi:10.1016/S0929-693X(08)74223-4. PMID 19000862.
24. Lehtopolku, M.; Nakari, U.-M.; Kotilainen, P.; Huovinen, P.; Siitonen, A.; Hakanen, A. J. (2010). "Antimicrobial Susceptibilities of Multidrug-Resistant Campylobacter jejuni and C. coli Strains: In Vitro Activities of 20 Antimicrobial Agents". Antimicrobial Agents and Chemotherapy 54 (3): 1232–6. doi:10.1128/AAC.00898-09. PMC 2825995. PMID 20038624.
25. "FSA warns that chicken bacteria could be next meat scandal". The Telegraph. January 23, 2013.
26. "Don't wash raw chicken". Food Standards Agency.
27. "Campylobacter survey: cumulative results from the full 12 months (Q1 - Q4)" (Press release). Food Standards Agency. May 28, 2015. Retrieved October 23, 2015.
28. Williams, Aretha; Oyarzabal, Omar A (2012). "Prevalence of Campylobacter spp. in skinless, boneless retail broiler meat from 2005 through 2011 in Alabama, USA". BMC Microbiology 12: 184. doi:10.1186/1471-2180-12-184. PMC 3490988. PMID 22920043.
29. Food Safety and Inspection Service (April 24, 2015). "Quarterly Progress Report on Salmonella and Campylobacter: Testing of Selected Raw Meat and Poultry Products: Preliminary Results, July 2014 to September 2014". United States Department of Agriculture.
30. Public Health Agency of Canada, FoodNet Canada

External links

• Campylobacter genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID
• Campylobacter info from the CDC
• Chicken, beams, and Campylobacter: rapid differentiation of foodborne bacteria via vibrational spectroscopy and MALDI-mass spectrometry