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''Campylobacter'' (meaning "curved bacteria") is a
genus Genus ( plural genera ) is a taxonomic rank used in the biological classification of extant taxon, living and fossil organisms as well as Virus classification#ICTV classification, viruses. In the hierarchy of biological classification, genus com ...
of
Gram-negative bacteria Gram-negative bacteria are bacteria that do not retain the crystal violet stain used in the Gram staining method of bacterial differentiation. They are characterized by their cell envelopes, which are composed of a thin peptidoglycan cell wall ...
. ''Campylobacter'' typically appear comma- or s-shaped, and are
motile Motility is the ability of an organism to move independently, using metabolic energy. Definitions Motility, the ability of an organism to move independently, using metabolic energy, can be contrasted with sessility, the state of organisms th ...
. Some ''Campylobacter'' species can infect humans, sometimes causing
campylobacteriosis Campylobacteriosis is an infection by the '' Campylobacter'' bacterium, most commonly ''C. jejuni''. It is among the most common bacterial infections of humans, often a foodborne illness. It produces an inflammatory, sometimes bloody, diarrhea or ...
, a diarrhoeal disease in humans. Campylobacteriosis is usually self-limiting and antimicrobial treatment is often not required, except in severe cases or immunocompromised patients. The most known source for ''Campylobacter'' is
poultry Poultry () are domesticated birds kept by humans for their eggs, their meat or their feathers. These birds are most typically members of the superorder Galloanserae (fowl), especially the order Galliformes (which includes chickens, quails, a ...
, but due to their diverse
natural reservoir In infectious disease ecology and epidemiology, a natural reservoir, also known as a disease reservoir or a reservoir of infection, is the population of organisms or the specific environment in which an infectious pathogen naturally lives and rep ...
, ''Campylobacter'' spp. can also be transmitted ''via'' water. Other known sources of ''Campylobacter'' infections include food products, such as unpasteurised milk and contaminated fresh produce. Sometimes the source of infection can be direct contact with infected animals, which often carry ''Campylobacter'' asymptomatically. At least a dozen species of ''Campylobacter'' have been implicated in human disease, with ''C. jejuni'' (80–90%) and '' C. coli'' (5-10%) being the most common. ''
C. jejuni ''Campylobacter jejuni'' () is a species of pathogenic bacteria, one of the most common causes of food poisoning in Europe and in the US. The vast majority of cases occur as isolated events, not as part of recognized outbreaks. Active surveillan ...
'' is recognized as one of the main causes of bacterial foodborne disease in many developed countries. It is the number one cause of bacterial gastroentritis in Europe, with over 246,000 cases confirmed annually. ''
C. jejuni ''Campylobacter jejuni'' () is a species of pathogenic bacteria, one of the most common causes of food poisoning in Europe and in the US. The vast majority of cases occur as isolated events, not as part of recognized outbreaks. Active surveillan ...
'' infection can also cause
bacteremia Bloodstream infections (BSIs), which include bacteremias when the infections are bacterial and fungemias when the infections are fungal, are infections present in the blood. Blood is normally a sterile environment, so the detection of microb ...
in immunocompromised people, while '' C. lari'' is a known cause of recurrent diarrhea in children. '' C. fetus'' can cause spontaneous abortions in
cattle Cattle (''Bos taurus'') are large, domesticated, cloven-hooved, herbivores. They are a prominent modern member of the subfamily Bovinae and the most widespread species of the genus ''Bos''. Adult females are referred to as cows and adult mal ...
and
sheep Sheep or domestic sheep (''Ovis aries'') are domesticated, ruminant mammals typically kept as livestock. Although the term ''sheep'' can apply to other species in the genus ''Ovis'', in everyday usage it almost always refers to domesticated s ...
, and is an
opportunistic pathogen An opportunistic infection is an infection caused by pathogens (bacteria, fungi, parasites or viruses) that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune ...
in humans.


Morphology and Phenotype

''Campylobacter'' spp. generally appear as curved or comma-shaped rods, and are able to move via unipolar or bipolar
flagella A flagellum (; ) is a hairlike appendage that protrudes from certain plant and animal sperm cells, and from a wide range of microorganisms to provide motility. Many protists with flagella are termed as flagellates. A microorganism may have f ...
. They grow best between 37–42 °C in a
microaerophilic A microaerophile is a microorganism that requires environments containing lower levels of dioxygen than that are present in the atmosphere (i.e. < 21% O2; typically 2–10% O2) for optimal growth. A more re ...
environment. When exposed to atmospheric oxygen, ''C. jejuni'' is able to change into a coccus form. Most species of ''Campylobacter'' are positive by the
oxidase test The oxidase test is used to determine if an organism possesses the cytochrome c oxidase enzyme. The test is used as an aid for the differentiation of ''Neisseria'', ''Moraxella'', '' Campylobacter'' and ''Pasteurella'' species (oxidase positive). I ...
and
catalase test Catalase is a common enzyme found in nearly all living organisms exposed to oxygen (such as bacteria, plants, and animals) which catalyzes the decomposition of hydrogen peroxide to water and oxygen. It is a very important enzyme in protecting t ...
and are able to reduce nitrate. The number of known
quinolone Quinolone may refer to: * 2-Quinolone * 4-Quinolone * Quinolone antibiotic A quinolone antibiotic is a member of a large group of broad-spectrum bacteriocidals that share a bicyclic core structure related to the substance 4-quinolone. They ...
-resistant ''Campylobacter'' strains is growing. It is suggested that this is caused by the overuse of quinolone antibiotics in animal agriculture.


History

Theodor Escherich Theodor Escherich (; 29 November 1857 – 15 February 1911) was a Germans, German-Austrians, Austrian pediatrics, pediatrician and a professor at universities in University of Graz, Graz and University of Vienna, Vienna. He discovered and de ...
was the first to describe in 1886 what are known today as ''Campylobacters'' in the stool samples of infants, who perished from a disease he named "cholera infantum". In the following years until the end of the century, a number of publications appeared, describing the occurrence of such "spirilla" in cases of "cholera-like" and "dysenteric" disease. These organisms were mainly found in the colon or associated with mucous in diarrhoeal stool specimens. ''Vibrio''-like bacteria were also described by Sir
John McFadyean Sir John McFadyean FRSE LLD (1853 - 1941) was a Scottish veterinary surgeon and Professor of Veterinary Science. He was Principal of (and a Professor at) the Royal Veterinary College from 1894 to 1927. In 1906 he was the first person to isolat ...
and Stockman in 1913 in fetal tissues of aborted sheep. For several years Campylobacters were continuously referred to as ‘‘Vibrio-like organisms’’, until 1963 when Sebald and Veron gave the name "''Campylobacter''" to the genus based on their shape and microaerophilic growth requirement and after showing significant biological differences with ''Vibrio'' species.


Genomics

The
genome In the fields of molecular biology and genetics, a genome is all the genetic information of an organism. It consists of nucleotide sequences of DNA (or RNA in RNA viruses). The nuclear genome includes protein-coding genes and non-coding ge ...
s of several ''Campylobacter'' species have been sequenced, beginning with ''C. jejuni'' in 2000. These genome studies have identified molecular markers specific to members of ''Campylobacter''. ''Campylobacter'' ssp. genomes are rather small compared to those of other gastrointestinal pathogens, with sizes ranging between 1.60 and 1.90 Mbp. A characteristic of most ''Campylobacter'' genomes is the presence of
hypervariable region A hypervariable region (HVR) is a location within nuclear DNA or the D-loop of mitochondrial DNA in which base pairs of nucleotides repeat (in the case of nuclear DNA) or have substitutions (in the case of mitochondrial DNA). Changes or repeats in ...
s, which can differ greatly between different strains. Studies have investigated the genes responsible for motility in ''Campylobacter'' species. Some ''Campylobacter'' species contain two
flagellin Flagellin is a globular protein that arranges itself in a hollow cylinder to form the filament in a bacterial flagellum. It has a mass of about 30,000 to 60,000 daltons. Flagellin is the principal component of bacterial flagella, and is present ...
genes in tandem for motility, ''flaA'' and ''flaB''. These genes undergo
intergenic An intergenic region is a stretch of DNA sequences located between genes. Intergenic regions may contain functional elements and Non-coding DNA#Junk DNA , junk DNA. ''Inter''genic regions should not be confused with ''intra''genic regions (or int ...
recombination, further contributing to their virulence. A single
Type VI secretion system The type VI secretion system (T6SS) is molecular machine used by a wide range of Gram-negative bacterial species to transport effectors from the interior (cytoplasm or cytosol) of a bacterial cell across the cellular envelope into an adjacent targe ...
(T6SS) cluster was also predicted in approximately one-third of ''Campylobacter'' species, grouping into three distinct organisations and harbouring up to five ''vgrG'' genes.


Bacteriophage

The confusing taxonomy of ''Campylobacter'' over the past decades makes identifying the earliest reports of ''Campylobacter''
bacteriophage A bacteriophage (), also known informally as a ''phage'' (), is a duplodnaviria virus that infects and replicates within bacteria and archaea. The term was derived from "bacteria" and the Greek φαγεῖν ('), meaning "to devour". Bacteri ...
s difficult. Bacteriophages specific to the species now known as ''C. coli'' and ''C. fetus ''(previously ''Vibrio coli'' and ''V. fetus''), were first isolated from cattle and pigs during the 1960s, and ''Campylobacter''
bacteriophage therapy Phage therapy, viral phage therapy, or phagotherapy is the therapeutic use of bacteriophages for the treatment of pathogenic bacterial infections. This therapeutic approach emerged at the beginning of the 20th century but was progressively r ...
is an ongoing area of research in the age of bacterial antibiotic resistance.


Pathogenesis

''Campylobacter'' can cause a gastrointestinal infection, campylobacteriosis. The incubation period is 24–72 hours after infection. This is characterized by an inflammatory, sometimes bloody
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...
or
dysentery Dysentery (UK pronunciation: , US: ), historically known as the bloody flux, is a type of gastroenteritis that results in bloody diarrhea. Other symptoms may include fever, abdominal pain, and a feeling of incomplete defecation. Complications ...
syndrome, mostly including cramps, fever, and pain. 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. ''Campylobacter'' is sensitive to the stomach's normal production of
hydrochloric acid Hydrochloric acid, also known as muriatic acid, is an aqueous solution of hydrogen chloride. It is a colorless solution with a distinctive pungent smell. It is classified as a strong acid Acid strength is the tendency of an acid, symbol ...
: as a result, the
infectious dose The concept of minimal infective dose (MID) has traditionally been used for infectious bacteria that contaminate foods. MID was defined as the number of bacteria ingested (the dose) from which a pathology is observed in the consumer. Examples such ...
is relatively high, and the bacteria rarely cause illness when a person is exposed to less than 10,000 organisms. Nevertheless, people taking antacid medication (e. g. people with
gastritis Gastritis is inflammation of the lining of the stomach. It may occur as a short episode or may be of a long duration. There may be no symptoms but, when symptoms are present, the most common is upper abdominal pain (see dyspepsia). Other possi ...
or
stomach ulcers Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines ...
) are at higher risk of contracting disease from a smaller number of organisms, since this type of medication neutralizes normal
gastric acid Gastric acid, gastric juice, or stomach acid is a digestive fluid formed within the stomach lining. With a pH between 1 and 3, gastric acid plays a key role in digestion of proteins by activating digestive enzymes, which together break down the ...
. In humans, the sites of tissue injury include the
jejunum The jejunum is the second part of the small intestine in humans and most higher vertebrates, including mammals, reptiles, and birds. Its lining is specialised for the absorption by enterocytes of small nutrient molecules which have been previous ...
, the
ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine ma ...
, and the colon. Most strains of ''C jejuni'' produce
cytolethal distending toxin Cytolethal distending toxins (abbreviated CDTs) are a class of hetero trimeric toxins produced by certain gram-negative bacteria that display DNase activity. These toxins trigger G2/M cell cycle arrest in specific mammalian cell lines, leading ...
, which inhibits cell division and impedes activation of the immune system. This helps the bacteria to evade the immune system and survive for a limited time inside intestinal cells . ''Campylobacter'' has, on rare occasions, been suggested to cause
hemolytic uremic syndrome Hemolysis or haemolysis (), also known by several other names, is the rupturing ( lysis) of red blood cells (erythrocytes) and the release of their contents (cytoplasm) into surrounding fluid (e.g. blood plasma). Hemolysis may occur in vivo ...
and
thrombotic thrombocytopenic purpura Thrombotic thrombocytopenic purpura (TTP) is a blood disorder that results in blood clots forming in small blood vessels throughout the body. This results in a low platelet count, low red blood cells due to their breakdown, and often kidney, h ...
, though no unequivocal case reports exist . In some cases, a ''Campylobacter'' infection can be the underlying cause of
Guillain–Barré syndrome Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation or pain often ...
.
Gastrointestinal perforation Gastrointestinal perforation, also known as ruptured bowel, is a hole in the wall of part of the gastrointestinal tract. The gastrointestinal tract includes the esophagus, stomach, small intestine, and large intestine. Symptoms include severe ab ...
is a rare complication of ileal infection. ''Campylobacter'' has also been associated with
periodontitis Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main caus ...
.


Detection

Campylobacter testing needs to be done to manage the risk of foodborne ''Campylobacter'' and reducing the level of foodborne ''Campoboteriosis'', to protect people and to determine if a person is infected with ''Campylobacter.''


In humans

Usually, detection of ''Campylobacter'' in humans is done by laboratory culturing a stool sample or swab of the rectum collected by a healthcare provider. Results take about 48–72 hours for preliminary results. Confirmation test and testing to determine the species of Campylobacter or drug sensitivities of the organism require additional time.


In livestock

Usually, detection of Campylobacter in livestock is done by laboratory culturing a faecal sample. Results take about 48–72 hours.


In meat

Usually, detection of Campylobacter in meat is done by laboratory culturing a homogenised sample. Results takes about 48–72 hours.


Treatment

The infection is usually self-limiting and, in most cases, symptomatic treatment by liquid and electrolyte replacement is sufficient to treat human infections. Symptoms typically last 5–7 days. Treatment with antibiotics has only a minor effect on the typical duration of the infection in non-complex cases, and is discouraged except in high-risk patients. Diagnosis of campylobacteriosis is made by testing a fecal specimen. Standard treatment in high-risk cases is
azithromycin Azithromycin, sold under the brand names Zithromax (in oral form) and Azasite (as an eye drop), is an antibiotic medication used for the treatment of a number of bacterial infections. This includes middle ear infections, strep throat, pneumon ...
, a
macrolide The Macrolides are a class of natural products that consist of a large macrocyclic lactone ring to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. The lactone rings are usually 14-, 15-, or 16-membered. Macrol ...
antibiotic, especially for ''Campylobacter'' infections in children, although other antibiotics, such as quinolones, tetracycline and other macrolides are sometimes used to treat gastrointestinal ''Campylobacter'' infections in adults. In case of systemic infection, other bactericidal antibiotics are used, such as
ampicillin Ampicillin is an antibiotic used to prevent and treat a number of bacterial infections, such as respiratory tract infections, urinary tract infections, meningitis, salmonellosis, and endocarditis. It may also be used to prevent group B strepto ...
,
amoxicillin/clavulanic acid Amoxicillin/clavulanic acid, also known as co-amoxiclav or amox-clav, sold under the brand name Augmentin, among others, is an antibiotic medication used for the treatment of a number of bacterial infections. It is a combination consisting of a ...
, or
aminoglycoside Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside (sugar). The term can also refer ...
s.
Fluoroquinolone A quinolone antibiotic is a member of a large group of broad-spectrum bacteriocidals that share a bicyclic core structure related to the substance 4-quinolone. They are used in human and veterinary medicine to treat bacterial infections, as wel ...
antibiotics, such as
ciprofloxacin Ciprofloxacin is a fluoroquinolone antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra abdominal infections, certain types of infectious diarrhea, respiratory tract infections, skin infec ...
or
levofloxacin Levofloxacin, sold under the brand name Levaquin among others, is an antibiotic medication. It is used to treat a number of bacterial infections including acute bacterial sinusitis, pneumonia, H. pylori (in combination with other medications), ...
, may no longer be effective in some cases, due to resistance. In addition to antibiotics, dehydrated children may require intravenous fluid treatment in a hospital.


Epidemiology


United Kingdom

In January 2013, the UK's
Food Standards Agency , type = Non-ministerial government department , nativename = , nativename_a = , nativename_r = , logo = Food Standards Agency.svg , logo_width = , logo_caption = , seal = , seal_width = , seal_caption = , picture = , picture_width = , ...
(FSA) 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 of them. In June 2014, the FSA started a campaign against washing raw chicken, as washing can spread germs onto clean surfaces by splashing. In May 2015, cumulative results for samples taken from fresh chickens between February 2014 and February 2015 were published by the FSA and showed 73% of chickens tested positive for the presence of ''Campylobacter''.


United States

''Campylobacter'' infections increased 14% in the United States in 2012 compared to the rate from 2006 to 2008. This represents the highest reported number of infections since calendar year 2000. High prevalence of ''Campylobacter'' (40% or more) has been reported in raw chicken meat in regional retail stores in the US, which remained steady from 2005 through 2011. The last
USDA The United States Department of Agriculture (USDA) is the federal executive department responsible for developing and executing federal laws related to farming, forestry, rural economic development, and food. It aims to meet the needs of com ...
quarterly progress report on ''Salmonella'' and ''Campylobacter'' testing of meat and poultry, for July–September 2014, showed 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).


Canada

FoodNet Canada has reported that ''Campylobacter'' was the most common pathogen found on packaged chicken breast, with nearly half of all samples testing positive. Additionally, ''Campylobacter'' and ''Salmonella'' were the most common causes of gastrointestinal illness in Canada.


New Zealand

In August 2016, an estimated 8,000+ residents of
Havelock North Havelock North ( mi, Te Hemo-a-Te Atonga) is a town in the Hawke's Bay region of the North Island of New Zealand, situated less than 2 km south-east of the city of Hastings. It was a borough for many years until the 1989 reorganisation of local ...
, a town with around 13,000 residents, had gastric illness after the water supply was thought to be contaminated by ''Campylobacter''.


Norway

In June 2019, an estimated 2,000 residents of
Askøy Askøy is a municipality in Vestland county, Norway. The island municipality is located in the Midhordland district of the county, sitting in a large group of islands immediately northwest of the city of Bergen. The administrative centre of the ...
municipality got sick due to the presence of ''C. jejuni'' in the water supply. Two deaths were connected to the outbreak, and it was the largest outbreak of ''Campylobacter'' in Norway. The suspected source of the contamination was thought to be horse faeces, which leaked into a drinking water pool. A ''C. jejuni'' water isolate thought to be the cause of the outbreak was examined with human isolates, and showed the highest pathogenic potential in vitro, transcriptomic and genomic investigations. This could suggest why the isolate was able to cause an outbreak.


Sweden

During the period of August 2016 to June 2017 there was a large outbreak of ''C. jejuni'' in Sweden. It was the largest outbreak that has been reported so far. 5000 more cases than would be expected during this period were reported to the authorities. The source of the outbreak was contaminated chicken meat that came from the same producer. The reason for the increased incidence and elevated levels of ''Campylobacter'' was reported to be an improperly installed washing plant, where dirty water was accidentally used to wash transport cages.


See also

*
Helicobacter ''Helicobacter'' is a genus of Gram-negative bacteria possessing a characteristic helical shape. They were initially considered to be members of the genus '' Campylobacter'', but in 1989, Goodwin ''et al.'' published sufficient reasons to justif ...


References


External links


Campylobacter
genomes and related information a
PATRIC
a Bioinformatics Resource Center funded b
NIAID

''Campylobacter'' info from the CDC
{{Authority control Bacteria genera Campylobacterota Capnophiles Food microbiology