Campylobacter jejuni (/ˈkæmpɪloʊˌbæktər dʒəˈdʒuːni/) is
one of the most common causes of food poisoning in the United States
and in Europe. The vast majority of cases occur as isolated events,
not as part of recognized outbreaks. Active surveillance through
the Foodborne Diseases Active Surveillance Network (FoodNet) indicates
that about 14 cases are diagnosed each year for each 100,000 persons
in the population. The
European Food Safety Authority
European Food Safety Authority estimated in
2011 that there are approximately nine million cases of human
campylobacteriosis per year in the European Union. Campylobacter
jejuni is in a genus of bacteria that is among the most common causes
of bacterial infections in humans worldwide.
"curved rod", deriving from the Greek campylos (curved) and baktron
(rod). It has been noted that there "is wide diversity in the genus.
The species are metabolically and genetically different to the extent
that one can question whether one genus is adequate to house all of
the species." Of its many species, C. jejuni is considered one of the
most important from both a microbiological and public health
C. jejuni is also commonly found in animal feces.
Campylobacter is a
helical-shaped, nonspore-forming, Gram-negative, microaerophilic,
nonfermenting bacterium forming motile rods with a single polar
flagellum, which are also oxidase-positive and grow optimally at 37 to
42 °C. When exposed to atmospheric oxygen, C. jejuni
is able to change into a coccal form. This species of pathogenic
bacteria is one of the most common causes of human gastroenteritis in
Food poisoning caused by
Campylobacter species can be
severely debilitating, but is rarely life-threatening. It has been
linked with subsequent development of Guillain–Barré syndrome,
which usually develops two to three weeks after the initial
illness. Individuals with recent C. jejuni infections develop
Guillain-Barré syndrome at a rate of 0.3 per 1000 infections, about
100 times more often than the general population.
5 Possible complications
6.1.1 United States
10 Natural genetic transformation
11 Laboratory characteristics
13 External links
In 1886 a pediatrician, Theodor Escherich, observed Campylobacters
from diarrhea samples of children. The first isolation of C.
jejuni was in Brussels, Belgium, from stool samples of a patient with
Campylobacteriosis is an infectious disease caused by bacteria of the
genus Campylobacter. In most people who become ill with
campylobacteriosis, symptoms develop within two to five days of
exposure to the organism and illness typically lasts seven days
Infection with C. jejuni usually results in
enteritis, which is characterised by abdominal pain, diarrhea, fever,
Diarrhea itself can vary in severity from loose to bloody
stools. The disease is usually self-limiting. However, it does respond
to antibiotics. Severe (accompanying fevers, blood in stools) or
prolonged cases may require erythromycin, azithromycin, ciprofloxacin,
or norfloxacin. Fluid replacement via Oral Rehydration Salts may be
needed and intravenous fluid may be required for serious cases.
Studies on the pathogenesis of C. jejuni show that for this organism
to cause disease, the susceptibility of the host and the relative
virulence of the infecting strain are both important. Infection
results from the ingestion of contaminated food or water, and the
infective dose can be as low as 800 organisms. To initiate infection,
the organism must penetrate the gastrointestinal mucus, which it does
using its high motility and spiral shape. The bacteria must then
adhere to the gut enterocytes and can then induce diarrhea by toxin
release. C. jejuni releases several different toxins, mainly
enterotoxin and cytotoxins, which vary from strain to strain and
correlate with the severity of the enteritis. During infection, levels
of all immunoglobulin classes rise. Of these, IgA is the most
important because it can cross the gut wall. IgA immobilises
organisms, causing them to aggregate and activate complement, and also
gives short-term immunity against the infecting strain of
organism. The bacteria colonize the small and large intestines,
causing inflammatory diarrhea with fever. Stools contain leukocytes
and blood. The role of toxins in pathogenesis is unclear. C jejuni
antigens that cross-react with one or more neural structures may be
responsible for triggering the Guillain–Barré syndrome.
C. jejuni is commonly associated with poultry, and it naturally
colonises the digestive tract of many bird species. All types of
poultry and wild birds can become colonized with Campylobacter. One
study found that 30% of European starlings in farm settings in
Oxfordshire, United Kingdom, were carriers of C. jejuni. It is also
common in cattle, and although it is normally a harmless commensal of
the gastrointestinal tract in these animals, it can cause
campylobacteriosis in calves. It has also been isolated from wombat
and kangaroo feces, being a cause of bushwalkers' diarrhea.
Contaminated drinking water and unpasteurized milk provide an
efficient means for distribution. Contaminated food is a major source
of isolated infections, with incorrectly prepared meat and poultry as
the primary source of the bacteria. Moreover, surveys show that 20
to 100% of retail chickens are contaminated. This is not overly
surprising, since many healthy chickens carry these bacteria in their
intestinal tracts. Raw milk is also a source of infections. The
bacteria are often carried by healthy cattle and by flies on farms.
Unchlorinated water may also be a source of infections. However,
properly cooking chicken, pasteurizing milk, and chlorinating drinking
water kill the bacteria.
Campylobacter is not, in contrast to
Salmonella, transmitted vertically and therefore humans do not get
infected by consuming eggs.
Local complications of
Campylobacter infections occur as a result of
direct spread from the gastrointestinal tract and can include
cholecystitis, pancreatitis, peritonitis, and massive gastrointestinal
hemorrhage. Extraintestinal manifestations of
are quite rare and may include meningitis, endocarditis, septic
arthritis, osteomyelitis, and neonatal sepsis. Bacteremia is detected
in <1% of patients with
Campylobacter enteritis and is most likely
to occur in patients who are immunocompromised or among the very young
or very old. Transient bacteremia in immunocompetent hosts with C.
jejuni enteritis may be more common, but not detected because most
strains are rapidly cleared by the killing action of normal human
serum and because blood cultures are not routinely performed for
patients with acute gastrointestinal illness.
Serious systemic illness caused by
Campylobacter infection rarely
occurs, but can lead to sepsis and death. The case-fatality rate for
Campylobacter infection is 0.05 per 1000 infections. For instance, one
major possible complication that C. jejuni can cause is
Guillain–Barré syndrome, which induces neuromuscular paralysis in a
sizeable percentage of those who suffer from it. Over time, the
paralysis is typically reversible to some extent; nonetheless, about
20% of patients with GBS are left disabled, and around 5% die. Another
chronic condition that may be associated with
is what was formerly known as Reiter's syndrome, a form of reactive
Reactive arthritis is a complication strongly
associated with a particular genetic make-up. That is, persons who
have the human lymphocyte antigen B27 (HLA-B27) are most susceptible.
Most often, the symptoms of reactive arthritis will occur up to
several weeks after infection.
An estimated 2 million cases of
Campylobacter enteritis occur
annually, accounting for 5–7% of cases of gastroenteritis.
Campylobacter organisms have a large animal reservoir, with up to 100%
of poultry, including chickens, turkeys, and waterfowl, having
asymptomatic intestinal infections. The major reservoirs of C. fetus
are cattle and sheep. Nonetheless, the incidence of Campylobacter
infections has been declining. Changes in the incidence of
Campylobacter infections have been monitored by the
Foodborne Diseases Active Surveillance Network (FoodNet) since 1996.
Campylobacter incidence showed a 27% decrease compared with
1996–1998. In 2010, the incidence was 13.6 cases per 100,000
population, and this did not change significantly compared with
C. jejuni infections are extremely common worldwide, although exact
figures are not available. New Zealand reported the highest national
campylobacteriosis rate, which peaked in May 2006 at 400 per 100,000
Campylobacter organisms are isolated more frequently from males than
females. Homosexual men appear to be at increased risk for infection
Campylobacter species such as
Helicobacter cinaedi and
Campylobacter infections can occur in all age groups. Studies show a
peak incidence in children younger than 1 year and in persons aged
15–29 years. The age-specific attack rate is highest in young
children. In the United States, the highest incidence of Campylobacter
infection in 2010 was in children younger than 5 years and was 24.4
cases per 100,000 population, However, the rate of fecal cultures
Campylobacter species is greatest in adults and older
Campylobacter infection should drink plenty of fluids as
long as the diarrhea lasts to maintain hydration. One must drink
plenty of fluids and get rest. If he or she cannot drink enough fluids
to prevent dehydration or if the symptoms are severe, medical help is
indicated. In more severe cases, certain antibiotics can be used and
can shorten the duration of symptoms if given early in the illness.
Moreover, maintenance of electrolyte balance, not antibiotic
treatment, is the cornerstone of treatment for Campylobacter
enteritis. Indeed, most patients with this infection have a
self-limited illness and do not require antibiotics at all.
Nevertheless, antibiotics should be used in specific clinical
circumstances. These include high fevers, bloody stools, prolonged
illness (symptoms that last >1 week), pregnancy, infection with
HIV, and other immunocompromised states.
Some simple food-handling practices can help prevent Campylobacter
Cook all poultry products thoroughly. Make sure that the meat is
cooked throughout (no longer pink) and any juices run clear. All
poultry should be cooked to reach a minimum internal temperature of
165 °F (74 °C).
Wash hands with soap before preparing food.
Wash hands with soap after handling raw foods of animal origin and
before touching anything else.
Prevent cross-contamination in the kitchen by using separate cutting
boards for foods of animal origin and other foods and by thoroughly
cleaning all cutting boards, countertops, and utensils with soap and
hot water after preparing raw food of animal origin.
Do not drink unpasteurized milk or untreated surface water.
Make sure that people with diarrhea, especially children, wash their
hands carefully and frequently with soap to reduce the risk of
spreading the infection.
Wash hands with soap after contact with pet feces.
The genome of C. jejuni strain NCTC11168 was published in 2000,
revealing 1,641,481 base pairs (30.6% G+C) predicted to encode 1,654
proteins and 54 stable
RNA species. The genome is unusual in that
virtually no insertion sequences or phage-associated sequences and
very few repeat sequences are found. One of the most striking findings
in the genome was the presence of hypervariable sequences. These short
homopolymeric runs of nucleotides were commonly found in genes
encoding the biosynthesis or modification of surface structures, or in
closely linked genes of unknown function. The apparently high rate of
variation of these homopolymeric tracts may be important in the
survival strategy of C. jejuni.
Initial transposon mutagenesis screens revealed 195 essential genes,
although this number is likely to go up with additional analysis.
Natural genetic transformation
C. jejuni is naturally competent for genetic transformation.
Natural genetic transformation is a sexual process involving DNA
transfer from one bacterium to another through the intervening medium,
and the integration of the donor sequence into the recipient genome by
homologous recombination. C. jejuni freely takes up foreign DNA
harboring genetic information responsible for antibiotic
Antibiotic resistance genes are more frequently
transferred in biofilms than between planktonic cells (single cells
that float in liquid media).
Growth at 25 °C
Growth at 35–37 °C
Growth at 42 °C
Growth on MacConkey agar
Motility (wet mount)
Resistance to nalidixic acid
Resistance to cephalothin
Scanning electron micrograph depicting a number of Campylobacter
Under light microscopy, C. jejuni has a characteristic "sea-gull"
shape as a consequence of its helical form.
Campylobacter is grown on
specially selective "CAMP" agar plates at 42 °C, the normal
avian body temperature, rather than at 37 °C, the temperature at
which most other pathogenic bacteria are grown. Since the colonies are
oxidase positive, they usually only grow in scanty amounts on the
Microaerophilic conditions are required for luxurious growth.
A selective blood agar medium (Skirrow's medium) can be used. Greater
selectivity can be gained with an infusion of a cocktail of
antibiotics: vancomycin, polymixin-B, trimethoprim, and actidione
([Preston's agar]), and growth under microaerophilic conditions at
^ a b c d Foodsafety.gov. "Campylobacter". www.foodsafety.gov.
^ a b c d e "Food Safety: Campylobacter". U.S. Centers for Disease
Control and Prevention. Retrieved 2016-04-18.
^ EFSA Panel on Biological Hazards (BIOHAZ) (2011-04-01). "Scientific
Campylobacter in broiler meat production: control options
and performance objectives and/or targets at different stages of the
food chain". EFSA Journal. 9 (4): n/a–n/a.
doi:10.2903/j.efsa.2011.2105. ISSN 1831-4732.
^ a b "
Campylobacter Food Poisoning".
www.about-campylobacter.com. Retrieved 2016-04-18.
^ Ryan KJ, Ray CG, eds. (2004). Sherris Medical Microbiology (4th
ed.). McGraw Hill. ISBN 0-8385-8529-9.
^ Online Bacteriological Analytical Manual, Chapter 7: Campylobacter
^ Gorbach, Sherwood L.; Falagas, Matthew, eds. (2001). The 5 minute
infectious diseases consult (1st ed.). Lippincott Williams &
Wilkins. ISBN 0-683-30736-3. "Multiple
Sequenced". 2005-01-04. Retrieved 2007-07-27.
^ a b Perez-Perez, Guillermo I.; Blaser, Martin J. (1996-01-01).
Baron, Samuel, ed.
Campylobacter and Helicobacter (4th ed.). Galveston
(TX): University of Texas Medical Branch at Galveston.
ISBN 0963117211. PMID 21413331.
^ Crushell, Ellen; Harty, Sinead; Sharif, Farhana; Bourke, Billy
(2004-01-01). "Enteric Campylobacter: Purging Its Secrets?". Pediatric
Research. 55 (1): 3–12. doi:10.1203/01.PDR.0000099794.06260.71.
^ Fujimoto, S; Amako, K (1990). "
Guillain–Barré syndrome and
Campylobacter jejuni infection". Lancet. 335: 1350.
^ McCarthy, N.; Giesecke, J. (2001-03-15). "Incidence of
Guillain-Barré syndrome following infection with Campylobacter
jejuni". American Journal of Epidemiology. 153 (6): 610–614.
doi:10.1093/aje/153.6.610. ISSN 0002-9262.
^ a b Altekruse, Sean. "
Campylobacter jejuni—An Emerging Foodborne
Pathogen". Emerging Infectious Diseases. 5 (1): 28–35.
doi:10.3201/eid0501.990104. PMC 2627687 .
^ Wallis, M. R. (1994-03-01). "The pathogenesis of Campylobacter
jejuni". British Journal of Biomedical Science. 51 (1): 57–64.
ISSN 0967-4845. PMID 7841837.
^ F M Colles, N D McCarthy, J C Howe, C L Devereux, A G Gosler, and M
C J Maiden Dynamics of
Campylobacter colonization of a natural host,
Sturnus vulgaris (European Starling) Environ Microbiol. 2009 January;
11(1): 258–267. doi:10.1111/j.1462-2920.2008.01773.x.
^ Nutrition, Center for Food Safety and Applied. "Bad Bug Book - BBB -
Campylobacter jejuni". www.fda.gov. Retrieved 2016-04-18.
^ Skirrow, MB; Jones, DM; Sutcliffe, E; Benjamin, J (1993).
Campylobacter bacteraemia in England and Wales, 1981–1991".
Epidemiol Infect. 110: 567–73. doi:10.1017/s0950268800050986.
^ "What is Reactive Arthritis?". Reactive Arthritis.
^ a b Acheson, David; Allos, Ban Mishu (2001-04-15). "Campylobacter
jejuni Infections: Update on Emerging Issues and Trends". Clinical
Infectious Diseases. 32 (8): 1201–1206. doi:10.1086/319760.
ISSN 1058-4838. PMID 11283810.
^ Jennifer Lynn Bonheur. BS Anand, ed. "Bacterial Gastroenteritis".
^ a b c d "
Campylobacter Infections: Background, Pathophysiology,
^ 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.
^ Stahl, M; Stintzi, A (2011). "Identification of essential genes in
C. Jejuni genome highlights hyper-variable plasticity regions".
Functional & Integrative Genomics. 11 (2): 241–57.
doi:10.1007/s10142-011-0214-7. PMID 21344305.
^ a b Bae J, Oh E, Jeon B (2014). "Enhanced transmission of antibiotic
Campylobacter jejuni biofilms by natural
transformation". Antimicrob. Agents Chemother. 58 (12): 7573–5.
doi:10.1128/AAC.04066-14. PMC 4249540 .
^ FJ Bolton; L Robertson (1982). "A selective medium for isolating
Campylobacter jejuni/coli" (pdf). J Clin Pathol. 35: 462–476.
Campylobacter jejuni genomes and related information at PATRIC, a
Bioinformatics Resource Center funded by NIAID
Current research on
Campylobacter jejuni at the Norwich Research Park
Type strain of
Campylobacter jejuni at
BacDive - the Bacterial
Bacterial disease: Proteobacterial G−
primarily A00–A79, 001–041, 080–109
Epidemic typhus, Brill–Zinsser disease, Flying squirrel typhus
Rocky Mountain spotted fever
Japanese spotted fever
North Asian tick typhus
Queensland tick typhus
Flinders Island spotted fever
African tick bite fever
American tick bite fever
Rickettsia aeschlimannii infection
Flea-borne spotted fever
Ehrlichiosis: Anaplasma phagocytophilum
Human granulocytic anaplasmosis, Anaplasmosis
Human monocytotropic ehrlichiosis
Ehrlichiosis ewingii infection
Bartonellosis: Bartonella henselae
Either B. henselae or B. quintana
Carrion's disease, Verruga peruana
Meningococcal disease, Waterhouse–Friderichsen syndrome,
Eikenella corrodens/Kingella kingae
Burkholderia cepacia complex
Bordetella pertussis/Bordetella parapertussis
Rhinoscleroma, Klebsiella pneumonia
Escherichia coli: Enterotoxigenic
Enterobacter aerogenes/Enterobacter cloacae
Citrobacter koseri/Citrobacter freundii
Typhoid fever, Paratyphoid fever, Salmonellosis
Shigellosis, Bacillary dysentery
Proteus mirabilis/Proteus vulgaris
Far East scarlet-like fever
Brazilian purpuric fever
Legionella pneumophila/Legionella longbeachae
Aeromonas hydrophila/Aeromonas veronii
Campylobacteriosis, Guillain–Barré syndrome
Peptic ulcer, MALT lymphoma, Gastric cancer
Adulterants, food contaminants
Mercury in fish
Monosodium glutamate (MSG)
High-fructose corn syrup
Escherichia coli O104:H4
Escherichia coli O157:H7
Parasitic infections through food
Ethylenediaminetetraacetic acid (EDTA)
Toxins, poisons, environment pollution
Arsenic contamination of groundwater
Benzene in soft drinks
Food contamination incidents
Swill milk scandal
1858 Bradford sweets poisoning
1900 English beer poisoning
Morinaga Milk arsenic poisoning incident
1971 Iraq poison grain disaster
Toxic oil syndrome
1993 Jack in the Box E. coli outbreak
1996 Odwalla E. coli outbreak
2006 North American E. coli outbreaks
ICA meat repackaging controversy
2008 Canada listeriosis outbreak
2008 Chinese milk scandal
2008 Irish pork crisis
2008 United States salmonellosis outbreak
2011 Germany E. coli outbreak
2011 Taiwan food scandal
2011 United States listeriosis outbreak
2013 Bihar school meal poisoning
2013 horse meat scandal
2013 Taiwan food scandal
2014 Taiwan food scandal
2017 Brazil weak meat scandal
2017–18 South African listeriosis outbreak
Food safety incidents in China
Regulation, standards, watchdogs
Acceptable daily intake
Food labeling regulations
Food libel laws
International Food Safety Network
Quality Assurance International
Centre for Food Safety
European Food Safety Authority
Institute for Food Safety and Health
International Food Safety Network
Ministry of Food and Drug Safety