Campylobacter Jejuni

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Campylobacter Jejuni

Campylobacter jejuni is one of a family of bacteria known as Campylobacteriaceae that collectively are responsible for a significant number of reported cases of gastroenteritis in the UK. Gastrointestinal infection with Campylobacter spp. can produce significant long term sequelae, such as reactive arthritis and the neurological condition Guillain-Barre Syndrome. This report will give a brief overview of campylobacter jejuni with regard to its microbiology, and the identification and management of campylobacter infection. Campylobacters were recognised as a cause of human illness in the 1970s, but were probably first identified in humans by Escherich in 1886, who identified spiral shaped bacteria of the colons of children who had died from a condition he called “cholera infantum” (Escherisch 1886). Veterinary research at the beginning of the twentieth century identified similar bacteria in livestock, and the bacteria (termed at the time “vibrio” or “spirillium”) was implicated in a number of reported cases in both animals and humans throughout the mid-twentieth century (Butzler 2004). The key breakthrough was reported in 1972, when Dekeyser and Butzler were able to isolate the bacteria now known as campylobacter jejuni from the stool of an infected patient (Dekeyser 1972). Campylobacter spp. are classified as part of rRNA superfamily VI, a classification of bacteria that also includes Helicobacter and Arcobacter (Vandamme 1991). Campylobacters, and other members of the classification, are small, gram-negative bacteria that are specially adapted to colonise the surface of the mucous membranes of the digestive tract. This is reflected in the morphology of the bacteria, which has a spiral-shaped body with long unsheathed flagella at each tip. Consequently, Campylobacter are highly motile, and are able to tunnel through the mucous layer and colonise the membrane below, which is a key ability as they are highly susceptible to acidity. They are partially anaerobic, alongside other members of the classification, and undergo transformation to coccoid forms when exposed to adverse conditions (Moran 1987). Presently, 18 subspecies of Campylobacter have been identified and 11 of these are thought to be pathogenic in humans. By far the most common are campylobacter jejuni and campylobacter coli; together, these bacteria are a leading cause of diarrhoeal illness. Principal risk factors for infection with campylobacter jejuni include the consumption of undercooked meat, especially poultry, inadequately pasteurised milk, contaminated water and pets with diarrhoea (Gillespie 2008). There may be human-human transmission via the faeco-oral route if personal hygiene is unsatisfactory (Wilson 2008). There is an incubation period of around 3 days, though this can range from 1-7 days. There is occasionally a prodromal illness of fever, myalgia and headache lasting around 24 hours, and patients who present with the prodromal illness often have a more severe infection than those presenting with gastrointestinal symptoms (Minton 2004). The principal illness is characterised by colicky, periumbical abdominal pain, pyrexia (the fever may be as high as 40â?°C) and profuse diarrhoea, often with up to 10 bowel movements each day. The stool may be watery initially, and blood may appear in the stool as the infection progresses.

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