under the microscope
By Rodney E . Rohde , PhD , MS , SM ( ASCP ) CM SVCM , MBCM , FACSc
Let ’ s Go Campy ( ing )
According to the most recent 2019 CDC publication , Antibiotic Resistance ( AR ) Threats in the United States , Campylobacter causes an estimated 1.5 million infections and $ 270 million in direct medical costs every year . Of those infections , 29 percent have decreased susceptibility to fluoroquinolones ( e . g ., ciprofloxacin ) or macrolides ( e . g ., azithromycin ), the antibiotics used to treat severe Campylobacter infections . CDC ranks AR threats from high to low as urgent , serious , concerning and watched . Campylobacter currently sits in the serious threat rank .
Campylobacter ( meaning “ curved bacteria ”) is a genus of Gram-negative bacteria . These bacteria typically appear as comma- or S-shaped and are motile . The genus is pronounced as cam · pylo · bac · ter | ( kam-pi-lō-ˈbak-tər ). Some species can infect humans , sometimes causing campylobacteriosis , a diarrheal disease in humans . In many instances , these infections are self-limiting and do not require treatment unless one is immunocompromised . However , there is a growing issue of antibiotic resistance with this genus . There are about a dozen known Campylobacter spp . implicated in human disease . The primary human pathogens are C . jejuni (~ 80 percent to 90 percent ) and C . coli (~ 5 percent to 10 percent ) which are the most common .
Campylobacter causes an estimated 1.5 million illnesses each year in the United States . People can get this infection by eating raw or undercooked poultry or eating something that touched it . The most known source for Campylobacter is poultry . However , due to its large and diverse natural reservoir , the infection can also occur from eating other foods , including seafood , meat , and produce , by contact with animals , and by drinking untreated water . Sources of infection can also be direct contact with infected animals ( e . g . chickens ), which often carry Campylobacter asymptomatically . C . jejuni leads the cause of bacterial foodborne disease in many developed countries , including Europe and the United States .
In this article , I will introduce Campylobacter and information aimed at a general understanding of the characteristics of this pathogen in the environment . Primarily , I will utilize information obtained from the Centers for Disease Control and Prevention along with professional experience .
How does one prevent infection ? Since Campylobacter spp . are found in such a large and diverse number of environments , including animal reservoirs there are a number of public health measures one should follow to prevent infection .
● Wash your hands !
● Keep certain foods separated ; especially keep raw poultry away from other foods . Use separate cutting boards and clean them properly .
● Cook food properly , especially poultry ( minimum internal temperature of 165 ° F ). It is one of the top causes of Campylobacter illnesses in the United States . Poultry includes chicken , turkey , duck , goose , and other farmed birds .
● Drink pasteurized milk ( raw milk can carry Campylobacter and other harmful germs that can make you very sick ).
● Do not drink untreated water .
● Be careful with pets and livestock since they can carry Campylobacter and other germs .
Can an outbreak occur with this bacteria ? Outbreaks are not commonly reported , considering how often people get sick from this bacterium , but the frequency has been increasing . Typically , poultry , raw milk , and untreated water have been the most commonly identified sources .
●In a very recent example of an outbreak , CDC and public health officials in several states are investigating a multistate outbreak of multidrug-resistant Campylobacter jejuni infections linked to puppies purchased from pet stores . To date , 30 people infected with the outbreak strain of Campylobacter jejuni , which causes diarrheal illness , have been reported from 13 states . Four hospitalizations have been reported and currently there has been no mortality .
●Epidemiologic and laboratory evidence indicate that contact with puppies , especially those at pet stores , is the likely source of this outbreak .
●Campylobacter bacteria isolated from clinical samples from ill people in this outbreak are resistant to commonly recommended , first-line antibiotics .
How is this organism diagnosed and what are the typical treatment options ?
Campylobacter infection is diagnosed when a laboratory test detects Campylobacter bacteria in stool , body tissue , or fluids . The test could be a culture that isolates the bacteria or a rapid diagnostic test that detects genetic material of the bacteria ( e . g . PCR testing ). Sometimes a direct examination of a stool sample using contrast microscopy or Gram ’ s strain provides for a rapid presumptive diagnosis that
• Campylobacter causes an estimated
1.5 million illnesses each year in the United States .
• People can get this infection by eating raw or undercooked poultry or eating something that touched it .
• The most known source for Campylobacter is poultry .