Campylobacter Infections Follow-up

Updated: Jun 16, 2017
  • Author: Mahmud H Javid, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Follow-up

Further Inpatient Care

In some cases, systemic Campylobacter infections are diagnosed retrospectively following empirical antibiotic therapy with clinical resolution. In such cases, follow-up blood cultures should be obtained, and treatment can be stopped if they are negative.

Oral erythromycin may not be adequate for systemic C jejuni or C fetus endovascular infections.

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Deterrence/Prevention

Pasteurization of milk and chlorination of drinking water destroy Campylobacter organisms.

Unpasteurized milk and untreated surface water should not be consumed.

Raw milk may not be safe, even if it conforms to routine testing by somatic cell and coliform counts. [33]

Treatment with antibiotics can reduce fecal excretion.

Health care workers with Campylobacter infections should not provide direct patient care or prepare food while they have diarrhea or are shedding Campylobacter organisms in the stool. However, person-to-person transmission is unusual.

After diarrhea resolves, infective organisms may be present in the stool for up to 3 weeks.

Separate cutting boards should be used for foods of animal origin and other foods. After preparing raw food of animal origin, all cutting boards and countertops should be carefully cleaned with soap and hot water. [34, 35]

Chicken should be adequately cooked.

When outbreaks occur, community education can be directed at proper food-handling techniques, including thorough cooking of poultry.

As noted above, handling and consumption of poultry meat is a significant source of illness. One control strategy that has been suggested is to keep colonized and noncolonized flocks separate. [36]

Fresh chicken can be the dominant source of Campylobacter infection, and replacing this with frozen chicken can reduce Campylobacter levels. [6]

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Complications

Potential complications of Campylobacter infections include the following:

  • Toxic megacolon
  • Pseudomembranous colitis
  • Gastrointestinal hemorrhage
  • Hemolytic-uremic syndrome
  • Thrombotic thrombocytopenic purpura
  • Immunoproliferative small intestinal disease (This is a type of lymphoma that involves mucosa-associated lymphoid tissue [MALT]. It has been found to be associated with C jejuni infection. [37] )
  • Bacteremia
  • Urinary tract infection
  • Pancreatitis
  • Stillbirths, septic abortions ( C fetus)
  • Intrauterine growth restriction [40]
  • Guillain-Barré syndrome (GBS) (GBS may develop secondary to cross-immunoreactivity between human gangliosides GM1 and GD1a and C jejuni lipopolysaccharides. In one study, up to 25% of patients with GBS had stool cultures positive for C jejuni. However, because of shortcomings of standard serological methods, the role of C jejuni may have been underestimated. [41, 42] In a study using a highly specific ELISA based on recombinant antigens, 80% of 36 patients with acute GBS were found to have serological evidence of preceding C jejuni infection, compared with 3.5% of controls. [43] In a 2012 study from New Zealand, investigators reported a marked reduction in GBS incidence 3 years after initiation of an intensive program to prevent food borne campylobacteriosis. [44] Of the over 8,000 C jejuni multilocus sequence typing sequence types (STs) described, ST-22 has been associated with Guillain-Barré syndrome. [45] )
  • Meningitis [46, 30, 29]
  • Infected aortoiliac aneurysms [19]
  • A sub-group of inflammatory bowel disease [2, 3]
  • Infected endometrial cysts/tubo-ovarian abscess [47]
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Prognosis

Generally, Campylobacter infections carry an excellent prognosis. The disease is almost always self-limited, with or without specific therapy.

The illness usually lasts less than a week, but some patients develop a longer-relapsing diarrheal illness that lasts several weeks.

The occasional deaths attributable to C jejuni infection usually occur in elderly or immunocompromised hosts.

Attributable deaths may also occur in young, healthy individuals secondary to volume depletion.

The rarer C fetus infection may also be fatal in debilitated hosts.

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Patient Education

Many Campylobacter infections are potentially preventable through education.

Meat and poultry should be cooked well.

Hands should be washed carefully after preparing food.

Parents should be informed that sick pets (eg, puppies, kittens) may harbor human pathogens and must be kept away from young children.

Untreated surface water and unpasteurized milk should be avoided.

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