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Sunnerhagen T, Grenthe R, Kampmann C, Karlsson Söbirk S, Bläckberg A. Campylobacter Infections With and Without Bacteremia: A Comparative Retrospective Population-Based Study. Open Forum Infect Dis 2024; 11:ofae131. [PMID: 38524227 PMCID: PMC10960602 DOI: 10.1093/ofid/ofae131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background Bacteremia with species in the genus Campylobacter is rare, and knowledge of the disease course in comparison with Campylobacter enteritis is limited. Methods This is a retrospective population-based study. Episodes of Campylobacter bacteremia and Campylobacter enteritis with a concurrent negative blood culture result that occurred between 2015 and 2022 in southern Sweden were identified through the laboratory database. Medical records were reviewed, and clinical features between patients with bacteremic Campylobacter infections were compared with patients with Campylobacter spp found in feces. Results The study included 29 bacteremic infections with Campylobacter and 119 cases of Campylobacter spp found in feces. Patients with Campylobacter bacteremia were significantly older than those with enteritis (72 years [IQR, 58-62] vs 58 years [IQR, 33-67], P < .0001). Eleven patients with bacteremia developed sepsis within 48 hours from blood culturing, and no patient died within 30 days from hospital admission. Conclusions Campylobacter bacteremia is rare and occurs mainly in the elderly with comorbidities. In comparison with Campylobacter infections limited to the gastrointestinal tract, patients with bacteremic Campylobacter infections are older and seem more prone to develop sepsis. Classical gastroenteritis symptoms in bacteremic cases with Campylobacter may be absent.
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Affiliation(s)
- Torgny Sunnerhagen
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
- Clinical Microbiology, Infection Prevention and Control, Office for Medical Services, Lund, Sweden
| | - Rasmus Grenthe
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christian Kampmann
- Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden
| | - Sara Karlsson Söbirk
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
- Clinical Microbiology, Infection Prevention and Control, Office for Medical Services, Lund, Sweden
| | - Anna Bläckberg
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden
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Tau L, Adler A, Shalom O, Paran Y, Poradosu RC, Shasha D, Ben-Ami R. Clinical features and outcomes of bacteremic and non-bacteremic Campylobacteriosis: a case-control study. Infection 2022; 50:1225-1231. [PMID: 35316528 DOI: 10.1007/s15010-022-01798-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/02/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Campylobacter bloodstream infection (C-BSI) is uncommon, and its clinical significance is unclear. The aim of the study was to determine risk factors and clinical outcomes associated with Campylobacter BSI. METHODS We performed a single center retrospective case-control study comparing patients with C-BSI (cases) and patients with nonbacteremic Campylobacter enteritis (controls), from January 2007 through June 2020. Case and control patients were matched by age and sex at a ratio of 1:2. Demographic, clinical, and microbiological characteristics were compared between groups. RESULTS We identified 76 patients with C-BSI and matched them with 149 nonbacteremic patients with Campylobacter enteritis. Rates of C-BSI increased tenfold in 2014 following the introduction of BacTAlert FA/FN Plus blood culture bottles. Baseline variables significantly associated with C-BSI on multivariable logistic regression were fever, absence of diarrhea and recent exposure to antibiotics. Compared with controls, C-BSI was associated with higher 30-day mortality (12% vs. 2%, P = 0.003), more frequent need for intensive care (6.6% vs. 1.2%, P = 0.032) and longer hospital stay (median, 5 days vs. 3 days, P = 0.003). There was a high proportion of immunocompromised patients in both groups (55%). CONCLUSIONS C-BSI is identified with increasing frequency, reflecting both changes in epidemiology and improved sensitivity of blood culture systems. Our findings indicate that detection of Campylobacter spp. in blood culture is associated with significantly higher rates of death and other adverse outcomes.
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Affiliation(s)
- Luba Tau
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel-Aviv, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Amos Adler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Microbiological Laboratory, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ohad Shalom
- Microbiological Laboratory, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Yael Paran
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Cohen Poradosu
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Shasha
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Ben-Ami
- Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Moffatt CRM, Kennedy KJ, O'Neill B, Selvey L, Kirk MD. Bacteraemia, antimicrobial susceptibility and treatment among Campylobacter-associated hospitalisations in the Australian Capital Territory: a review. BMC Infect Dis 2021; 21:848. [PMID: 34419003 PMCID: PMC8379883 DOI: 10.1186/s12879-021-06558-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Campylobacter spp. cause mostly self-limiting enterocolitis, although a significant proportion of cases require hospitalisation highlighting potential for severe disease. Among people admitted, blood culture specimens are frequently collected and antibiotic treatment is initiated. We sought to understand clinical and host factors associated with bacteraemia, antibiotic treatment and isolate non-susceptibility among Campylobacter-associated hospitalisations. METHODS Using linked hospital microbiology and administrative data we identified and reviewed Campylobacter-associated hospitalisations between 2004 and 2013. We calculated population-level incidence for Campylobacter bacteraemia and used logistic regression to examine factors associated with bacteraemia, antibiotic treatment and isolate non-susceptibility among Campylobacter-associated hospitalisations. RESULTS Among 685 Campylobacter-associated hospitalisations, we identified 25 admissions for bacteraemia, an estimated incidence of 0.71 cases per 100,000 population per year. Around half of hospitalisations (333/685) had blood culturing performed. Factors associated with bacteraemia included underlying liver disease (aOR 48.89, 95% CI 7.03-340.22, p < 0.001), Haematology unit admission (aOR 14.67, 95% CI 2.99-72.07, p = 0.001) and age 70-79 years (aOR 4.93, 95% CI 1.57-15.49). Approximately one-third (219/685) of admissions received antibiotics with treatment rates increasing significantly over time (p < 0.05). Factors associated with antibiotic treatment included Gastroenterology unit admission (aOR 3.75, 95% CI 1.95-7.20, p < 0.001), having blood cultures taken (aOR 2.76, 95% CI 1.79-4.26, p < 0.001) and age 40-49 years (aOR 2.34, 95% CI 1.14-4.79, p = 0.02). Non-susceptibility of isolates to standard antimicrobials increased significantly over time (p = 0.01) and was associated with overseas travel (aOR 11.80 95% CI 3.18-43.83, p < 0.001) and negatively associated with tachycardia (aOR 0.48, 95%CI 0.26-0.88, p = 0.02), suggesting a healthy traveller effect. CONCLUSIONS Campylobacter infections result in considerable hospital burden. Among those admitted to hospital, an interplay of factors involving clinical presentation, presence of underlying comorbidities, complications and increasing age influence how a case is investigated and managed.
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Affiliation(s)
- Cameron R M Moffatt
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, 2602, Canberra, ACT, Australia.
| | - Karina J Kennedy
- Department of Microbiology, Canberra Hospital and Health Services, Canberra, ACT, Australia
| | - Ben O'Neill
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, 2602, Canberra, ACT, Australia
| | - Linda Selvey
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Martyn D Kirk
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, 2602, Canberra, ACT, Australia
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Amuakwa-Mensah F, Marbuah G, Mubanga M. Climate variability and infectious diseases nexus: Evidence from Sweden. Infect Dis Model 2017; 2:203-217. [PMID: 29928737 PMCID: PMC6002069 DOI: 10.1016/j.idm.2017.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/23/2017] [Accepted: 03/21/2017] [Indexed: 11/30/2022] Open
Abstract
Many studies on the link between climate variability and infectious diseases are based on biophysical experiments, do not account for socio-economic factors and with little focus on developed countries. This study examines the effect of climate variability and socio-economic variables on infectious diseases using data from all 21 Swedish counties. Employing static and dynamic modelling frameworks, we observe that temperature has a linear negative effect on the number of patients. The relationship between winter temperature and the number of patients is non-linear and "U" shaped in the static model. Conversely, a positive effect of precipitation on the number of patients is found, with modest heterogeneity in the effect of climate variables on the number of patients across disease classifications observed. The effect of education and number of health personnel explain the number of patients in a similar direction (negative), while population density and immigration drive up reported cases. Income explains this phenomenon non-linearly. In the dynamic setting, we found significant persistence in the number of infectious and parasitic-diseased patients, with temperature and income observed as the only significant drivers.
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Affiliation(s)
- Franklin Amuakwa-Mensah
- Department of Economics, Swedish University of Agricultural Sciences (SLU), Box 7013, S-750 07, Uppsala, Sweden
| | - George Marbuah
- Department of Economics, Swedish University of Agricultural Sciences (SLU), Box 7013, S-750 07, Uppsala, Sweden
| | - Mwenya Mubanga
- Department of Medical Sciences, Uppsala University, Box 1115, Husargatan 3, 752 37, Uppsala, Sweden
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Hessulf F, Ljungberg J, Johansson PA, Lindgren M, Engdahl J. Campylobacter jejuni-associated perimyocarditis: two case reports and review of the literature. BMC Infect Dis 2016; 16:289. [PMID: 27297408 PMCID: PMC4907281 DOI: 10.1186/s12879-016-1635-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 06/07/2016] [Indexed: 11/12/2022] Open
Abstract
Background Campylobacter spp. are among the most common bacterial causes of gastroenteritis world-wide and mostly follow a benign course. We report two cases of Campylobacter jejuni-associated perimyocarditis, the first two simultaneous cases published to date and the third and fourth cases over all in Sweden, and a review of the literature. Case presentation A previously healthy 24-yo male (A) presented at the Emergency Department(ED) with recent onset of chest pain and a 3-day history of abdominal pain, fever and diarrhoea. The symptoms began within a few hours of returning from a tourist visit to a central European capital. Vital signs were stable, the Electrocardiogram(ECG) showed generalized ST-elevation, laboratory testing showed increased levels of C-reactive protein(CRP) and high-sensitive Troponin T(hsTnT). Transthoracic echocardiogram (TTE) was normal, stool cultures were positive for C Jejuni and blood cultures were negative. Two days after patient A was admitted to the ED his travel companion (B), also a previously healthy male (23-yo), presented at the same ED with almost identical symptoms: chest pain precipitated by a few days of abdominal pain, fever and diarrhoea. Patient B declared that he and patient A had ingested chicken prior to returning from their tourist trip. Laboratory tests showed elevated CRP and hsTnT but the ECG and TTE were normal. In both cases, the diagnosis of C jejuni-associated perimyocarditis was set based on the typical presentation and positive stool cultures with identical strains. Both patients were given antibiotics, rapidly improved and were fully recovered at 6-week follow up. Conclusion Perimyocarditis is a rare complication of C jejuni infections but should not be overlooked considering the risk of heart failure. With treatment, the prognosis of full recovery is good but several questions remain to be answered regarding the pathophysiology and the male preponderance of the condition.
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Affiliation(s)
- Fredrik Hessulf
- Department of Anaesthesiology and Intensive Care Medicine, Hallands Hospital, Halmstad, Sweden.
| | - Johan Ljungberg
- Department of Internal Medicine, Hallands Hospital, Halmstad, Sweden
| | | | - Mats Lindgren
- Department of Internal Medicine, Hallands Hospital, Halmstad, Sweden
| | - Johan Engdahl
- Department of Internal Medicine, Hallands Hospital, Halmstad, Sweden.,Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Harvala H, Rosendal T, Lahti E, Engvall EO, Brytting M, Wallensten A, Lindberg A. Epidemiology of Campylobacter jejuni infections in Sweden, November 2011-October 2012: is the severity of infection associated with C. jejuni sequence type? Infect Ecol Epidemiol 2016; 6:31079. [PMID: 27059819 PMCID: PMC4826459 DOI: 10.3402/iee.v6.31079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/07/2016] [Accepted: 03/16/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Campylobacter jejuni is among the most frequent causes of bacterial gastroenteritis in Europe. Over 8,000 C. jejuni multilocus sequence typing sequence types (STs) have been described; ST-21 and ST-45 have been identified as the most frequent types in all human studies so far. In contrast to other STs, ST-22 has been associated with the Guillain-Barré syndrome and ST-677 was recently linked to severe systemic infections in Finland. We investigated risk factors associated with hospitalisation in individuals with C. jejuni infections acquired in Sweden. METHODS A total of 1,075 individuals with domestically acquired C. jejuni infection diagnosed between November 2011 and October 2012 in Sweden were included in this retrospective cohort study. Typing data for the isolates as well as clinical data including hospitalisation dates and diagnosis codes for individuals with C. jejuni infection were obtained. Factors associated with hospitalisation and length of hospitalisation were investigated by multivariable analysis. RESULTS A total of 289 individuals were hospitalised due to C. jejuni infection (26.8%); those with co-morbidities were over 14 times more likely to become hospitalised than those without (odds ratio [OR]: 14.39, 95% confidence interval [CI]: 6.84-30.26). Those with underlying co-morbidities were also hospitalised longer than those without (4.22 days vs. 2.86 days), although this was not statistically significant. C. jejuni ST-257 (OR: 2.38; CI: 1.08-5.23), but not ST-22 or ST-677, was significantly associated with hospitalisation. CONCLUSION ST-677 was not associated with increased hospitalisation or a longer hospital stay in our study whilst ST-257 was. However, individuals with C. jejuni infections were generally more frequently hospitalised than previously demonstrated; this requires further consideration including possible targeted interventions.
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Affiliation(s)
- Heli Harvala
- Public Health Agency of Sweden, Solna, Sweden
- European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; ;
| | | | - Elina Lahti
- National Veterinary Institute of Sweden, Uppsala, Sweden
| | - Eva O Engvall
- National Veterinary Institute of Sweden, Uppsala, Sweden
| | | | - Anders Wallensten
- Public Health Agency of Sweden, Solna, Sweden
- Section of Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ann Lindberg
- National Veterinary Institute of Sweden, Uppsala, Sweden
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