Campylobacter jejuni infection as a hospital problem: an overview

Abstract

Campylobacter jejuni is now recognized as one of the major causes of gastroenteritis in humans. Much has been learned in recent years about the clinical manifestations of this infection (Butzler et al., 1973; Karmali & Fleming, 1979; Skirrow, 1977). In developing countries, C. jejuni is a leading cause of morbidity in the first 2 years of life. In the developed countries, C. jejuni is an important cause of acute diarrhoea in all age groups but particularly in childhood. Symptoms range from a few loose stools to fulminant bloody diarrhoea in the presence of abdominal cramps, high fever and toxic appearances. Abdominal pain may be the only symptom, and on occasions the pain may be so severe as to mimic appendicitis. Several species have been isolated in humans in relation to disease (Table I), but C. jejuni represents by far the most important group within the campylobacter family. Erythromycin has been recommended as the drug of choice in treating symptomatic C. jejuni infections, based on in-vitro susceptibility of the organisms and uncontrolled clinical observations. In these studies, a lack of clinical effect was attributed to the delay in starting therapy as a consequence of the late bacteriological results. In a recent study