Abstract
BackgroundArcobacter species, particularly A. butzleri, but also A. cryaerophilus constitute emerging pathogens causing gastroenteritis in humans. However, isolation of Arcobacter may often fail during routine diagnostic procedures due to the lack of standard protocols. Furthermore, defined breakpoints for the interpretation of antimicrobial susceptibilities of Arcobacter are missing. Hence, reliable epidemiological data of human Arcobacter infections are scarce and lacking for Germany. We therefore performed a 13-month prospective Arcobacter prevalence study in German patients.ResultsA total of 4636 human stool samples was included and Arcobacter spp. were identified from 0.85% of specimens in 3884 outpatients and from 0.40% of specimens in 752 hospitalized patients. Overall, A. butzleri was the most prevalent species (n = 24; 67%), followed by A. cryaerophilus (n = 10; 28%) and A. lanthieri (n = 2; 6%). Whereas A. butzleri, A. cryaerophilus and A. lanthieri were identified in outpatients, only A. butzleri could be isolated from samples of hospitalized patients. Antimicrobial susceptibility testing of Arcobacter isolates revealed high susceptibilities to ciprofloxacin, whereas bimodal distributions of MICs were observed for azithromycin and ampicillin.ConclusionsIn summary, Arcobacter including A. butzleri, A. cryaerophilus and A. lanthieri could be isolated in 0.85% of German outpatients and ciprofloxacin rather than other antibiotics might be appropriate for antibiotic treatment of infections. Further epidemiological studies are needed, however, to provide a sufficient risk assessment of Arcobacter infections in humans.
Highlights
Arcobacter species, A. butzleri, and A. cryaerophilus constitute emerging pathogens causing gastroenteritis in humans
Of German outpatients and ciprofloxacin rather than other antibiotics might be appropriate for antibiotic treatment of infections
A. cryaerophilus by multiplex PCR, while rpoB sequencing revealed that two of the putative A. butzleri isolates belong to the species A. lanthieri
Summary
Arcobacter species, A. butzleri, and A. cryaerophilus constitute emerging pathogens causing gastroenteritis in humans. Isolation of Arcobacter may often fail during routine diagnostic procedures due to the lack of standard protocols. Reliable epidemiological data of human Arcobacter infections are scarce and lacking for Germany. Arcobacter infections sometimes result in reproductive disorders, mastitis, and diarrhea, whereas the bacteria can be isolated from healthy carriers [4]. Severe cases following Arcobacter infection have been reported including prolonged watery gastroenteritis with abdominal cramps, bacteremia, endocarditis and peritonitis [5, 7, 8]. Given that the isolation and identification of Arcobacter may fail in routine diagnostic settings, robust epidemiological data on Arcobacterinduced morbidities are limited. There are no Arcobacter prevalence data for Germany, since
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