Campylobacter Infection In Children Research Articles

Campylobacter occurrence and antimicrobial resistance profile in under five-year-old diarrheal children, backyard farm animals, and companion pets.

Campylobacteriosis disproportionately affects children under five in low-income countries. However, epidemiological and antimicrobial resistance (AMR) information at the children-animal interface is lacking. We hypothesized that Campylobacter is a major cause of enteritis in children in Ethiopia, and contact with animals is a potential source of transmission. The objective of the study was to determine Campylobacter occurrence and its AMR in children under five with diarrhea, backyard farm animals, and companion pets. Stool from 303 children and feces from 711 animals were sampled. Campylobacter was isolated through membrane filtration on modified charcoal cefoperazone deoxycholate agar plates under microaerobic incubation, and the technique showed to be feasible for use in regions lacking organized laboratories. Typical isolates were characterized with MALDI-TOF MS and multiplex PCR. Of 303 children, 20% (n = 59) were infected, with a higher proportion in the 6 to 11-month age group. Campylobacter occurred in 64% (n = 14) of dogs and 44% (n = 112) of poultry. Campylobacter jejuni was present in both a child and animal species in 15% (n = 23) of 149 households positive for Campylobacter. MICs using the gradient strip diffusion test of 128 isolates displayed resistance rates of 20% to ciprofloxacin and 11% to doxycycline. MICs of ciprofloxacin and doxycycline varied between C. coli and C. jejuni, with higher resistance in C. coli and poultry isolates. Campylobacter infection in children and its prevalent excretion from backyard poultry and dogs is a understudied concern. The co-occurrence of C. jejuni in animals and children suggest household-level transmission As resistance to ciprofloxacin and doxycycline was observed, therapy of severe campylobacteriosis should consider susceptibility testing. Findings from this study can support evidence-based diagnosis, antimicrobial treatment, and further investigations on the spread of AMR mechanisms for informed One Health intervention.

Campylobacter infection in children and adults in Bulgaria: comparative characteristics and antimicrobial resistance

Campylobacter infection is a serious health problem worldwide. There is still insufficient information in Bulgaria about the spread and course of the infection. Data on campylobacteriosis in adults are particularly scarce. In our study, we performed a comparative analysis in patients in different age groups, including the resistance of isolated strains. In the period 2018-2020, a total of 1,120 patients hospitalised with acute diarrhoea syndrome, aged 0-97 years, were studied, and a total of 1,120 faecal samples were examined by culture techniques and multiplex polymerase chain reaction (PCR). The antimicrobial resistance of some of the isolates was determined. A total of 385 (34.37%) isolates belonged to Campylobacter spp.: 340 (88.31%) to Campylobacter jejuni and 45 (11.68%) C. coli, respectively. The highest incidence was observed in the youngest (< 5 years of age) and the oldest (≥ 65 years of age) patients. Elderly adults are most likely to present with poor and non-specific symptoms despite the severe course of the infection. We observed severe antimicrobial resistance to tetracycline in both young children and older adults (about 40%). In older adults, we observed high resistance to ciprofloxacin. Regarding the C. jejuni strains, the resistance was 19.07% in the youngest, but it reached 59.15% in older adults. The mimicry of the symptoms in older adults can be misleading for the clinician with regard both to the diagnosis and the severity of the infection.

Epidemiology of Campylobacter Gastroenteritis in New Zealand Children and the Effect of The Campylobacter Strategy: A 20-year Observational Study.

Campylobacter species are a common cause of gastroenteritis in New Zealand (NZ) as well as worldwide. This study aimed to describe epidemiologic trends in disease notifications and hospital admissions because of Campylobacter gastroenteritis in NZ children from 1997 to 2016. In this population-based descriptive study, age-specific and age-standardized notification and hospitalization rates were analyzed for Campylobacter infections in children <15 years of age. Variations in disease by time, sex, age, ethnicity and geography were described. During the 20-year period considered, there were 39,970 notifications (59.1% male) and 1458 hospitalizations (61.8% male) because of Campylobacter gastroenteritis in NZ children. Before 2006, notification rates increased by 3.4% annually [95% confidence interval (CI): 0.7%-6.2%], with a peak of 340 notifications per 100,000 children in 2003. The average percentage change (APC) in hospitalizations was 7.4% (95% CI: 4.0%-10.9%) in the same period. From 2006 to 2008, notification and hospitalization rates fell by 25% and 30%, respectively. Since 2008, age-standardized incidence rates have been stable at 161 notifications (APC: -3.1; 95% CI: 0.82 to -6.9) and 6.73 hospitalizations (APC: 2.2; 95% CI: -2.0 to 6.5) per 100,000 children per year. Notification rates were highest in children 1-4 years of age. Hospitalizations rates were highest in children <1 year of age. NZ has previously had high rates of Campylobacter gastroenteritis in children. Implementation of a national strategy to reduce foodborne Campylobacter infection appears to have contributed to an observed reduction in rates between 2006 and 2008. The burden of Campylobacter disease is highest in the community health setting, with only a small proportion of cases needing hospitalization.

Campylobacter Infections in Children

1. Rebecca G. Same, MD* 2. Pranita D. Tamma, MD, MHS* 1. *Division of Pediatric Infectious Diseases, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD * Abbreviations: CDC: : Centers for Disease Control and Prevention CIDT: : culture-independent diagnostic testing GBS: : Guillain-Barre syndrome HIV: : human immunodeficiency virus IBD: : inflammatory bowel disease Ig: : immunoglobulin Campylobacter is one of the 2 most common causes of foodborne illness in the United States. It most commonly occurs in children younger than 5 years of age. Campylobacter species can cause a wide range of syndromes, from asymptomatic infections to severe systemic infections. After completing this article, readers should be able to: 1. Recognize that Campylobacter is a common cause of foodborne illness in the United States and internationally. 2. Understand the indications for testing and the treatment of Campylobacter infection. Campylobacter species are an important cause of infection throughout the world, especially in young children. Campylobacter jejuni is the most common Campylobacter species in the United States, where it is 1 of the top 2 causes of foodborne illness. (1) Other important species include Campylobacter upsaliensis , Campylobacter lari , and Campylobacter fetus , which can cause serious systemic infections in all age groups, particularly in immunocompromised patients. Campylobacter species infections cause gastroenteritis and typically present with diarrhea that may or may not be bloody, emesis, and abdominal pain. Campylobacter infection in children can mimic intussusception, appendicitis, or inflammatory bowel disease (IBD). Immune-mediated complications of Campylobacter infection include reactive arthritis and Guillain-Barre syndrome (GBS). Campylobacter infection is a nationally notifiable disease, and confirmed cases should be reported through the Centers for Disease Control and Prevention (CDC) Foodborne Diseases Active Surveillance Network. Most Campylobacter infections are mild and self-limited and require only supportive care, although some may lead to severe dehydration. Serious infection or infections in immunocompromised hosts may benefit from treatment with macrolide antibiotics. Increasing …

Campylobacter jejuni transcriptional and genetic adaptation during human infection.

Campylobacter jejuni infections are a leading cause bacterial food-borne diarrheal illness worldwide, and Campylobacter infections in children are associated with stunted growth and therefore long-term deficits into adulthood. Despite this global impact on health and human capital, how zoonotic C. jejuni responds to the human host remains unclear. Unlike other intestinal pathogens, C. jejuni does not harbor pathogen-defining toxins that explicitly contribute to disease in humans. This makes understanding Campylobacter pathogenesis challenging and supports a broad examination of bacterial factors that contribute to C. jejuni infection. Here we use a controlled human infection model to characterize C. jejuni transcriptional and genetic adaptations in vivo, along with a non-human primate infection model to validate our approach. We found variation in 11 genes is associated with either acute or persistent human infections and include products involved in host cell invasion, bile sensing, and flagella modification, plus additional potential therapeutic targets. Particularly, a functional version of the cell invasion protein A (cipA) gene product is strongly associated with persistently infecting bacteria and we went on to identify its biochemical role in flagella modification. These data characterize the adaptive C. jejuni response to primate infections and suggest therapy design should consider the intrinsic differences between acute and persistently infecting bacteria. Additionally, RNA-sequencing revealed conserved responses during natural host commensalism and human infections. 39 genes were differentially regulated in vivo across hosts, lifestyles, and C. jejuni strains. This conserved in vivo response highlights important C. jejuni survival mechanisms such as iron acquisition and evasion of the host mucosal immune response. These advances highlight pathogen adaptability across host species and demonstrate the utility of multidisciplinary collaborations in future clinical trials to study pathogens in vivo.

Clinical Predictors of Shigella and Campylobacter Infection in Children in the United States

BackgroundInfectious gastroenteritis is a major cause of morbidity and mortality among children worldwide. While most episodes are self-limiting, for select pathogens such as Shigella and Campylobacter, etiological diagnosis may allow effective antimicrobial therapy and aid public health interventions. Unfortunately, clinical predictors of such pathogens are not well established and are based on small studies using bacterial culture for identification.MethodsWe used prospectively collected data from a multi-center study of pediatric gastroenteritis employing multi-pathogen molecular diagnostics to determine clinical predictors associated with 1) Shigella and 2) Shigella or Campylobacter infection. We used machine learning algorithms for clinical predictor identification, then performed logistic regression on features extracted plus pre-selected variables of interest.ResultsOf 993 children enrolled with acute diarrhea, we detected Shigella spp. in 56 (5.6%) and Campylobacter spp. in 24 (2.4%). Compared with children who had neither pathogen detected (of whom, >70% had ≥1 potential pathogen identified), bloody diarrhea (odds ratio 4.0), headache (OR 2.2), fever (OR 7.1), summer (OR 3.3), and sick contact with GI illness (OR 2.2), were positively associated with Shigella, and out-of-state travel (OR 0.3) and vomiting and/or nausea (OR 0.4) were negatively associated (Table). For Shigella or Campylobacter, predictors were similar but season was no longer significantly associated with infection.ConclusionThese results can create prediction models and assist clinicians with identifying patients who would benefit from diagnostic testing and earlier antibiotic treatment. This may curtail unnecessary antibiotic use, and help to direct and target appropriate use of stool diagnostics.Disclosures A. Leber, BioFIre Diagnostics: Research Contractor and Scientific Advisor, Research support, Speaker honorarium and Travel expenses J. Daly, Biofire: Grant Investigator, Grant recipient R. Selvarangan, BioFire Diagnostics: Board Member and Investigator, Consulting fee and Research grant Luminex Diagnostics: Investigator, Research grant J. Dien Bard, BioFire: Consultant and Investigator, Research grant and Speaker honorarium K. Holmberg, BioFire Diagnostics: Employee, Salary K. Bourzac, BioFire Diagnostics: Employee, Salary K. C. Chapin, BioFire Diagnstics: Investigator, Research support A. Pavia, BioFire Diagnostics: Grant Investigator, Research grant

Sensitive and rapid detection of campylobacter species from stools of children with diarrhea in Japan by the loop-mediated isothermal amplification method.

We detected Campylobacter spp. in 5% (20/380) of diarrheal stool samples collected at an outpatient clinic in Kyoto using a commercial loop-mediated isothermal amplification (LAMP) kit with a fluorescent detection reagent after DNA extraction. The sensitivity and specificity were 100% in comparison with those of semi-nested PCR for the differentiation of Campylobacter jejuni and Campylobacter coli. Fourteen of the 20 samples were already determined as C. jejuni by the culture method. All 20 samples were also positive for C. jejuni by the PCR method. Among the 58 cultured samples, the sensitivity of the culture method against the LAMP method was 93.3% (14/15) and the specificity was 100% (43/43). The detection rate of Campylobacter spp. from the heated supernatants by the LAMP method was lower than that from the supernatant after DNA extraction. In total, 25% (5/20) of the Campylobacter-positive samples by the LAMP method were co-infected with norovirus (3/20), rotavirus (1/20), and human parechovirus (1/20), although no other bacterial co-infection was identified by the culture method. C. jejuni was mostly detected in children aged >5 years throughout the year. Based on these results, we concluded that care should be taken while diagnosing Campylobacter infection in children. Our newly modified LAMP method is a rapid, easy, and useful method for this diagnosis.

Clinical course of Campylobacter infections in children

BackgroundIn recent years, an increased number of children infected with bacteria of the Campylobacter type is observed. It is estimated that approximately in 1% of the population of Europe and of the United States Campylobacter infection occurs. Aim of studyThe aim of the study was a retrospective analysis of the clinical course of Campylobacter infection in children according to the age and associated infections. Materials and methodsThe retrospective analysis included 71 children (mean age 2 years) hospitalized in the Gastroenterology Unit between Jan 2008 and Dec 2010. In all children with the Campylobacter infection clinical symptoms, laboratory tests and associated infections were analyzed. ResultsCampylobacter infection was diagnosed in 71 children (42 boys), which represented 5.28% of the children among 1343 patients hospitalized because of vomiting or diarrhea. In 22 children the Campylobacter infection was accompanied by other gastrointestinal infections (enteropathogenic strains of E. coli, Rotavirus, Salmonella). Mean duration of hospitalization was 7.24 days. According to age, analyzing the clinical symptoms of campylobacteriosis statistically significant incidence of watery diarrhea in children over 1 year of age has been shown, and abdominal pain in children over 3 years of age has been demonstrated. Diarrhea with blood occurred most frequently in children under 1 year of age. ConclusionsDue to the observed increasing incidence of Campylobacter infections it seems to be reasonable to take feces inoculation in children with diarrhea to 3 years of age, especially in the presence of bloody feces.

Campylobacter Infection in Children in Malawi Is Common and Is Frequently Associated with Enteric Virus Co-Infections

Background Campylobacter species are the most common cause of bacterial gastroenteritis in the developed world. However, comparatively few studies have determined the epidemiological features of campylobacteriosis in resource-poor settings.MethodsA total of 1,941 faecal specimens collected from symptomatic (diarrhoeic) children and 507 specimens from asymptomatic (non-diarrhoeic) children hospitalised in Blantyre, Malawi, between 1997 and 2007, and previously tested for the presence of rotavirus and norovirus, was analysed for C. jejuni and C. coli using a real time PCR assay.Results Campylobacter species were detected in 415/1,941 (21%) of diarrhoeic children, with C. jejuni accounting for 85% of all cases. The median age of children with Campylobacter infection was 11 months (range 0.1–55 months), and was significantly higher than that for children with rotavirus and norovirus (6 months and 7 months respectively; P<0.001). Co-infection with either rotavirus or norovirus was noted in 41% of all cases in the diarrhoeic group. In contrast, the detection rate of Campylobacter in the non-diarrhoeic group was 14%, with viral co-infection identified in 16% of children with Campylobacter. There was no association between Campylobacter detection rate and season over the 10 year period.DiscussionUsing molecular detection methodology in hospitalised Malawian children, we have demonstrated a high prevalence of Campylobacter infection, with frequent viral co-infection. The burden of Campylobacter infection in young African children may be greater than previously recognised.

Heterogeneity of Campylobacter species isolated from serial stool specimens of Egyptian children using pulsed field gel electrophoresis.

BackgroundThe genus Campylobacter spp. is a common cause of human acute bacterial enteritis and travellers’ diarrhoea worldwide.ObjectiveTo determine whether multiple serial isolations of Campylobacter spp., when obtained from a single child, represented the same or a different organism.MethodsIn a birth cohort study conducted in Egypt, numerous children showed serial isolations of Campylobacter spp. Of these, 13 children were selected from different households based on the successive isolation of six or more Campylobacter isolates from stool samples.ResultsEighty isolates were recovered and identified as either Campylobacter coli (n = 25) or Campylobacter jejuni (n = 55). Pulsed-field gel electrophoresis (PFGE) revealed the presence of 38 unique C. jejuni and 24 C. coli profiles at a similarity level of ≥ 90%. Although no serially-identical isolates were detected in six children, others demonstrated at least one identical couple of isolates; all identified serially between one to six weeks. Two children demonstrated > 80% similar couples of isolates that appeared seven months apart. PFGE could be a useful tool for differentiating reinfection, relapse and convalescent excretion phases.ConclusionOur data suggest that Campylobacter infection in children is a complex process; children are exposed to multiple species in endemic environments and strains of the same bacterium appear to be shed serially between one to six weeks after the first exposure. Isolates that persisted for longer periods were relatively less similar, as shown from the results of this study.

A descriptive review of selected nonviral enteric illnesses reported in children in Quebec between 1999 and 2006.

To review the epidemiology of selected nonviral enteric illnesses reported in children in Quebec between 1999 and 2006. Incidence rates were calculated to describe age, sex, temporal and geographical characteristics of the selected nonviral enteric cases reported in children who were between zero and four years of age. Standard descriptive methods were used to analyze the temporal and geographical distributions of the incidence rates. A total of 5068 cases were reported. Of these, three pathogens accounted for the majority of the infections: Giardia (32.52%), Salmonella (30.98%) and Campylobacter (30.82%). Salmonella was most frequent in children younger than one year of age, whereas comparable incidence rates for the three pathogens were calculated for children between one and four years of age. For Giardia, the geographical distributions showed that the highest rates were in areas with more than 100,000 inhabitants (except Montreal, Quebec); for Salmonella, the highest rates were in Montreal; and for Campylobacter, the highest rates were in areas with fewer than 10,000 inhabitants. No detectable trends were seen over the study period for the three pathogens. Seasonal summer peaks were noted for Salmonella and Campylobacter, contrasting with late summer to early autumn peaks for Giardia. Findings suggest that Giardia, Salmonella and Campylobacter were the most common causes of nonviral enteric illnesses reported in children in Quebec. Giardia cases seemed to arise from different sources and transmission routes than the other two pathogens. Characteristics specific to Campylobacter infections in children, namely its predominance in areas with low population densities, and to Salmonella infections, namely predominance in the Greater Montreal area, should be further investigated to better guide prevention and control measures.

Prevalence of potential virulence markers in Polish Campylobacter jejuni and Campylobacter coli isolates obtained from hospitalized children and from chicken carcasses

The pathogenicity of thermotolerant Campylobacter species, common food-borne pathogens, depends on certain factors unevenly distributed among strains of different origin. The prevalence of such markers has never been examined in a population of Polish Campylobacter strains of human and poultry origin. Therefore, we analysed the presence of the cadF, cdtA, cdtB and cdtC genes and the iam sequence in Campylobacter jejuni (n = 115) and Campylobacter coli (n = 57) isolates from children with diarrhoea and from chicken carcasses. The cadF gene was present in nearly 100% of Campylobacter isolates tested, regardless of their origin or species. In contrast, the iam region was found in 83.3% and 100% of C. coli isolates from children and chickens, respectively, but in only 1.6% and 54.7%, respectively, of C. jejuni isolates. Similarly, the detection rates of cdt genes varied between human and chicken isolates. All three cdt genes were found in nearly all C. jejuni isolates from both children and chickens, but in only 5.6% of human C. coli isolates as compared to 87.2% of chicken C. coli isolates. This different distribution of genetic markers between human and chicken isolates indicates that some Campylobacter infections in children may have additional sources other than contaminated chicken meat.

A cohort study of enteric campylobacter infection in children from birth to two years in Bangui (Central African Republic)

A cohort of 111 children from Bangui, Central African Republic, was followed for enteric campylo-bacter infection from birth until the age of 2 years. Stools were examined at each episode of diarrhoea, and bi-weekly up to the age of 6 months irrespective of the presence of diarrhoea. 349 episodes of diarrhoeal illness were recorded (1·6 per child-year). Campylobacters were isolated from 41 (11·7%) of the 349 episodes, but in half of them another enteric pathogen was also isolated. Campylobacters were statistically associated with diarrhoea only before the age of 6 months. Bi-weekly sampling up to this age detected 75 infections (1·3 per child-year), yet only 12 (16%) were associated with diarrhoea. Campylobacter coli was isolated slightly more often (51%) than C. jejuni (49%); biotyping and serogrouping showed that no strain was especially associated with disease. Fewer children who had campylobacter infection before the age of 6 months suffered campylobacter diarrhoea between 6 and 24 months of age than those who did not, but the difference did not reach statistical significance. A significantly higher rate of isolation was found in the homes of infected children (human and animal contacts) than of non-infected children. Campylobacter infections were statistically associated with the presence of live poultry and the lack of piped water in homes.

Prospective study of enteric Campylobacter infections in children from birth to 6 months in the Central African Republic.

A survey of enteric Campylobacter infections was performed in Bangui, Central African Republic, with a cohort of 127 children from birth to 6 months of age by biweekly culture of stools; 82 infections were observed, and 41.7% of the children presented at least 1 infection before 6 months of age. Only 15.9% of the infected children had a diarrheic syndrome; moreover, 61.5% of these diarrheic children had another enteropathogen associated with Campylobacter species. In about half the cases, Campylobacter spp. were excreted for more than 4 days. More than half of the children had at least one diarrheic episode, for which an enteropathogen was identified in one third of the cases, before 6 months of age.

Severe campylobacter infection in children

Children suffering from Campylobacter jejuni infection and who were admitted to children's hospitals in Bristol and Newcastle over a period of 2 years are reviewed. Gastro-intestinal disease caused by C. jejuni was as common as that due to Salmonella spp. Three neonates suffered particularly severe infections which resembled necrotising enterocolitis. One such case is described.