Campylobacter

Objectives

1. Demonstrate the pathogenesis of Campylobacter jejuni.

2. Describe lab diagnosis of Campylobacter jejuni.
3. Compare the pathogenicity of C jejuni and C fetus.

Võ Thị Chi Mai

Human diseases caused by
Campylobacter spp.
Campylobacter jejuni

Microscopic morphology
Spirilla 0,2 – 0,5 μm

Growth characteristics
• Slender, curved, Gram-neg. rod
• Microaerophilic, rapid motile
• Slow binary fission
• Optimal growth at 42oC (thermophilic)
• Killed by: dryness, 0oC, gastric acid
• Survival several weeks in milk, food, water at 4oC.
 Antigenic structure

Pathogenesis
• Porte entry: oral. Infectious dose ≈ 500 bacteria.
• Campylobacter jejuni are able to attach many kinds of cells.
• They penetrate the epithelial cells of the small & large intestines,
then multiply within and beneath the epithelium.
• They secrete a heat-labile enterotoxin, cytotoxic enzymes.
• Clinical significance: Ulcerative colitis; Bacteremia.
 Signs & symptoms
• Incubation period: 1-7 days
• Severe abdominal pain.
• Bloody, mucous stools.
• Fever, nausea, vomiting, headaches
• Self-limiting in 3 – 5 days. Sometimes extending beyond 2 weeks.

Consequences
• Guillain-Barré syndrome (C jejuni serotype O19): an acute severe
neuromuscular paralysis that seems to be an autoimmune
reaction.
• Reactive arthritis (in patients with HLA-B27): joint pain & swelling
persisting from 1 week to several months.
 Epidemiology
• 4 – 10% of bacterial diarrhea
• In infants less than 1 year of age
• Transmission route: contaminating food, milk, water, diseased
domestic animals.

Treatment
Rehydration & electrolyte-balance therapy.
azithromycin / tetracycline / amoxicillin-clavulanate.

Prevention
Cooking and handling raw poultry properly.
Rigid sanitary control of water & milk supplies.
 Bacteriological diagnosis
• Specimen: stool
• Gram staining: Gram-negative, S-shaped / gull-winged bacilli
• Culture: Skirrow’s or Campy blood agar.
Incubated at 420C in 48h, under microaerophilic condition.
• Oxidase +, catalase +, reducing nitrate, hydrolyzing hippurate.
Do not ferment or oxidize carbohydrates.
• Ag detection test: sensitivity 80-90%; specificity >95%.
• Nucleic acid-based tests.

C jejuni in stool

Scanning electron micrograph of C jejuni

 Campylobacter fetus

General characteristics
• Resistant to complement- and Ab-mediated serum killing due to
a heat-stable, capsule-like protein (Protein S)
• Zoonotic infections transmitted to human. C fetus spread from
gastrointestinal tract to the blood & distal foci.
• Causing diseases in elderly & immunocompromised people:
Septicemia - Septic thrombophlebitis - Meningoencephalitis
 Campylobacter fetus
General characteristics

• Zoonotic infections transmitted to human. C fetus spread

from gastrointestinal tract to the blood & distal foci.
• Resistant to complement- & Ab-mediated serum killing due
to a heat-stable, capsule-like protein (Protein S)
• Causing diseases in elderly & immunocompromised people:
Septicemia - Septic thrombophlebitis - Meningoencephalitis
 Campylobacter fetus
Lab work

• Incubating culture at 37oC, under microaerophilic condition.

Treatment
• C fetus: aminoglycoside, imipenem.
Summary
• The two main pathogens of Campylobacter species
are C jejuni and C fetus.
• These zoonotic pathogens transmit to human via
gastrointestinal tract.
• C jejuni cause gastroenteritis.
• C fetus cause vascular infections, gastroenteritis,
meningoencephalitis.