Campylobacter fetus bacteremia in a young healthy adult transmitted by khat chewing

[A case of recurrent Campylobacter fetus meningitis, occurring two months after the ‍initial infection was successfully treated]

A 43-year-old man was admitted to our department due to fever and headache. The cerebrospinal fluid analysis confirmed bacterial meningitis. Campylobacter species were isolated from blood cultures on the third day of admission. The patient was treated with meropenem (MEPM) and discharged on the 17th day. However, he experienced a recurrence of meningitis and was readmitted on the 68th day, initiating MEPM therapy. Campylobacter fetus was isolated from cerebrospinal fluid cultures on the 74th day. MEPM was continued until the 81st day, followed by one month of minocycline (MINO) therapy. The patient had an uneventful recovery without further recurrence. This case highlights the potential for recurrence of Campylobacter fetus meningitis approximately two months after the resolution of the initial infection. In addition to carbapenem therapy for at least two weeks, the adjunctive administration of MINO may be beneficial.

Khat chewing in pregnant women associated with prelabor rupture of membranes, evidence from eastern Ethiopia

Introduction

Prelabor rupture of membranes (PROM) is a major factor that affects pregnancy outcome. Results from previous studies have suggested that there is an association between pregnant women, khat chewing and preterm birth, but evidence of association with PROM is sparse. This study therefore aims at identifying association between khat chewing in pregnancy and premature rupture of membranes in eastern Ethiopia.

Methods

A health facility-based cross-sectional study was conducted among 1688 pregnant women who came for delivery service in Harar town, Eastern Ethiopia between June to October in 2016. Data were collected using a pre-tested structured questionnaire and checklist to extract data from the medical record. The association between khat and PROM was examined using logistic regression analysis. A statistical significance was declared at p-value < 0.05.

Results

Of the 1688 pregnant women who participated in the study, 397 had prelabor rupture of the membranes, representing a proportion of 23.5% [(95% CI: (21.5, 25.6%)]. Of these 397 prelabor rupture of the membranes 198 (31.53%) were from Khat chewing mothers and, 199(18.77%) were from non-khat chewing mothers. After controlling for potential confounders, the multivariable logistic regression analysis revealed the odds of PROM was 1.51 times higher among khat chewed pregnant women [AOR = 1.51; 95% CI; (1.11, 2.07)] were had no khat chewing.

Conclusion

This study found a significant association between khat chewing in pregnancy and PROM. Efforts to reduce PROM need to consider prevention of khat chewing in pregnancy. A specific strategy need to protect pregnant women from khat chewing.

Meningoencephalitis Caused by a Campylobacter fetus in a Patient with Chronic Alcoholism

We herein report a case of Campylobacter fetus meningoencephalitis in a patient with chronic alcoholism. C. fetus is a rare cause of meningitis. The patient presented with hallucinations and monology, and alcohol withdrawal was initially suspected. After he was unsuccessfully treated for alcohol withdrawal delirium, we diagnosed C. fetus meningoencephalitis. Ampicillin monotherapy gradually improved his clinical status. A previous report stated that C. fetus infection is associated with chronic alcoholism. In patients with chronic alcoholism and disturbed consciousness, an atypical bacterial central nervous system infection, such as C. fetus meningoencephalitis, should be considered.

Campylobacter coli meningitis in a 57-year-old patient

Campylobacter coli is a major pathogen rarely responsible for extra-intestinal infections. We report a case of Campylobacter coli bacteremia and meningitis in a 57-year-old immunocompetent Belgian man. The strain, isolated from cerebrospinal fluid, belonged to the unusual sequence type 8418 (ST8418). The patient fully recovered after meropenem treatment.

Campylobacter fetus meningitis associated with eating habits of raw meat and raw liver in a healthy patient: A case report and literature review

Meningitis caused by the zoonotic pathogen Campylobacter fetus in immunocompetent adults is rare. We report a 48-year-old Japanese woman with no underlying disease who was found to have meningitis caused by C. fetus. Both C. fetus subsp. fetus and C. fetus subsp. venerealis were isolated from the cerebrospinal fluid culture. The mode of infection in our patient was considered to be associated with the consumption of raw beef and raw cattle liver on a regular basis. Public awareness and education to avoid the consumption of raw or undercooked meat might help prevent C. fetus meningitis.

Clinical and epidemiological analysis of Campylobacter fetus subsp. fetus infections in humans and comparative genetic analysis with strains isolated from cattle

Background

Campylobacter fetus subspecies fetus (CFF) is an important pathogen for both cattle and humans. We performed a systematic epidemiological and clinical study of patients and evaluated the genetic relatedness of 17 human and 17 bovine CFF isolates by using different genotyping methods. In addition, the serotype, the dissemination of the genomic island containing a type IV secretion system (T4SS) and resistance determinants for tetracycline and streptomycin were also evaluated.

Methods

The isolates from patients diagnosed with CFF infection as well as those from faecal samples of healthy calves were genotyped using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), as well as single locus sequence typing (SLST) targeting cmp1 and cmp2 genes encoding two major outer membrane proteins in CFF. The presence of the genomic island and identification of serotype was determined by PCRs targeting genes of the T4SS and the sap locus, respectively. Tetracycline and streptomycin resistance phenotypes were determined by minimal inhibitory concentration. Clinical data obtained from medical records and laboratory data were supplemented by data obtained via telephone interviews with the patients and treating physicians.

Results

PFGE analysis defined two major clusters; cluster A containing 16 bovine (80 %) isolates and cluster B containing 13 human (92 %) isolates, suggesting a host preference. Further genotypic analysis using MLST, SLST as well as sap and T4SS PCR showed the presence of genotypically identical isolates in cattle and humans. The low diversity observed within the cmp alleles of CFF corroborates the clonal nature of this pathogen. The genomic island containing the tetracycline and streptomycin resistance determinants was found in 55 % of the isolates in cluster A and correlated with phenotypic antibiotic resistance.

Conclusions

Most human and bovine isolates were separated on two phylogenetic clusters. However, several human and bovine isolates were identical by diverse genotyping methods, indicating a possible link between strains from these two hosts.

Campylobacter Fetus Meningitis in Adults: Report of 2 Cases and Review of the Literature

The zoonotic pathogen Campylobacter fetus is a rare cause of bacterial meningitis. Little is known about the clinical characteristics, predisposing factors and outcome of C fetus meningitis in adults.We report cases of C fetus meningitis in a nationwide cohort study of adult bacterial meningitis patients in the Netherlands and performed a review of the literature.Two patients with C fetus meningitis were identified from January 2006 through May 2015. The calculated annual incidence was 0.02 per million adults. Combined with the literature, we identified 22 patients with a median age of 48 years. An immunocompromised state was present in 16 patients (73%), mostly due to alcoholism (41%) and diabetes mellitus (27%). The source of infection was identified in 13 out of 19 patients (68%), consisting of regular contact with domestic animals in 5 and working on a farm in 4. Recurrent fever and illness was reported in 4 patients (18%), requiring prolonged antibiotic treatment. Two patients died (9%) and 3 survivors (15%) had neurological sequelae.C fetus is a rare cause of bacterial meningitis and is associated with an immunocompromised state. Based on the apparent slow clinical response seen in this limited number of cases, the authors of this study recommend a prolonged course of antimicrobial therapy when C fetus is identified as a causative agent of bacterial meningitis. Cases appeared to do best with carbapenem therapy.

Campylobacter fetus bacteremia in an immunocompetent traveler

Campylobacter fetus bacteremia is a rare human infection that occurs almost exclusively in the setting of advanced age, immunosuppression, human immunodeficiency virus infection, alcoholism, or recent gastrointestinal surgery. This report of C. fetus bacteremia in a 39-year-old immunocompetent traveler who ate raw beef identifies C. fetus as a potential emerging pathogen in normal hosts.

Campylobacter fetus infections in humans: exposure and disease

Campylobacter fetus can cause intestinal illness and, occasionally, severe systemic infections. Infections mainly affect persons at higher risk, including elderly and immunocompromised individuals and those with occupational exposure to infected animals. Outbreaks are infrequent but have provided insight into sources. Source attribution of sporadic cases through case-control interviews has not been reported. The reservoirs for C. fetus are mainly cattle and sheep. Products from these animals are suspected as sources for human infections. Campylobacter fetus is rarely isolated from food, albeit selective isolation methods used in food microbiology are not suited for its detection. We hypothesize that the general population is regularly exposed to C. fetus through foods of animal origin, cross-contaminated foodstuffs, and perhaps other, as yet unidentified, routes. Campylobacter fetus infection should be suspected particularly in patients with nonspecific febrile illness who are immunocompromised or who may have been occupationally exposed to ruminants.

Meningitis and endocarditis caused by Campylobacter fetus after raw-liver ingestion

We report Campylobacter fetus meningitis associated with endocarditis in a 75-year-old diabetic man after he consumed raw liver. C. fetus was isolated from blood samples and cerebrospinal fluid. Cure was obtained with combined intravenous imipenem-gentamicin for 4 weeks; no relapse occurred after 6 months of follow-up.