Inhibition of Campylobacter coli and Campylobacter jejuni by antibiotics used in selective growth media

Research Note: A baseline survey of thermotolerant Campylobacter in retail chicken in southern Brazil

Chicken is a leading source of thermotolerant Campylobacter, which triggers human foodborne enteritis. This study evaluated thermotolerant Campylobacter contamination of retail chicken in southern Brazil, using qualitative and quantitative analyses. Selective enrichment in Bolton broth for 24 and 48 h after plating onto modified charcoal-cefoperazone-deoxycholate (mCCD) agar and Preston agar was assessed. The combined results of the detection and enumeration methods revealed a frequency of 70% occurrence of thermotolerant Campylobacter in chicken samples. Campylobacter was enumerated in 60% of the samples, whereas 46% of the samples were positive in the qualitative analysis. Quantitative analysis showed average counts of 3.10 ± 0.15 log₁₀ CFU/sample. Higher numbers of Campylobacter-positive samples were found using 24-h enrichment before plating onto Preston agar (46%) than onto mCCD agar (2%). The majority of isolated strains were identified as Campylobacter jejuni, and Campylobacter coli was also found but to a lesser extent. Subtyping revealed a clear distinction between strains isolated from different chicken sources. The enriched samples plated onto mCCD agar showed extensive spreading of nonproducing extended-spectrum β-lactamases Proteus mirabilis that hampered the identification of Campylobacter colonies. P. mirabilis strains showed resistance to cefoperazone, trimethoprim, and polymyxin B present in broth and plate media used and were inhibited by rifampicin present in Preston agar. The results underline the effect of the spread of contaminant strains on Campylobacter cultures, which might be prevented using a recently revised International Organization for Standardization method for qualitative analysis of chicken.

New colorimetric aptasensor for rapid on-site detection of Campylobacter jejuni and Campylobacter coli in chicken carcass samples

Campylobacter is the most common cause of infectious intestinal disease, with nearly all cases caused by two species: C. jejuni and C. coli. We recently reported a gold nanoparticle-based two-stage aptasensing platform, which was improved in the present study for the rapid and on-site detection of both C. jejuni and C. coli in food samples. Compared to the previous platform, the improved platform yielded a more obvious colour change from red to purple due to the aggregation of gold nanoparticles, and does not require additional time or a pH optimization step for the aptamers to be adsorbed onto the gold nanoparticles. Using a highly specific aptamer that binds to live C. jejuni and C. coli, the improved aptasensor was highly effective for testing pure culture samples. The accuracy of the newly developed platform was comparable (p = 0.688) to that of the gold-standard detection method of tazobactam-supplemented culture, whereas it was superior to the official agar-based detection method (p = 0.016) in a validation study with 50 naturally contaminated chicken carcass samples. This is the first study on a colorimetric sensor that targets both live C. coli and C. jejuni in naturally contaminated samples. In addition, we provide the first evidence that both morphological status and the amount of Campylobacter present play key roles in the effectiveness of colorimetric detection. Thus, suitable selection of an antibody or aptamer with consideration of the morphological status of pathogens in samples is essential for direct detection without enrichment. Our data suggest that the sensor developed in this study can provide an excellent screening method, with a reduction in the detection time from 48 h to 30 min after enrichment, thus saving time, labour, and cost.

The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in 2016

The data on antimicrobial resistance in zoonotic and indicator bacteria in 2016, submitted by 28 EU Member States (MSs), were jointly analysed by the EFSA and ECDC. Resistance in bacterial isolates of zoonotic Salmonella and Campylobacter from humans, animals and food, and resistance in indicator Escherichia coli as well as in meticillin-resistant Staphylococcus aureus from animals and food were addressed. 'Microbiological' resistance was assessed using epidemiological cut-off (ECOFF) values; for some countries, qualitative data on isolates from humans were interpreted in a way that corresponds closely to ECOFF-defined 'microbiological' resistance. In Salmonella from humans, the occurrence of resistance to ampicillin, sulfonamides and tetracyclines was high, whereas resistance to third-generation cephalosporins was low. In Salmonella and E. coli isolates from broilers, fattening turkeys and their meat, resistance to ampicillin, (fluoro)quinolones, tetracyclines and sulfonamides was frequently high, whereas resistance to third-generation cephalosporins was rare. The occurrence of ESBL-/AmpC producers was low in Salmonella and E. coli from poultry and in Salmonella from humans. The prevalence of ESBL-/AmpC-producing E. coli, assessed in poultry and its meat for the first time, showed marked variations among MSs. Fourteen presumptive carbapenemase-producing E. coli were detected from broilers and its meat in two MSs. Resistance to colistin was observed at low levels in Salmonella and E. coli from poultry and meat thereof and in Salmonella from humans. In Campylobacter from humans, broilers and broiler meat, resistance to ciprofloxacin and tetracyclines was high to extremely high, whereas resistance to erythromycin was low to moderate. Combined resistance to critically important antimicrobials in isolates from both humans and animals was generally uncommon, but very high to extremely high multidrug resistance levels were observed in certain Salmonella serovars. Specific serovars of Salmonella (notably Kentucky) from both humans and animals exhibited high-level resistance to ciprofloxacin, in addition to findings of ESBL.

Comparative performance of isolation methods using Preston broth, Bolton broth and their modifications for the detection of Campylobacter spp. from naturally contaminated fresh and frozen raw poultry meat

The performance of different isolation methods was evaluated for the detection of Campylobacter from naturally contaminated raw poultry meat. Therefore, fresh and frozen poultry meat samples were analysed using the standard procedure (ISO 10272-1:2006), enrichment in Preston broth, and enrichment in modified Bolton broth (supplemented with (i) potassium clavulanate (C-BB), (ii) triclosan (T-BB), (iii) polymyxin B (P-BB)). The enrichment cultures were streaked onto both modified charcoal cefoperazone deoxycholate agar (mCCDA) and RAPID'Campylobacter agar (RCA). Moreover, direct plating on mCCDA and RCA was performed to quantify Campylobacter. In total, 33 out of 59 fresh retail meat samples (55.9%) were Campylobacter positive. For both fresh and frozen poultry meat samples, enrichment in Bolton broth (ISO 10272-1:2006) resulted in a higher number of positive samples than enrichment in Preston broth. Supplementation of Bolton broth with potassium clavulanate (C-BB) and triclosan (T-BB) enhanced the Campylobacter recovery from fresh poultry meat compared to non-supplemented Bolton broth, although the use of C-BB was less applicable than T-BB for Campylobacter recovery from frozen samples. Additionally, the use of RCA resulted in a higher isolation rate compared to mCCDA. The present study demonstrates the impact of culture medium on the recovery of Campylobacter from fresh and frozen naturally contaminated poultry meat samples and can support laboratories in choosing the most appropriate culturing method to detect Campylobacter.

Influence of enrichment and isolation media on the detection of Campylobacter spp. in naturally contaminated chicken samples

Investigating Campylobacter epidemiology requires adequate technique and media to ensure optimal culturing and accurate detection and isolation of Campylobacter strains. In the present study, we investigated the performances of three enrichment durations in Bolton broth (0, 24 and 48h) and compared four isolation media (mCCDA, Karmali, Butzler no. 2 and CampyFood agar (CFA)) for the detection of Campylobacter positive samples and the identification of Campylobacter species, from naturally contaminated broiler chicken samples (caeca, neck skin from carcasses, and skin from thighs). We compared our local results to those we obtained with samples from a European survey (caeca and neck skin) and a national survey (neck skin, thigh skin, and breast). Direct plating favored the detection of positive samples highly contaminated by Campylobacter (caeca and neck skin from carcasses) whatever the media. A longer enrichment reduced the rates of Campylobacter recovery except when using Butzler no. 2, more particularly for neck skin which background microflora was less important than in caeca. As a matter of fact, enrichment allowed a higher detection rate of positive samples with low Campylobacter contamination levels (breast, thigh skin), this detection being enhanced when using Butzler no. 2. When comparing the 3 other selective media, CFA was the 2nd most efficient media prior to mCCDA and Karmali. Interestingly, enrichment promoted the growth of Campylobacter coli but this promotion was least with Butzler no. 2 agar. Our study has confirmed the need to adapt the method to the types of samples for improving the detection of Campylobacter and that the method may affect the prevalence of the species.

Campylobacter species in animal, food, and environmental sources, and relevant testing programs in Canada

Campylobacter species, particularly thermophilic campylobacters, have emerged as a leading cause of human foodborne gastroenteritis worldwide, with Campylobacter jejuni, Campylobacter coli, and Campylobacter lari responsible for the majority of human infections. Although most cases of campylobacteriosis are self-limiting, campylobacteriosis represents a significant public health burden. Human illness caused by infection with campylobacters has been reported across Canada since the early 1970s. Many studies have shown that dietary sources, including food, particularly raw poultry and other meat products, raw milk, and contaminated water, have contributed to outbreaks of campylobacteriosis in Canada. Campylobacter spp. have also been detected in a wide range of animal and environmental sources, including water, in Canada. The purpose of this article is to review (i) the prevalence of Campylobacter spp. in animals, food, and the environment, and (ii) the relevant testing programs in Canada with a focus on the potential links between campylobacters and human health in Canada.

Evaluation of detection methods for Campylobacter infections among under-fives in Mwanza City, Tanzania

Introduction

Campylobacter species are recognized as a major cause of acute gastroenteritis in humans throughout the world. The diagnosis is mainly based on stool culture. This study was done to evaluate the effectiveness of staining methods (Gram stain using 0.3% carbol fuchsin as counter stain and 1% carbol fuchsin direct stain) versus culture as the gold standard.

Methods

A total of 300 children attending Bugando Medical Centre (BMC) and the Sekou Toure regional hospital with acute watery diarrhea were enrolled. Two sets of slides were prepared stained with 1% carbol fuchsin for 30 seconds first set, and the second set stained with Gram's stain using 0.3% carbol fuchsin as counter stain for five minutes. Concurrently, stool samples were inoculated on Preston Agar selective.

Results

Of 300 stool specimens, 14(4.7%) showed positive culture after 48 hours of incubation and 28 (9.3%) shows typical morphology of Campylobacter species by both Gram stain and direct stain. The sensitivity of the Gram stain using 0.3% carbol fuchsin as counter stain and 1% carbol fuchsin simple stain versus culture as gold standard was 64.3%, with a specificity of 93.4%. The positive predictive value and negative predictive value were 32.1% and 98.2% respectively.

Conclusion

The detection of Campylobacter by 1% carbol fuchsin is simple, inexpensive, and fast, with both a high sensitivity and specificity. Laboratories in settings with high prevalence of campylobacteriosis and/or limited resources can employ 1% carbol fuchsin direct stain in detecting campylobacter infections.

Improvement of capture efficacy of immunomagnetic beads forCampylobacter jejuniusing reagents that alter its motility

Previous studies using the immunomagnetic beads separation (IMS) technique have shown high detection limits of live campylobacters but low detection limits of formalin-killed campylobacters. The present study investigated if the addition of various concentrations of reagents that alter the motility of live Campylobacter jejuni could enhance the recovery of the organisms by IMS. The addition of 5% glycerol, 0.001% formalin, 10% polyethylene glycol, or 0.001% agarose in a buffer slowed down the movement of C. jejuni and increased the recovery of live C. jejuni, using beads coated with specific monoclonal antibodies (mAbs). The highest recovery yielded was 5.2- ± 3.3-fold with 5% glycerol at 105colony-forming units (CFU)·mL−1. The addition of 5% glycerol also improved isolation at lower concentrations of C. jejuni (102to 104CFU·mL−1) in buffer. The recovery by IMS of C. jejuni killed by 1% formalin was increased up to as high as 17-fold compared with the recovery of live organisms, as detected using a real-time polymerase chain reaction assay. The reagents investigated did not enhance the immunological reactivity of the mAbs to this organism. These results indicate that the addition of several reagents enhanced the capture of C. jejuni by IMS, which could be partially due to the slowing down of the movement or the altering of the motility of C. jejuni and to the increasing of the contact time between C. jejuni and immunomagnetic beads.

Improvement of modified charcoal-cefoperazone-deoxycholate agar by supplementation with a high concentration of polymyxin B for detection of Campylobacter jejuni and C. coli in chicken carcass rinses

Modified charcoal-cefoperazone-deoxycholate agar (mCCDA) was improved by supplementation with a high concentration of polymyxin B. The ability of the supplemented medium to isolate Campylobacter jejuni and C. coli from chicken carcass rinses was compared to that of Campy-Cefex agar and mCCDA. Modification of mCCDA with increased polymyxin B yielded a significantly (P < 0.05) higher isolation rate and greater selectivity than those achieved using Campy-Cefex agar and mCCDA.

A charcoal- and blood-free enrichment broth for isolation and PCR detection of Campylobacter jejuni and Campylobacter coli in chicken

The microaerophilic nature of Campylobacter and its requirement of ∼5% O(2) for growth have complicated its recovery from foods. The addition to the enrichment media of oxygen quenchers such as charcoal or blood could interfere with PCR for its detection. In this study, a two-step simple aerobic method for Campylobacter detection is proposed. A modification of the Tran blood-free enrichment broth (BFEB), in which charcoal was excluded from the medium (M-BFEB), was compared with the original formulation and other enrichment broths. Campylobacter jejuni and Campylobacter coli were screened by PCR directly from the enrichment media. Various levels of pure cultures of C. jejuni and C. coli combined with Escherichia coli were inoculated into Preston, Bolton, BFEB, and the modified BFEB (M-BFEB). In addition, Campylobacter was inoculated onto retail purchased chicken skin and recovery was quantified. Rates of recovery after 24 to 48 h of enrichment at 42 °C under aerobic incubation for BFEB and M-BFEB and microaerobic incubations for Preston and Bolton broths were determined. Overall, our results indicated that the most sensitive medium was Bolton's, followed by either BFEB or M-BFEB; the least sensitive was Preston's. M-BFEB was directly coupled to a PCR assay to detect Campylobacter, avoiding intermediate plating. Campylobacter was detected in the presence of up to 10(8) E. coli cells per ml. M-BFEB facilitated detection of both C. jejuni and C. coli artificially inoculated onto chicken skin samples. M-BFEB coupled to PCR is a rapid and attractive alternative for isolation and identification of C. coli and C. jejuni from poultry.

Comparison of loop-mediated isothermal amplification assay and conventional culture methods for detection of Campylobacter jejuni and Campylobacter coli in naturally contaminated chicken meat samples

We investigated the efficacy of a loop-mediated isothermal amplification (LAMP) assay for detection of chicken meat samples naturally contaminated with Campylobacter jejuni and Campylobacter coli. A total of 144 Preston enrichment broth cultures from chicken meat samples were assessed by using the LAMP assay and conventional culture methods, which consist of a combination of Preston enrichment culturing and plating onto Butzler and modified charcoal cefoperazone deoxycholate agars. Compared with C. jejuni-C. coli isolation using the conventional culture test, the LAMP results showed 98.5% (67/68) and 97.4% (74/76) sensitivity and specificity, respectively, and the positive and negative predictive values were 97.1% (67/69) and 98.7% (74/75), respectively. The conventional culture test required more than 3 to 4 days to isolate and identify C. jejuni and C. coli in the Preston enrichment cultures. In contrast, the LAMP assay was markedly faster, requiring less than 90 min from the beginning of DNA extraction to final detection and differentiation of C. jejuni and C. coli. In total, the LAMP assay required 23.5 to 25.5 h from the beginning of the enrichment culture to final determination. These results suggest that our LAMP assay is a powerful tool for rapid, sensitive, and practical detection of C. jejuni and C. coli which may facilitate surveillance and control of C. jejuni-C. coli contamination in chicken, as well as investigations of food poisoning incidents caused by these organisms. This is the first report of a highly sensitive and specific LAMP assay to detect and differentiate C. jejuni and C. coli in chicken meat samples.

Evaluation of different plate media for direct cultivation of Campylobacter species from live broilers

Accurate identification and optimal culturing procedures for Campylobacter spp. from live broilers are needed for epidemiological studies. Because there is no standardized protocol, we designed and conducted studies to evaluate different selective media for the culturing and isolation of Campylobacter spp. from cecal and fecal samples obtained from battery-reared and commercial broilers. Five media selective for Campylobacter were evaluated: Campylobacter agar base, Campylobacter, Campy-Line, modified Campy-Cefex, and modified charcoal cefoperazone deoxycholate agar. With contaminated broilers reared in battery cages, Campylobacter agar base, Campylobacter, modified Campy-Cefex, and modified charcoal cefoperazone deoxycholate agar revealed similar isolation rates (P > 0.05), whereas Campy-Line showed a lower efficacy (P < 0.05). With commercial live broilers, modified Campy-Cefex agar was more consistent for the isolation of Campylobacter from feces, whereas modified Campy-Cefex and modified charcoal cefoperazone deoxycholate agar showed similar isolation rates from cecal samples. Campy-Line agar showed a lower identification rate (P < 0.05) for both fecal and cecal samples. A multiplex PCR assay used for identification showed that Campylobacter jejuni and Campylobacter coli DNA was present in the samples. Pulsed field gel electrophoresis restriction profiles differed among samples collected from different commercial farms but were similar for isolates from the same farm, suggesting clonal differences. No variation was seen in pulsed field gel electrophoresis patterns among isolates cultured on different media. Our data suggest that the choice of plate medium may influence the efficiency of isolating Campylobacter spp. from broiler chickens by direct plating from fecal or cecal samples.

Novel Campylobacter isolation method using hydrophobic grid membrane filter and semisolid medium

Culture procedures for isolation of thermophilic campylobacters from food matrices are complex, labor intensive, and time-consuming. Most available methods include the use of antibiotics as selective agents to prevent the growth of competing microflora. A simple procedure for isolation of thermophilic campylobacters after enrichment in Rosef's enrichment broth was developed using a hydrophobic grid membrane filter (HGMF) on semisolid medium (SSM). SSM contains no antibiotics, and the HGMF physically separates Campylobacter from the enrichment broth, allowing isolation based on differential motility. The HGMF-SSM method was compared to the Agriculture and Agri-Food Canada Food Safety Procedures Manual (FSPM-10) method (Isolation of Thermophilic Campylobacters from Fresh Pork, Beef Veal, Poultry and Ready-to-Eat Meat Products), which includes the use of selective antibiotics. During the initial study, after enrichment the HGMF-SSM method yielded pure cultures of campylobacters after 16 to 18 h (overnight) compared with 48 h for the FSPM-10 method. Ninety-four turkey samples collected at local retail stores and 38 frozen pig fecal samples were processed by both methods. Thirty-five samples (26.5%) were positive by the HGMF-SSM method; 24 (18.2%) of these positive samples contained Campylobacter jejuni and 11 (8.3%) contained Campylobacter coli. With the FSPM-10 method, 25 samples (18.9%) were positive: 21 (15.9%) with C. jejuni and 4 (3%) with C. coli. For a subsequent field study, only the HGMF-SSM method was used to isolate Campylobacter from 1,200 chicken samples and 454 turkey samples sold at retail. Analysis of five subisolates from various samples indicated that only one type of Campylobacter was recovered by the HGMF-SSM method, as ascertained by MICs for 10 antimicrobials, sequencing of the short variable region of the flaA gene, and fingerprinting based on amplified fragment length polymorphism. The absence of antibiotics in the SSM may explain the higher recovery of thermophilic campylobacters. The HGMF-SSM method resulted in improved isolation of campylobacters and is simpler, faster, cheaper, and less labor intensive than the FSPM-10 method. The recovery of one type of Campylobacter from the chicken samples may have important implications, particularly in epidemiological studies.

Towards an international standard for PCR-based detection of foodborne thermotolerant campylobacters: interaction of enrichment media and pre-PCR treatment on carcass rinse samples

As part of a large EU project for standardisation of polymerase chain reaction (PCR), a systematic evaluation of the interaction of enrichment media, type of DNA polymerase and pre-PCR sample treatment for a PCR detecting thermotolerant campylobacters was carried out. The growth-supporting capacity and PCR compatibility of enrichment in Preston, Mueller-Hinton and Bolton broth (blood-containing and blood-free) were evaluated. The effect of resin-based DNA extraction and DNA extraction by boiling on the final PCR assay was investigated. The time-course studies indicated that a 20-h sample enrichment in blood-containing Bolton broth, followed by a simple resin-based extraction of DNA and a PCR amplification using Tth polymerase, resulted in strong and clear PCR amplicons for target (287 bp) and internal amplification control (IAC, 124 bp). The enrichment PCR-based method, tested on 68 presumably naturally contaminated poultry-rinse samples, showed a diagnostic sensitivity of 97.5% (39 PCR-positive/40 total positive samples) and a diagnostic specificity of 100% (28 PCR-negative/28 total negative samples; P=0.32) when compared to a standard bacteriological method (ISO 10272).

Effect of temperature on viability of Campylobacter jejuni and Campylobacter coli on raw chicken or pork skin

To determine growth and survival of Campylobacter jejuni and Campylobacter coli on chicken and pork, Campylobacter spp. (10(4) CFU/cm2) were inoculated on pieces of raw, irradiated chicken or pork skin and exposed to temperatures ranging from -20 to 42 degrees C under either microaerobic or aerobic conditions. Viable counts over 48 h declined 2 to 3 log CFU/cm2 at -20 degrees C and 1 to 2 log CFU/cm2 at 25 degrees C regardless of skin type, species of Campylobacter, or level of oxygen. At 4 degrees C, there was no significant change in the number of Campylobacter over 48 h. At both 37 and 42 degrees C, the number of viable Campylobacter increased significantly (2 to 3 log CFU/cm2, P < 0.0001) under microaerobic conditions but decreased 0.5 to 1.5 log CFU/cm2 in air. Preincubation of skins for 24 h at 42 degrees C under microaerobic conditions to establish Campylobacter on the surface prior to lowering the temperature to -20, 4, or 25 degrees C and incubating in air resulted in a decline in viability for the first 4 h (0.5 to 1 log CFU/cm2). However, after this initial drop in viability, no additional effect on viability was observed compared with incubation at -20, 4, or 25 degrees C in air without microaerobic preincubation at 42 degrees C. Preincubation of inoculated skins at -20, 4, or 25 degrees C in air for 24 h followed by a shift in temperature to 42 degrees C for 4, 8, 24, or 48 h and a shift to microaerobic conditions resulted in an overall decline in viability on raw pork skin but not on raw chicken skin. In contrast, preincubation of inoculated skins at -20, 4, or 25 degrees C for 24 h in air followed by a shift in temperature to 37 degrees C and microaerobic conditions did not result in a decrease in viable counts for either chicken or pork skins. Overall, viability of C. coli and C. jejuni on chicken and pork skins was similar. Therefore, a lower incidence of Campylobacter spp. in pork than in poultry postslaughter, despite a similar prevalence in live animals, is not due to differences in viability of C. coli versus C. jejuni on raw chicken or pork skin.

Campylobacter and fluoroquinolones: a bias data set?

There is no universally accepted standard method for the isolation of Campylobacter spp. and it is considered that currently available isolation media are not yet optimal for the recovery of Campylobacter spp. from a range of sample types. Almost all methods incorporate antibiotics into the isolation media to inhibit growth of other bacteria within the sample. It is established that the incorporation of such antibiotics into isolation media will inhibit the growth of some Campylobacter spp. as well as other bacteria. The results of the use of such suboptimal isolation methods are that the isolates which 'survive' the isolation procedure will be those which: (i) are able to 'out compete' the rest of the bacteria in the sample, i.e. they are able to grow faster; (ii) are resistant to the antibiotics used in the isolation media; and (iii) are randomly selected by the laboratory technician as being a 'typical'Campylobacter spp. It is clear that such a procedure is intrinsically biased and will mean that species resistant to the antibiotics used in the media will be isolated. This introduces real doubt that the bacteria isolated are truly representative of those initially found on the sample. It is also becoming clear that Campylobacter spp. are rather difficult to isolate as pure cultures and many are in fact mixtures of more than one strain. Again this introduces great uncertainty as to the prevalence and distribution of respective species from the different sample types. This is especially true when considering isolation of Campylobacter spp. causing disease in man as there is no certainty that the selected isolate is that which was responsible for disease. The incorporation of antibiotics into the isolation media not only introduces the issue of species bias but perhaps more importantly exposes the Campylobacter spp. to a cocktail of antibiotics thereby providing the potential for them to 'switch on' antibiotic resistance mechanisms. It might be argued that this has always been the case for isolation of Campylobacter spp., however, we know that the antibiotic cocktails used in media over the last 10 years have changed and indeed there was a time when the filtration protocol which didn't use antibiotics was more widely used. As most reports in the literature do not state what methods were used to isolate Campylobacter spp. it is not possible to quantify any relationship between antibiotics used in the isolation media and susceptibility data. An approved method for Campylobacter susceptibility testing was not available until May 2002, all data generated prior to this date will have been generated using non-standard methods. As tremendous variability in the reproducibility data for Campylobacter spp. was observed during the development of the standard agar dilution susceptibility method, data generated with disk diffusion and broth microdilution methods must be considered with caution. It has been shown that, compared with the conventional agar dilution method, the E-test tends to give rise to lower minimal inhibitory concentrations (MICs) for sensitive strains and higher MICs for resistant strains. There are no recommended antibiotic breakpoint concentrations for Campylobacter spp. A breakpoint is used to separate sensitive from resistant strains of bacteria and is thus crucial to any discussion of antibiotic resistance. This discussion is further complicated by introduction of the terms microbiological and clinical breakpoints. While a microbiological breakpoint can be a useful parameter with regard to identifying resistance factors it cannot on its own be used to predict whether that bacteria will respond to treatment from an appropriate antibiotic. Predicting clinical response is a function of the clinical breakpoint which considers the pharmacokinetic profile of the antimicrobial compound, i.e. the concentration of the antimicrobial compound in the body and the MIC. The National Committee for Clinical Laboratory Standards (NCCLS) uses microbiological, pharmacokinetic and clinical data to establish breakpoints, without c and clinical data to establish breakpoints, without such considerations it is not possible to consider what is truly clinically sensitive and resistant. There are no reported studies that have systematically determined appropriate breakpoints for Campylobacter, there are data however, which relate MICs to clinical outcome. It is without dispute that microbiological resistance in Campylobacter spp. occurs as a result of mutation in the gyrA gene with single point mutations most frequently causing a four- to eightfold shift in the MIC. What is also clear is that if a high enough concentration of antimicrobial relative to MIC of the infecting organism can be achieved not only will the parent organism be killed but also the 'resistant' mutant. Considering the above and the concentrations of ciprofloxacin achieved in the gastro-intestinal tract it is not surprising that clinical cure can be demonstrated for organisms with an MIC of 32 microg ml(-1).

Comparison of two selective media for the isolation of Campylobacter species from a pediatric population in Mexico

Two selective media for the isolation of Campylobacter species, a blood containing medium (CampyBAP) and blood-free, charcoal based formulation (CCDA) were compared for the ability to isolate Campylobacter species during a 1-year period. Of the 1,132 stool samples cultured during the study, 42 Campylobacter species were recovered using both media (3.7% yield). CCDA was better than CampyBAP for isolating C. jejuni subsp jejuni (18/20 vs 8/20, P = 0.002) and for all isolates, CCDA was superior over CampyBAP (39/42 vs 13/42, P < 0.0001). Overall, CCDA is a superior medium compared with CampyBAP for isolating Campylobacter species in our study population.

Disc susceptibility testing for thermomphilic campylobacters

The minimum inhibitory concentrations (MICs) and zone diameters around NCCLS strength discs of 100 clinical isolates of thermophilic Campylobacter species, including 79 strains of Campylobacter jejuni subsp. jejuni, 19 of C. coli and two of C. lari, plus three type strains of these species, were determined for erythromycin, clindamycin, nalidixic acid, norfloxacin, ciprofloxacin, ampicillin, piperacillin, cephalothin, ceftriaxone, chloramphenicol, gentamicin and tetracycline. Using error-rate bounded analysis and adjustment of MIC breakpoints to fit natural populations, tentative interpretive zone diameter criteria were set for each of the antimicrobials. Application of these criteria showed that resistance to quinolones was not detected in species other than C. lari. Two strains of C. jejuni subsp. jejuni were susceptible to cephalothin. The type strain of C. lari was susceptible to erythromycin and resistant to clindamycin. Full resistance to erythromycin, chloramphenicol or gentamicin was not found in any strain, while nine strains were resistant to tetracycline. This disc method should provide a simple approach to resistance detection for surveillance or routine testing of invasive isolates.

Sub-typing of animal and human Campylobacter spp. using RAPD

Based on a 10-mer primer (5'-CCTGTTAGCC-3'), a random amplified polymorphic DNA (RAPD) method for typing Campylobacter coli isolated from pigs was developed. The method proved effective with a high discrimination and good reproducibility. In contrast with serotyping no untypable strains were found out of a total of 269 isolates (veterinary, food and clinical) examined. The method was also successfully applied to typing Campylobacter jejuni from a similar range of sources.

Evaluation of API Campy in comparison with conventional methods for identification of thermophilic campylobacters

API Campy was compared with conventional biochemical methods for its ability to identify 100 thermophilic campylobacter isolates. When the results were read according to the manufacturer's instructions, API Campy showed 92% agreement with conventional methods. Extended incubation of the assimilation strip resulted in the correct identification of an additional two isolates. Discrepant results occurred for six isolates. Overall, API Campy offered no advantages over conventional methods.

The speciation and subtyping of campylobacter isolates from sewage plants and waste water from a connected poultry abattoir using molecular techniques

In this study the distribution of phenotypes of campylobacter strains in sewage and surface waters was investigated by subtyping and by speciation of isolates from various aquatic environments. These environments included two municipal sewage plants (SPA and SPB) and waste water from a poultry abattoir (WWA). Both the sewage plants SPA and SPB collected domestic and industrial waste, and SPA received drain water from WWA. SPB received no waste water from any meat-processing plant. The isolates were speciated by PCR and subtyped by PCR/RFLP based on the flagellin PCR products. From all three reservoirs, no Campylobacter lari was isolated, and approximately 80% of the isolates could be identified as C. jejuni and the rest belonged to the C. coli species. The PCR/RFLP typing technique has a high discrimination level and was reproducible between two separate laboratories. The 182 isolates tested yielded 22 distinct Dde I profiles. The results indicate that strains with profiles found in poultry are also detectable in waste water presumed to be solely from domestic and human sources. In addition some strains were unique to the known poultry-related sources, suggesting that avian-specific strains, non-pathogenic to man, may exist in the environment. In contrast some strains were unique to human waste indicating the potential importance of non-poultry sources of infection. No seasonality was observed in the profile distribution. So, at least in the Netherlands, it is unlikely that infections caused by contaminated surface waters contribute to the seasonality of human campylobacteriosis.

Culture media for the isolation of campylobacters

The history of the development of selective media for isolation of campylobacters, including the rationale for choice of selective agents is described. Developments have included modifications to allow incubation at 37 degrees C instead of 42 or 43 degrees C and changes in the types and concentrations of antibiotics in order not to inhibit organisms such as Campylobacter upsaliensis, C. jejuni subsp. doylei and some strains of C. coli and C. lari. When examining foods, plating media originally developed for isolation from faeces are normally used, sometimes after liquid enrichment. Most of the media include ingredients intended to protect campylobacters from the toxic effect of oxygen derivatives. Most commonly used are lysed or defibrinated blood; charcoal; a combination of ferrous sulphate, sodium metabisulphite and sodium pyruvate (FBP); and haemin or haematin. To date no medium includes an indicator system--for instance a pH indicator to show whether colonies produce acid or alkali from particular substrates. The manner in which liquid enrichment media are used has been modified for food samples to avoid inhibitory effects on sublethally damaged cells by toxic components in the formula. This is done by a preliminary period of incubation at reduced temperature and sometimes by delayed addition of antibiotics. Expensive and time-consuming methods have been proposed to achieve a microaerobic atmosphere while using liquid enrichment media. To date there is no generally accepted 'standard' method of isolating campylobacters from food.

Occurrence of plasmids and tetracycline resistance among Campylobacter jejuni and Campylobacter coli isolated from whole market chickens and clinical samples

Twenty whole market chickens, purchased from 10 different stores in the Taipei Metropolitan area, were examined for the presence of Campylobacter jejuni and Campylobacter coli. The microorganisms were recovered from 95% of the chickens. A survey of different sites on--breast, thigh and tail--showed that contamination was equally common on all these sites. One hundred and sixty-seven chicken isolates and the 41 clinical isolates of Campylobacter jejuni were examined for the occurrence of plasmid DNA in association with tetracycline resistance. A high plasmid occurrence rate of 91% and 44% was observed for C. jejuni from chickens and clinical isolates, respectively. Plasmids ranged in size from 16 to 208 Kb. A 61 Kb plasmid and a 50 Kb plasmid were common to the chicken isolates and clinical isolates, respectively. All chicken isolates and 78% of clinical isolates were tetracycline-resistant. The high rate of tetracycline resistance in chicken isolates probably related to use of tetracycline as a growth promoter for poultry. A tetO DNA Probe, highly specific for the detection of tetracycline resistance in C. jejuni and C. coli, was used to find the location of tetracycline resistance. Of 157 chicken isolates, 98% of isolates were positive with the tetO probe, 87% (137/157) on plasmids and 11% (17/157) on the chromosome; only three isolates did not hybridize with the tetO probe. Of 32 clinical isolates, 88% isolates hybridized with the tetO probe, 47% (15/32) on plasmids and 41% (13/32) on the chromosome; four isolates did not hybridize with the tetO probe.

Susceptibilities of beta-lactamase-positive and -negative strains of Campylobacter coli to beta-lactam agents

The percentages of susceptibility of 28 strains of Campylobacter coli to beta-lactam agents were 96% for amoxicillin and ampicillin, 57% for ticarcillin, 4% for cefoxitin and cefuroxime, 61% for cefotaxime, and 11% for ceftazidime. None of the strains were susceptible to penicillin G, piperacillin, cefazolin, cephalothin, cefamandole, and cefoperazone. All strains were susceptible to imipenem and ciprofloxacin, and 21% were susceptible to erythromycin. A beta-lactamase was detected in 68% of the strains by cefinase disks and by the nitrocefin method. The beta-lactamase-positive strains were significantly less susceptible to amoxicillin, ampicillin, and ticarcillin than the beta-lactamase-negative strains (P < or = 0.003). Clavulanic acid (0.25 microgram/ml) but not sulbactam and tazobactam (2 micrograms/ml) lowered to susceptible levels the amoxicillin and ampicillin MICs of the only strain of C. coli resistant to amoxicillin, ampicillin, and ticarcillin.

In vitro susceptibilities of aerotolerant Campylobacter isolates to 22 antimicrobial agents

We evaluated the in vitro activities of 22 antimicrobial agents against 78 human and animal isolates belonging to two aerotolerant Campylobacter species, C. cryaerophila and C. butzleri, using a broth microdilution technique. An additional 10 antimicrobial agents were included at concentrations found in selective Campylobacter media. Strains of C. cryaerophila belonged to two DNA hybridization groups: DNA hybridization group 1A, which includes the type strain of C. cryaerophila, and DNA hybridization group 1B. The aminoglycosides, fluoroquinolones, and one tetracycline (minocycline) demonstrated the most activity against all DNA hybridization groups (C. cryaerophila DNA groups 1A and 1B and C. butzleri). Most isolates were resistant to cephalosporin antibiotics, with the exception of cefotaxime, and were variably susceptible to trimethoprim-sulfamethoxazole. C. cryaerophila DNA hybridization group 1A isolates were generally susceptible to the tetracyclines, chloramphenicol, nalidixic acid, azithromycin, erythromycin, and roxithromycin and moderately susceptible to clindamycin, trimethoprim-sulfamethoxazole, ampicillin, and ampicillin-sulbactam. The MICs of tetracyclines were higher for C. butzleri and C. cryaerophila DNA hybridization group 1B isolates than for C. cryaerophila DNA hybridization group 1A isolates, but most strains were still susceptible to doxycycline and tetracycline; all isolates were susceptible to minocycline. C. butzleri and C. cryaerophila DNA hybridization group 1B isolates were generally resistant to the macrolide antibiotics (including erythromycin), chloramphenicol, clindamycin, nalidixic acid, ampicillin, and trimethoprim-sulfamethoxazole. Differences in antimicrobial susceptibility between aerotolerant Campylobacter species and more common Campylobacter species, e.g., C. jejuni, suggest that different treatment strategies may be necessary. Strains of all three DNA hybridization groups of aerotolerant Campylobacter isolates were susceptible to colistin, polymyxin B, and rifampin at concentrations commonly used in selective media. These results suggest that primary isolation methods for Campylobacter species may need to be modified to include aerotolerant Campylobacter strains.

Clinical features of sporadic Campylobacter infections in Norway

To assess risk factors and clinical impact of campylobacteriosis in Norway, a case-control study of sporadic cases of infection with thermotolerant Campylobacter spp. was conducted. This report describes: (1) the frequency and duration of signs and symptoms, antimicrobial treatment, hospitalization, and faecal carriage among the study patients; (2) diarrhoeal illness and campylobacter carriage among their household members; and (3) antimicrobial susceptibility pattern among bacterial isolates. A total of 135 patients with bacteriologically confirmed campylobacter infection were enrolled in the study. Of these, 58 (43%) were domestically acquired while 77 (57%) were acquired abroad. If the study enrollees are representative of the cases reported to the national surveillance system, the reported infections led to an estimated annual average of at least 8590 days of illness, 78 admissions to hospital, 329 days of hospital stay, 2236 days lost at work or at school, 1000 physician consultations, and 96 antimicrobial prescriptions among the 4.2 million Norwegians. Convalescent carriage of campylobacter was detected in 16% of the patients who submitted follow-up stool specimens; the organism was carried for a mean of 37.6 days (median 31, range 15-69) after the onset of illness. Antimicrobial treatment appeared to have reduced the likelihood of carriage once symptoms had resolved. Diarrhoeal illness was more commonly reported in members of case households than control households (OR = 5.44, p < 0.0001). Cases were more likely than controls to report antecedent recurrent diarrhoea (OR = 6.00, p = 0.034). Two cases of neonatal infection, probably acquired from the mother at the time of delivery, were detected.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro susceptibility of "Campylobacter upsaliensis" to twenty-four antimicrobial agents

The in vitro susceptibility of 41 strains of "Campylobacter upsaliensis" to 24 antimicrobial agents was determined using a broth microdilution procedure. Most isolates were susceptible to the fluoroquinolones and beta-lactam antibiotics tested, but all strains were resistant to trimethoprim (MBCs greater than or equal to 128 micrograms/ml) and teicoplanin (MBCs greater than or equal to 32 micrograms/ml). These agents may be useful in a selective isolation medium for "Campylobacter upsaliensis".

DNA probe culture confirmation assay for identification of thermophilic Campylobacter species

We studied the ability of a new DNA probe-based assay system to correctly identify isolates of the thermophilic campylobacters Campylobacter jejuni, C. coli, and C. laridis grown in vitro. We examined 424 organisms, including 214 Campylobacter isolates and 210 other aerobic and anaerobic isolates. The probe assay, which uses a new homogeneous system in which all reactions take place within a single tube, demonstrated 100% accuracy, producing neither false-positive nor false-negative results. The assay does not, however, distinguish among C. jejuni, C. coli, and C. laridis.

Comparison of some enrichment broths and growth media for the isolation of thermophilic campylobacters from surface water samples

Three different enrichment broths and two selective growth media were compared for isolating thermophilic campylobacters by combined membrane filtration and enrichment techniques from surface waters of different physical, chemical and bacteriological characteristics. Fifty-two strains of campylobacters were isolated from total of 1668 cultures. The various broth/medium combinations did not affect the dominance of C. jejuni over C. coli (total 49 C. jejuni and three C. coli). The most efficient combinations of enrichment broth and growth media were either Oosterom broth/blood-free charcoal-cefoperazone-deoxycholate agar (CCDA) medium or blood-free charcoal-cefoperazone-deoxycholate (CCD) broth/CCDA medium. Modified Preston broth (sheep blood instead of horse blood) with either of the growth media gave significantly lower yields although it suppressed efficiently the growth of contaminants. Skirrow medium had lower selectivity than CCDA medium and gave slightly lower isolation rate. Enrichment time (24 or 48 h) did not affect the isolation frequency of campylobacters but longer enrichment time increased the growth of contaminants. Prefiltration through membranes of pore sizes 5.0 and 1.2 microns decreased the growth of contaminants. However, these membranes retain campylobacters and must be cultured to avoid underestimation. From more polluted waters campylobacters were isolated most frequently with CCD broth and CCDA medium.

Prevalence of Campylobacter jejuni in ranch mink at pelting: Cultural, serological, and histological evidence of infection

This survey of 500 mink on three Wisconsin ranches at pelting gives an estimate of the prevalence of Campylobacter jejuni in the feces of clinically normal animals. On ranches 1 and 2, which used wet feed, C. jejuni was isolated by colon content culture from 7% and 32% of mink one year, and 43% and 13% the next year; the 200 bile samples tested were culture-negative. On ranch 3, which fed a pelleted ration, the organism was never isolated. Among culture-positive mink tested, 22 of 55 had bacterial agglutination serum titers to homologous and/or heterologous Campylobacter isolates from the ranch of origin. Four of 23 culture-negative animals tested had titers. No histological evidence of inflammatory changes in the lower ileum and/or colon was found, although Campylobacter-like organisms were rarely seen in silver-stained sections from both culture-negative and culture-positive animals. We conclude that the presence of C. jejuni in the mink gut does not necessarily indicate a role in gastrointestinal disease.

Isolation and characterization of catalase-negative and catalase-weak strains of Campylobacter species, including "Campylobacter upsaliensis," from humans with gastroenteritis

During 1987 and 1988, nine strains of catalase-negative or -weak Campylobacter species were isolated in Alberta, Canada. DNA hybridization studies demonstrated that seven strains were "Campylobacter upsaliensis," one strain was highly homologous with Campylobacter jejuni DNA, and one strain was a campylobacter unrelated to the other two species. All "C. upsaliensis" strains were hippurate negative, and six of seven were susceptible to cephalothin. The unusual variant of C. jejuni was hippurate positive and cephalothin resistant, whereas the unclassified strain was hippurate negative and resistant to intermediate levels of cephalothin. All patients from whom "C. upsaliensis" was isolated had diarrhea. Five of the patients were children two years old or younger, and two were adults. In this study, all catalase-negative and -weak strains were isolated from stool specimens by using a charcoal-based selective medium containing 32 micrograms of cefaperazone per ml and which was described by Hutchinson and Bolton (D. N. Hutchinson and F. J. Bolton, J. Clin. Pathol. 37:956-957, 1984).

Semisolid blood-free selective-motility medium for the isolation of campylobacters from stool specimens

Isolation of Campylobacter jejuni and C. coli from stool specimens is done by growing campylobacter colonies on solid selective media with or without blood. However, recognition of these colonies can be difficult. Therefore, we decided to evaluate an isolation procedure based on the swarming of campylobacters through a semisolid medium. We developed a semisolid blood-free selective motility (SSM) medium which is composed of Mueller-Hinton broth with 0.4% agar and supplemented with cefoperazone (30 micrograms/ml) and trimethoprim (50 micrograms/ml). The SSM medium was compared with our previously described Butzler Medium Virion (Goossens et al., J. Clin. Microbiol. 24:840-843, 1986) and blood-free medium (Bolton and Coates, J. Appl. Bacteriol. 54:115-125, 1983) with cefoperazone (32 micrograms/ml) (Bolton et al., J. Clin. Pathol. 37:956-957, 1986). Of 1,890 routine stool specimens tested, 100 were found to be positive for campylobacters: 95 were recovered with the SSM medium, 94 with the Virion medium, and 90 with the blood-free medium. The SSM medium performed equally well whether it was incubated in the special incubator or the candle jar. Only 4.4 and 7.3% of the plates grew contaminating fecal flora when incubated in the special incubator and the candle jar, respectively. Clearly the SSM medium is easy, quick, cheap, sensitive, and more selective than any other medium which has been developed so far and does not require the addition of blood. We believe that this medium has a future in the routine microbiology laboratory in developed as well as in developing countries.

Recovery of Campylobacter from human faeces stored at 4 degrees C

Six hundred and thirteen fresh diarrhoeal faeces were inoculated on Skirrow blood agar (SK), on Preston blood free agar (PBF), and in Campy-thioglycolate broth (CT). After 24 h of storage at 4 degrees C, specimens were again inoculated on SK and PBF, and in Campylobacter enrichment broth (CEB). CT tubes were placed overnight at 4 degrees C. Plates and CEB tubes were incubated at 43 degrees C in microaerophilic conditions. A total of 68 specimens was positive for campylobacter on direct plating. Sixty-four of them were also recovered after subculturing from CT, and only 51 from CEB. Delayed inoculation of plates after storage of samples at 4 degrees C yielded 57 isolates. The storage of faeces at 4 degrees C for 24 h significantly reduces the number of campylobacter isolates. When samples are not plated immediately we recommend inoculating a CT tube maintained at 4 degrees C overnight as a holding medium.

The genus Campylobacter: a decade of progress

In 1977, microbiologists and clinicians were awakened to the importance of the genus Campylobacter when it was learned that one species, Campylobacter jejuni, was a major cause of human enteritis. In the following decade substantial advances were made in diagnosis, isolation technology, identification, classification, serotyping, and epidemiology. The genus has undergone rapid expansion as advantage was taken of the deoxyribonucleic acid-deoxyribonucleic acid hybridization technique in defining new species. The 14 species now included in the genus, however, constitute a widely diverse group, and one species, C. pylori, which is associated with human gastroduodenitis, is under consideration for reassignment to another genus. The nomenclature of the subspecies of C. fetus has been resolved and the role of C. fetus subsp. fetus as an agent of human infections has been more clearly defined. The thermophilic campylobacteria that are etiological agents of human enteritis now include three species, C. jejuni, C. coli, and C. laridis. Recently defined species that have also been implicated as enteritis-causing agents include C. hyointestinalis, "C. upsaliensis," "C. cinaedi," and "C. fennelliae." The aerotolerant campylobacteria are now included in the species C. cryaerophila, and the campylobacteria isolated from salt marshes are included in C. nitrofigilis. The taxonomy and nomenclature of C. sputorum have been revised. C. sputorum now consists of three biovars (biotypes). Two of these, biovar sputorum and biovar bubulus, were previously considered to be separate subspecies and the third, biovar fecalis, was previously regarded as a separate species and known as "C. fecalis." The former subspecies C. sputorum subsp. mucosalis has been elevated to the rank of species. C. mucosalis is metabolically closely related to C. consisus. Human pathogens have not been identified among C. sputorum, C. mucosalis, or C. concisus. The goal of this article is to review developments during the last 10 years with emphasis on changes in taxonomy that are important from the perspective of the clinical microbiologist.

Characterization of freshly isolated Campylobacter coli strains and suitability of selective media for their growth

Typical and atypical Campylobacter strains were isolated from the colons of cattle and swine by techniques that enabled the selective pressures of antibiotics to be avoided. Some cephalothin-susceptible strains and a strain with an indeterminate hippurate reaction were classified as Campylobacter coli by DNA homology testing. Tetracycline-resistant isolates were obtained from animals with no recorded exposure to antibiotics. A selection of 12 C. coli and 6 C. jejuni strains was used to determine the ability of fresh isolates to grow on a range of selective media. C. coli isolates were inhibited more than C. jejuni on selective media containing antibiotics. The least inhibitory media were Skirrow medium (M. B. Skirrow, Br. Med. J. 2:9-11, 1977) and the charcoal-based media developed by Hutchinson and Bolton (D. N. Hutchinson and F. J. Bolton, J. Clin. Pathol. 37:956-957, 1984) and Karmali et al. (M. A. Karmali, A. E. Simon, M. Roscoe, P. C. Fleming, S. S. Smith, and J. Lane, J. Clin. Microbiol. 23:456-459, 1986). The plasmid contents of the isolates did not appear to be related to their sensitivity to growth on selective (antibiotic-containing) media. The study indicates that selective media used to detect Campylobacter spp. could select against the isolation of C. coli.

DNA probes for identification of tetracycline resistance genes in Campylobacter species isolated from swine and cattle

Tetracycline-resistant strains of Campylobacter jejuni and Campylobacter coli from swine and cattle colons were isolated and characterized by hybridization with DNA probes. A probe consisting of the 1.8-kilobase (kb) HincII fragment from pUA466 was highly specific for the detection of tetracycline resistance (Tcr) in C. jejuni and C. coli. The 5-kb tetM DNA probe from Streptococcus agalactiae plasmid pJI3 which has homology with the 1.8-kb HincII fragment from pUA466 could also be used to detect Tcr Campylobacter strains. However, the tetM probe had a much lower sensitivity and required a lower stringency of hybridization. Therefore, the 1.8-kb HincII fragment appeared to be more appropriate for the classification of Tcr in Campylobacter spp. No homology was detected between the Tcr determinant from Campylobacter spp. and the tetL and tetN probes from Streptococcus spp. DNA homology was demonstrated between pUA649, a derivative of plasmid pUA466 which had lost most of the Tcr region, and Tcr plasmids from C. jejuni and C. coli isolated from animal and human sources. There was also homology between pUA649 and the chromosomes of C. jejuni and C. coli strains. In this study, all but one of the tetracycline-resistant C. coli and C. jejuni strains contained plasmids of approximately 50 kb which hybridized with the 1.8-kb HincII probe. In one C. coli strain (UA703), Tcr appeared to be chromosomally mediated.

A blood-free medium for isolation of thermophilic Campylobacter species

A blood-free medium for the recovery of thermophilic Campylobacter was compared with Butzler Medium Virion during a one-year study using 2,893 human feces samples. Ninety Campylobacter strains (3.1%) were isolated after incubation for 48 h at 42 degrees C in a candle jar atmosphere. Three strains of Campylobacter jejuni were isolated on the blood-free medium only and one on Butzler Medium Virion only. Fecal flora was equally well inhibited on both media except for gram-positive organisms, which were completely inhibited only on the blood-free medium.