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Grammatikos A, Thomas M, Johnston S, Moghaddas F, Albur M, Yong P, Buckland M, Grigoriadou S, Whyte AF, Herwadkar A, Gompels M. Chronic or recurrent Campylobacter enteritis in primary immunodeficiency: A UK national case-series and review of the literature. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2948-2954.e4. [PMID: 37301434 DOI: 10.1016/j.jaip.2023.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 05/15/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Alexandros Grammatikos
- Bristol Immunology and Allergy Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom.
| | - Moira Thomas
- Clinical Immunology Service, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - Sarah Johnston
- Bristol Immunology and Allergy Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Fiona Moghaddas
- Bristol Immunology and Allergy Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Mahableshwar Albur
- Bristol Centre for Antimicrobial Research and Evaluation, North Bristol NHS Trust, Bristol, United Kingdom
| | - Patrick Yong
- Immunology Department, Frimley Park Hospital, Frimley Health NHS Trust, Frimley, United Kingdom
| | - Matthew Buckland
- Immunology Department, Barts and The London NHS Trust, London, United Kingdom
| | - Sofia Grigoriadou
- Immunology Department, Barts and The London NHS Trust, London, United Kingdom
| | - Andrew F Whyte
- Department of Allergy and Immunology, University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth, United Kingdom
| | - Archana Herwadkar
- Immunology Department, Northern Care NHS Foundation Trust, Manchester, United Kingdom
| | - Mark Gompels
- Bristol Immunology and Allergy Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
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2
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Bonilla-Moreno M, Torrecillas M, Laporte-Amargos J, González-Díaz A, Mussetti A, Tubau F, Gudiol C, Domínguez MA, Martí S, Rodríguez-Sevilla G, Ardanuy C. Development of Meropenem Resistance in a Multidrug-Resistant Campylobacter coli Strain Causing Recurrent Bacteremia in a Hematological Malignancy Patient. Antimicrob Agents Chemother 2023; 67:e0027223. [PMID: 37358413 PMCID: PMC10648861 DOI: 10.1128/aac.00272-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 06/04/2023] [Indexed: 06/27/2023] Open
Abstract
Campylobacter bacteremia is an uncommon disease that mainly occurs in immunocompromised patients and is associated with antibiotic resistance, particularly in Campylobacter coli. We report a patient with persistent blood infection because of a multidrug-resistant (MDR) C. coli strain over a 3-month period. Through this period monotherapy with meropenem was associated with the development of resistance to it. Improving immunity status and a combined therapy for intestinal decolonization were useful to control persistent C. coli infection in this patient.
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Affiliation(s)
- María Bonilla-Moreno
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
| | - Miriam Torrecillas
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
| | - Julia Laporte-Amargos
- Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, Barcelona, Spain
| | - Aída González-Díaz
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
- CIBER of Respiratory Diseases, ISCIII, Madrid, Spain
| | - Alberto Mussetti
- Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, Barcelona, Spain
- Clinical Haematology Department, Institut Català d’Oncologia-Hospitalet, Barcelona, IDIBELL, Barcelona, Spain
| | - Fe Tubau
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
- CIBER of Respiratory Diseases, ISCIII, Madrid, Spain
| | - Carlota Gudiol
- Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- CIBER of Infectious Diseases, ISCIII, Madrid, Spain
| | - M. Angeles Domínguez
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- CIBER of Infectious Diseases, ISCIII, Madrid, Spain
| | - Sara Martí
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
- CIBER of Respiratory Diseases, ISCIII, Madrid, Spain
- University of Barcelona, Barcelona, Spain
| | - Graciela Rodríguez-Sevilla
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
| | - Carmen Ardanuy
- Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona, IDIBELL, Barcelona, Spain
- CIBER of Respiratory Diseases, ISCIII, Madrid, Spain
- University of Barcelona, Barcelona, Spain
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CUNHA AA, QUISPE-CORNEJO AA, PEREIRA J, ARAÚJO E, PEREIRA E. Campylobacter coli cellulitis in X-linked agammaglobulinemia. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jiang L, Gao J, Wang P, Liu Y. Relapsing cellulitis associated with Campylobacter coli bacteremia in a Good’s syndrome patient: a case report. BMC Infect Dis 2022; 22:354. [PMID: 35397507 PMCID: PMC8994272 DOI: 10.1186/s12879-022-07324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/29/2022] [Indexed: 11/11/2022] Open
Abstract
Background Good’s syndrome (GS) is characterized by immunodeficiency, and patients diagnosed with GS are susceptible to infection or even bacteremia, which is the most evident complication. Campylobacter coli (C. coli) rarely causes bacteremia or extraintestinal infection. We report herein a case with GS in which right leg cellulitis associated with C. coli bacteremia occurred three times over one and a half years. Case presentation A 41-year-old Chinese male with GS was diagnosed with C. coli infection. He presented with swelling and redness of right lower leg and developed bacteremia due to C. coli repeatedly. Bacteremia was confirmed by bacteriological examination. Adding long-term oral antibiotic treatment with amoxicillin/clavulanate potassium and gentamicin following intravenous meropenem and amikacin was very effective. The blood cultures became negative and the patient has been free from any symptoms encountered for more than one year without relapse of bacteremia. Conclusions Patients with GS and their physicians should carefully consider the antibacterial treatment options against C. coli bacteremia. Combined anti-infective therapy involving aminoglycoside is preferred in the treatment of C. coli bacteremia in GS patients.
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Abstract
Campylobacter species are known to cause enteritis. However, over the past 40-50 years, there have been reports of varying presentations, such as cellulitis, spondylodiscitis and bacteraemia. Of the Campylobacter species, Campylobacter jejuni is the most common culprit for causing bacteraemia, however, Campylobacter coli bacteraemia is becoming more prevalent. Here, we discuss an unusual case of C. coli bacteraemia in a patient with decompensated liver cirrhosis.
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Affiliation(s)
- Sindhura Pisipati
- Internal Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA
| | - Adnan Zafar
- Internal Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Yousaf Zafar
- Internal Medicine, Naples Community Hospital Healthcare System, Naples, Florida, USA
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Schiaffino F, Kosek MN. Intestinal and Extra-Intestinal Manifestations of Campylobacter in the Immunocompromised Host. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020. [DOI: 10.1007/s40506-020-00243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dan M, Parizade M. Chronic high-level multidrug-resistant Campylobacter coli enterocolitis in an agammaglobulinemia patient: Oral gentamicin efficacy. Med Mal Infect 2020; 50:525-527. [PMID: 32353415 DOI: 10.1016/j.medmal.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/10/2019] [Accepted: 04/17/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Campylobacter is the most common cause of infectious diarrhea in agammaglobulinemia patients. These infections can be severe, prolonged, and recurrent in such patients. PATIENT AND METHODS We report a 29-year-old male patient with X-linked agammaglobulinemia with Campylobacter coli enterocolitis that persisted for nine months despite multiple 10- to 14-day courses of oral ciprofloxacin and azithromycin. RESULTS The isolate was highly resistant to ciprofloxacin, erythromycin, tetracycline, and fosfomycin. The patient failed to respond to intravenous ertapenem, 1.0g/day for two weeks, to which the pathogen was susceptible. He was finally cured with oral gentamicin, 80mg four times daily, and stool cultures remained negative during the seven-month follow-up. CONCLUSION Oral aminoglycoside might be the most appropriate choice for eradication of persistent Campylobacter in the intestinal tract for macrolide- and fluoroquinolone-resistant isolate in agammaglobulinemia patients with chronic diarrhea or relapsing systemic infections.
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Affiliation(s)
- M Dan
- Infectious Disease Clinic, Maccabi Health Services, Bat Yam, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - M Parizade
- Maccabi Health Services, Bacteriology Unit, National Laboratory, Rehovot, Israel
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Recurrent Campylobacter Enteritis in Patients with Hypogammaglobulinemia: Review of the Literature. J Clin Med 2020; 9:jcm9020553. [PMID: 32085573 PMCID: PMC7074135 DOI: 10.3390/jcm9020553] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 01/31/2023] Open
Abstract
Recurrent Campylobacter enteritis is a well-recorded complication of primary hypogammaglobulinemia but has only rarely been reported with other types of immunodeficiency, and no cases have been reported after rituximab-associated secondary hypogammaglobulinemia. We therefore reviewed our local microbiology laboratory databases and conducted a literature search, to provide a detailed characterization of the immunodeficiency states associated with recurrent Campylobacter enteritis. Published cases had primary hypogammaglobulinemia, most frequently in the setting of common variable immunodeficiency, x-linked agammaglobulinemia, and Good syndrome. No cases were identified in the literature after rituximab or secondary hypogammaglobulinemia. We report a 73-year-old patient with recurrent Campylobacter enteritis and hypogammaglobulinemia in the setting of non-Hodgkin lymphoma, chemotherapy, and maintenance rituximab. Physicians should be aware of the association of recurrent Campylobacter enteritis and immunodeficiency, most commonly in primary hypogammaglobulinemia. Rituximab alone may not be sufficiently immunosuppressive for recurrent campylobacteriosis to occur; additional factors, including hematological malignancy and its treatment, appear necessary. Patients with recurrent Campylobacter enteritis and those starting rituximab should be investigated for hypogammaglobulinemia and B-lymphopenia.
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9
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Martignani C, Massaro G, Bruno AG, Biffi M, Ziacchi M, Diemberger I. Acute primary purulent pericarditis in an adult patient with unknown X-linked agammaglobulinemia. Immunobiology 2019; 225:151861. [PMID: 31740078 DOI: 10.1016/j.imbio.2019.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/27/2019] [Accepted: 10/29/2019] [Indexed: 11/18/2022]
Abstract
X-linked agammaglobulinemia (XLA) is a rare form of inherited immunodeficiency due to an impairment in B-lymphocyte differentiation and maturation. In the majority of cases XLA is diagnosed in childhood, particularly among males affected by recurrent infections and with a family history of immunodeficiency. Infections of respiratory tract, gastrointestinal apparatus, eyes, nose and ears are frequent in XLA patients; on the contrary, infections of myocardium, cardiac valves and pericardium are rarely described in XLA. A 34-year-old man with unknown XLA was hospitalized because of syncope, due to pericardial tamponade, caused by acute primary purulent pericarditis. Immediate pericardiocentesis was effective in improving hemodynamics, and empiric antibiotic therapy was successful in controlling the infection. Purulent pericarditis is a rare disease with high mortality rate: it is usually caused by hematogenous bacterial propagation, direct infection of pericardial space by chest wounds or thoracic surgery, or extension of infection from adjacent tissues. However, this patient had no recent local or systemic infections. Because of unusual clinical picture during hospitalization he underwent further clinical and laboratory evaluations, that showed low immunoglobulin levels. After exclusion of acquired immunodeficiency, genetic tests were performed: they detected deletion of exons 8-9-10 of Bruton Tyrosine Kinase gene on X chromosome, leading to the diagnosis of XLA. Acute purulent primary pericarditis may also occur in adult XLA patients as first clinical manifestation. According to this case report, a primary immunodeficiency syndrome should be considered in patients with atypical cardiac infections and no predisposing conditions, regardless of age.
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Affiliation(s)
- Cristian Martignani
- Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy.
| | - Giulia Massaro
- Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Antonio Giulio Bruno
- Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Mauro Biffi
- Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Matteo Ziacchi
- Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Igor Diemberger
- Polo Cardio-Toraco-Vascolare, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
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10
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Hagiya H, Kimura K, Nishi I, Yoshida H, Yamamoto N, Akeda Y, Tomono K. Emergence of Carbapenem Non-susceptible Campylobacter coli after Long-term Treatment against Recurrent Bacteremia in a Patient with X-linked Agammaglobulinemia. Intern Med 2018; 57:2077-2080. [PMID: 29491300 PMCID: PMC6096023 DOI: 10.2169/internalmedicine.0312-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We herein report a case of recurrent Campylobacter coli bacteremia in a 37-year-old Japanese man with X-linked agammaglobulinemia (XLA). The patient experienced seven episodes of C. coli bacteremia over one year, with an erythematous rash intermittently emerged on the lower limbs. Although hospitalization for intravenous treatment was repeatedly recommended, he obstinately declined it. Following long-term oral antibiotic treatment with tebipenem and faropenem for the persistent infection, C. coli showed elevated minimum inhibitory concentrations to meropenem, a key drug for severe campylobacteriosis. Physicians should note that the overuse of antibiotics can lead to the emergence of carbapenem-non-susceptible Campylobacter strains.
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
- Department of Pediatrics, Osaka University Hospital, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
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11
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Yoon JG, Lee SN, Hyun HJ, Choi MJ, Jeon JH, Jung E, Kang S, Kim J, Noh JY, Choi WS, Song JY, Cheong HJ, Kim WJ. Campylobacter jejuni Bacteremia in a Liver Cirrhosis Patient and Review of Literature: A Case Study. Infect Chemother 2017; 49:230-235. [PMID: 28608661 PMCID: PMC5620392 DOI: 10.3947/ic.2017.49.3.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/15/2015] [Indexed: 11/24/2022] Open
Abstract
Campylobacter infection causes gastrointestinal symptoms such as abdominal pain or diarrhea. Occasionally, Campylobacter bacteremia affects immunocompromised patients; however, serious outcomes are known to be rare. Here, we present a case of a patient with Campylobacter bacteremia who had underlying liver cirrhosis. The patient had fever and diarrhea. These symptoms subsided after treatment with cefotaxime. Campylobacter jejuni was isolated in the blood culture after 10 days. In addition, previously reported cases of Campylobacter bacteremia in Asian countries were reviewed with respect to antimicrobial sensitivities.
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Affiliation(s)
- Jin Gu Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Saem Na Lee
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hak Jun Hyun
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Min Joo Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Ji Ho Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Eunju Jung
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Seonghui Kang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Jeeyong Kim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea.
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.,Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Korea
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Kim Y, Shin JA, Han SB, Cho B, Jeong DC, Kang JH. Recurrent Campylobacter jejuni bacteremia in a patient with hypogammaglobulinemia: A case report. Medicine (Baltimore) 2017. [PMID: 28640123 PMCID: PMC5484231 DOI: 10.1097/md.0000000000007238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Although some cases of recurrent bacteremia due to Campylobacter jejuni have been reported in immunocompromised patients, antibiotic treatment strategies to eradicate C. jejuni and prevent recurrent infections in immunocompromised patients have not been established. Authors' experience of such rare cases should be shared for improving patients' outcomes. PATIENT CONCERNS An 18-year-old boy with hypogammaglobulinemia, who received intravenous immunoglobulin replacement therapy every 3 weeks, was admitted to hospital repeatedly due to recurrent diarrhea and cellulitis of the leg. DIAGNOSES The patient was admitted 6 times, and among them, C. jejuni was isolated from blood cultures 4 times and stool cultures 2 times. INTERVENTIONS The patient experienced recurrent C. jejuni enteritis and bacteremia 5 times despite macrolide therapy. Doxycycline was administered for 3 months after the fifth admission. OUTCOMES Ten months after the completion of doxycycline therapy for 3 months, C. jejuni enteritis relapsed; however, since then, recurrent infection has not occurred for 10 months. LESSONS Immunocompromised patients can experience recurrent C. jejuni infection despite prolonged antibiotic therapy. Further studies to establish appropriate antibiotic therapy for eradicating colonized C. jejuni and preventing recurrent infection are needed.
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Affiliation(s)
| | | | - Seung Beom Han
- Department of Pediatrics
- The Vaccine Bio Research Institute
| | - Bin Cho
- Department of Pediatrics
- The Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dae Chul Jeong
- Department of Pediatrics
- The Vaccine Bio Research Institute
| | - Jin Han Kang
- Department of Pediatrics
- The Vaccine Bio Research Institute
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Tasaka K, Matsubara K, Nigami H, Iwata A, Isome K, Yamamoto G. [Invasive Campylobacter jejuni/coli Infections: 9 Case Reports at a Single Center between 2000 and 2015, and a Review of Literature Describing Japanese Patients]. ACTA ACUST UNITED AC 2016; 90:297-304. [PMID: 27529964 DOI: 10.11150/kansenshogakuzasshi.90.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There have been few coherent reports on extraintestinal infection or bacteremia caused by Campylobacter jejuni (C. jejuni) or C. coli in Japan. To clarify the clinical and microbiological characteristics of invasive infections caused by these two species, we retrospectively analyzed the records of patients from whom these pathogens had been isolated from sterile sites between 2000 and 2015. During this study period, we identified 9 patients. The clinical syndrome of all of these patients was bacteremia. Three patients had underlying diseases with both liver cirrhosis and malignant neoplasm, and all of these patients were aged 60 years or older. The remaining 6 patients were immunocompetent and younger than 40 years of age. All 9 patients had a fever of 38.5 degrees C or higher. The proportion of patients with gastrointestinal symptoms was lower for the 3 patients with underlying diseases, compared with the 6 patients without underlying diseases (1/3 cases vs, 4/6 cases). Of the 8 strains evaluated for antimicrobial susceptibility, all were susceptible to imipenem/cilastatin, kanamycin and erythromycin, and 2 were resistant to levofloxacin. Antimicrobial treatment was administered to 8 patients, but one spontaneously recovered without any treatment. We were able to follow the outcomes of 8 patients, and all of these patients completely recovered without relapses. We also reviewed 14 Japanese patients reported in the Japanese and English literature and found similar clinical features consisting of a high-grade fever and an association with underlying diseases and gastrointestinal symptoms. Of note, 3 agammaglobulinemic patients presented with bacteremia and extraintestinal infections and had multiple relapses. Based on the findings of our 9 cases and previous reports, the affected patients were divided into two groups according to clinical syndrome and therapeutic intervention. One group consisted of previously healthy children or young adults showing bacteremia. Most of them had enterocolitis complications but had a good prognosis. The other group consisted of patients with underlying diseases or elderly patients who presented with bacteremia alone or bacteremia with extraintestinal infections. The latter group, especially among those with humoral immunodeficiency, should be parentally treated with antimicrobial agents and requires careful monitoring for relapse. This is the largest case series study to examine invasive C. jejuni/coli infections in Japan, and it provides important epidemiological information on this rare infection.
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14
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Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin's Lymphoma: Case Report and Literature Review of a Difficult Diagnosis. Int J Mol Sci 2016; 17:544. [PMID: 27077849 PMCID: PMC4849000 DOI: 10.3390/ijms17040544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/02/2016] [Accepted: 04/07/2016] [Indexed: 02/06/2023] Open
Abstract
Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin’s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy.
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15
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Ruiz-Castillo A, Torres-Sánchez MJ, Aznar-Martín J. Molecular epidemiology and antimicrobial susceptibility of Campylobacter coli clinical isolates. Enferm Infecc Microbiol Clin 2014; 32:443-5. [PMID: 24768104 DOI: 10.1016/j.eimc.2014.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/12/2014] [Accepted: 02/24/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Campylobacter spp. is a major cause of acute bacterial diarrhea in humans worldwide, and C. coli is responsible for 10% of the cases. MATERIALS AND METHODS A study was made of the antimicrobial susceptibility using the E-test(®), and the clonal relationship using PCR-RFLP, of the flaA gene, as well as PFGE techniques on 43 C. coli clinical isolates. RESULTS Only 49% and 2% of the isolates were susceptible to erythromycin and ciprofloxacin, respectively. Imipenem and clindamyicn, with 100% and 84% of the strains, respectively, being susceptible, were the most active antimicrobials. The PCR-RFLP of flaA gene technique grouped fourteen isolates into six clusters, while the PFGE technique grouped eleven isolates into five clusters. CONCLUSION Ciprofloxacin and erythromycin are not suitable for the treatment of C. coli infections. Clindamycin could be considered as a therapeutic alternative in cases of enteritis, while imipenem is the best alternative for extra-intestinal infections. Both PFGE and PCR-RFLP can be useful to detect clones.
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Affiliation(s)
- Ana Ruiz-Castillo
- Servicio de Microbiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Javier Aznar-Martín
- Servicio de Microbiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
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Ge B, Wang F, Sjölund-Karlsson M, McDermott PF. Antimicrobial resistance in campylobacter: susceptibility testing methods and resistance trends. J Microbiol Methods 2013; 95:57-67. [PMID: 23827324 DOI: 10.1016/j.mimet.2013.06.021] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 06/17/2013] [Accepted: 06/23/2013] [Indexed: 01/31/2023]
Abstract
Most Campylobacter infections are self-limiting but antimicrobial treatment (e.g., macrolides, fluoroquinolones) is necessary in severe or prolonged cases. Susceptibility testing continues to play a critical role in guiding therapy and epidemiological monitoring of resistance. The methods of choice for Campylobacter recommended by the Clinical and Laboratory Standards Institute (CLSI) are agar dilution and broth microdilution, while a disk diffusion method was recently standardized by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Macrolides, quinolones, and tetracyclines are among the common antimicrobials recommended for testing. Molecular determination of Campylobacter resistance via DNA sequencing or PCR-based methods has been performed. High levels of resistance to tetracycline and ciprofloxacin are frequently reported by many national surveillance programs, but resistance to erythromycin and gentamicin in Campylobacter jejuni remains low. Nonetheless, variations in susceptibility observed over time underscore the need for continued public health monitoring of Campylobacter resistance from humans, animals, and food.
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Affiliation(s)
- Beilei Ge
- Division of Animal and Food Microbiology, Office of Research, Center for Veterinary Medicine, U.S. Food and Drug Administration, Laurel, MD 20708, USA.
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Relapsing Campylobacter jejuni Systemic Infections in a Child with X-Linked Agammaglobulinemia. Case Rep Pediatr 2013; 2013:735108. [PMID: 23862092 PMCID: PMC3686078 DOI: 10.1155/2013/735108] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/20/2013] [Indexed: 11/22/2022] Open
Abstract
X-linked agammaglobulinemia (XLA) is a primary immunodeficiency of the humoral compartment, due to a mutation in the Bruton tyrosine kinase (BTK) gene, characterized by a severe defect of circulating B cells and serum immunoglobulins. Recurrent infections are the main clinical manifestations; although they are especially due to encapsulated bacteria, a specific association with Campylobacter species has been reported. Here, we report the case of a boy with XLA who presented with relapsing Campylobacter jejuni systemic infections. His clinical history supports the hypothesis of the persistence of C. jejuni in his intestinal tract. Indeed, as previously reported, XLA patients may become chronic intestinal carriers of Campylobacter, even in absence of symptoms, with an increased risk of relapsing bacteraemia. The humoral defect is considered to be crucial for this phenomenon, as well as the difficulties to eradicate the pathogen with an appropriate antibiotic therapy; drug resistance is raising in Campylobacter species, and the appropriate duration of treatment has not been established. C. jejuni should always be suspected in XLA patients with signs and symptoms of systemic infection, and treatment should be based on antibiogram to assure the eradication of the pathogen.
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Antimicrobial susceptibilities of multidrug-resistant Campylobacter jejuni and C. coli strains: in vitro activities of 20 antimicrobial agents. Antimicrob Agents Chemother 2009; 54:1232-6. [PMID: 20038624 DOI: 10.1128/aac.00898-09] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
There is a paucity of information regarding antimicrobial agents that are suitable to treat severe infections caused by multidrug-resistant Campylobacter spp. Our aim was to identify agents that are potentially effective against multiresistant Campylobacter strains. The in vitro activities of 20 antimicrobial agents against 238 Campylobacter strains were analyzed by determining MICs by the agar plate dilution method or the Etest. These strains were selected from 1,808 Campylobacter isolates collected from Finnish patients between 2003 and 2005 and screened for macrolide susceptibility by using the disk diffusion test. The 238 strains consisted of 183 strains with erythromycin inhibition zone diameters of < or =23 mm and 55 strains with inhibition zone diameters of >23 mm. Of the 238 Campylobacter strains, 19 were resistant to erythromycin by MIC determinations (MIC > or = 16 microg/ml). Given that the resistant strains were identified among the collection of 1,808 isolates, the frequency of erythromycin resistance was 1.1%. All erythromycin-resistant strains were multidrug resistant, with 18 (94.7%) of them being resistant to ciprofloxacin (MIC > or = 4 microg/ml). The percentages of resistance to tetracycline and amoxicillin-clavulanic acid (co-amoxiclav) were 73.7% and 31.6%, respectively. All macrolide-resistant strains were susceptible to imipenem, meropenem, and tigecycline. Ten (52.6%) multiresistant strains were identified as being Campylobacter jejuni strains, and 9 (47.4%) were identified as being C. coli strains. These data demonstrate that the incidence of macrolide resistance was low but that the macrolide-resistant Campylobacter strains were uniformly multidrug resistant. In addition to the carbapenems, tigecycline was also highly effective against these multidrug-resistant Campylobacter strains in vitro. Its efficacy for the treatment of human campylobacteriosis should be evaluated in clinical trials.
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