Journal Article

<i>Campylobacter</i> Bacteremia: Clinical Features and Factors Associated with Fatal Outcome

Jérôme Pacanowski, Valérie Lalande, Karine Lacombe, Cherif Boudraa, Philippe Lesprit, Patrick Legrand, David Trystram, Najiby Kassis, Guillaume Arlet, Jean-Luc Mainardi, Florence Doucet-Populaire, Pierre-Marie Girard and Jean-Luc Meynard

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 47, issue 6, pages 790-796
Published in print September 2008 | ISSN: 1058-4838
Published online September 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/591530
Campylobacter Bacteremia: Clinical Features and Factors Associated with Fatal Outcome

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Background.Campylobacter bacteremia is uncommon. The influence of underlying conditions and of the impact of antibiotics on infection outcome are not known.

Methods.From January 2000 through December 2004, 183 episodes of Campylobacter bacteremia were identified in 23 hospitals in the Paris, France, area. The medical records were reviewed. Characteristics of bacteremia due to Campylobacter fetus and to other Campylobacter species were compared. Logistic regression analysis was performed to identify risk factors for fatal outcome within 30 days.

Results.Most affected patients were elderly or immunocompromised. C. fetus was the most commonly identified species (in 53% of patients). The main underlying conditions were liver disease (39%) and cancer (38%). The main clinical manifestations were diarrhea (33%) and skin infection (16%). Twenty-seven patients (15%) died within 30 days. Compared with patients with bacteremia due to other Campylobacter species, patients with C. fetus bacteremia were older (mean age, 69.5 years vs. 55.6 years; P<.001) and were more likely to have cellulitis (19% vs. 7%; P=.03), endovascular infection (13% vs. 1%; P=.007), or infection associated with a medical device (7% vs. 0%; P=.02). Independent risk factors for death were cancer (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.2–20.8) and asymptomatic infection (OR, 6.7; 95% CI, 1.5–29.4) for C. fetus bacteremia, the absence of prescription of appropriate antibiotics (OR, 12.2; 95% CI, 0.9–157.5), and prescription of third-generation cephalosporins (OR, 10.2; 95% CI, 1.9–53.7) for bacteremia caused by other species.

Conclusions.Campylobacter bacteremia occurs mainly in immunocompromised patients. Clinical features and risk factors of death differ by infection species.

Journal Article.  3769 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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