Virulence Characteristics Of Campylobacter Jejuni

It has one flagellum at either one or both poles of the cell. The cell contains periplasm between the outer and inner membrane. The endotoxin lipopolysaccharide composes the outer membrane. The outer membrane surface is embedded with membrane proteins. These membrane proteins are antigenic and are utilized for the invasion of the host. (LiJie. S, 2011)

Virulence:

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Campylobacter Jejuni bacterium deposits a group of proteins called Campylobacter Invasion Antigens (CIA proteins). (Konkel. ME, 2004).

The virulence characteristics of Campylobacter Jejuni strains were compared between 20 poultry isolates and 24 human isolates. This included four different virulence characteristics. On the basis of their PFGE pattern, strains were chosen to epitomize a heterogeneous population. The isolated were analyzed for their capability to interfere and activate interleukin-8 (IL-8) production in T84 cells, their construction of operative cytolethal distending toxin (CDT) using HEp-2 cells and their resistance of sodium deoxycholate. The strains with origin of human and poultry will appear with all four virulence factors. There will be strong differences that can be perceived amidst the strains. No difference was perceived between the two populations in terms of invasion and induction of IL-8. Human isolates captured more Hep-2 cells in their cell cycle than the poultry isolates. This proposed a greater production of CDT by the human isolates. (Van Deun. K, 2007)

All four virulence factors are boundless among Campylobacter Jejuni isolates. A greater degree of bile-salt resistance and more enunciated production of CDT are correlated with strains causing enteritis in human. (Van Deun. K, 2007)

Transmission:

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The Campylobacter Jejuni bacteria are found in a variety of places, such as the intestinal tracts of cats, dogs, poultry, cattle, pigs and other animals. The bacteria are also present in the intestinal tract of humans where it can exist without causing harm. (Alfaro. D, 2012)

These bacteria are transmitted through the fecal oral route, sexual contact of person to person, the ingestion of unpasteurized milk and raw poultry, ingestion of contaminated water (waterborne) and the exposure to sick puppies. (Javid. MH, 2012)

 

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Human Response:

The infected person will experience the following:

Headache and myalgias (muscle pain) lasting for 24 hours.

Abdominal pains are localized and may present with symptoms that mimic appendicitis. This is known as pseudoappendicitis at the Lower Right Quadrant of the abdomen. In most cases this acute abdominal pains may be the only symptom.

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Fever at 40áµ’ C which may last for more than a week

This is followed by watery, bloody bowel movements

25% of infected patients suffer from Tenesmus, a feeling of constantly needing to pass stool

Predilation of vascular sites may occur.

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Patient may also present with meningitis, infections of vasculature and abscesses

This bacterium causes the patient to be sick for extended periods of time and they may require hospitalization.

(Javid. MH, 2012)

Diagnosis

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Diagnosis of the infection is made on examination and results obtained from a stool culture. (Marler Clark)

This may be obtained in 2 ways:

The first way would be by isolation of the Campylobacter Jejuni strands from the stool culture. Stool samples are chilled when obtained and culture procedures are performed on the samples to enhance the growth of Campylobacter bacteria, if the bacteria are present. (Marler Clark)

A direct Gram Stain may also be used although it is not commonly used for analysis of bacterial gastroenteritis. This is a very fast method of obtaining a diagnosis but Campylobacter Jejuni is not easily visualized in most cases. Campylobacter Jejuni colonies are usually flat, irregular, pinkish-beige and spread along the streak-line. (Mangels, JI )

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Immunoglobulin systems

Campylobacter species may be diagnosed with agglutination tests. There are currently at least 3 tests present in the United States that test for Campylobacter species. However, these tests cannot be used as confirmation of the presence of Campylobacter Jejuni and a stool culture must be examined additionally. (Mangels, JI )

DIFFERENTIAL DIAGNOSIS:

A differential diagnosis is a list of diseases that present with similar symptoms, these include:

• Arteriovenous Malformations
• Clostridium Difficile Colitis:
• Inflammatory Bowel Disease:
• Mesenteric Artery Ischemia
• Salmonellosis
• Shigellosis
• Yersinia Enterocolitica

(Javid. MH, 2012)

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Treatment

Infection from the campylobacter bacteria is usually very self-limiting in most cases and using liquid treatment for the symptoms and electrolyte replacement is sufficient in human infections. Treatment by antibiotics is still under great controversy and is only of minor importance in benefitting the patient, judging from the duration of the symptoms although it should not be used as an option. (Ternhag. A et al., 2007)

Tetracycline can be used in adults and Erythromycin in children. (Fabrega. A et al., 2008)

Some studies show that Erythromycin rapidly eliminates the campylobacter from the feces but does not affect the amount of time the illness continues for. Nevertheless, if children have dysentery due to Campylobacter jejuni and are treated early with erythromycin, they tend to benefit more. Therefore, treatment with antibiotics depends on how severe the symptoms are. (Fabrega. A et al., 2008)

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Effectiveness of quinolones depends on the sensitivity of the organism, but the high rates of quinolone used in livestock means that quinolones are largely ineffective. (Fabrega. A et al., 2008)

Anti-motility agents such as loperamide can cause prolonged illness or intestinal perforation in any situations of unexpected diarrhea, hence it should not be taken. (Moore, JE et al., 2005)

Some antibiotics are ineffective against Campylobacter such as trimethropin/ sulfamethoxazale and ampicillin. (Moore, JE et al., 2005)

Prevention

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• Milk should be pasteurized.
• Drinking water should be treated with chlorine, to destroy organisms.
• Antibiotic treatment can reduce fecal excretion.
• Heath care workers should not provide direct care if they are infected.
• Separate cutting boards should be used for different kinds of foods.
• After preparation of raw food of animal origin, all cutting boards and counter-tops should be carefully cleaned with soap and hot water to ensure that there aren’t any infectious agents left behind.
• There should not be any contact with pet saliva and feces.

(Moore, JE et al., 2005)

Recommendations for the public & travellers

• Food should be properly cooked and served whilst it is still hot.
• Consume only pasteurized or boiled milk products.
• Avoid raw milk products.
• Be sure that ice is from safe and clean water.
• If you are not certain about the safety of drinking water, it is only advisable that you boil or disinfect it with a chemical disinfectant.
• Wash hands thoroughly and frequently with soap, especially after using the toilet and after contact with pets or farm animals.
• Fruits and vegetables should be washed thoroughly, more especially if they are to be eaten raw.
• Fruits and vegetables should be peeled before consumed.

(The World Health Organization)

Recommendations for food handlers

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• Hygienic rules during preparation of food should be observed, whether it is at home or by professionals.
• Professional food handlers should report immediately to their employer when any signs of fever, diarrhea, vomiting or any visible signs of infection become apparent.

(The World Health Organization)

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