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Campylobacter

Background:

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Other   (Gram Negative Bacilli)  
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>Aeromonas species:
     1] Aeromonas hydrophila
     2] Aeromonas veronii
     3] Aeromonas shubertii
>Bartonella species:
     1] Bartonella bacilliformis
     2] Bartonella henselae (organism responsible for cat scratch disease)
     3] Bartonella Quintana
     4] Other
>Campylobacter: led
     1] Campylobacter fetus
     2] Campylobacter jejuni
>Capnocytophaga species:
     1] Capnocytophaga canimorsus
     2] Capnocytophaga ochracea
>Francisella tularensis
>Helicobacter pylori
>Legionella species: ( L. pneumophila)
>Plesiomonas shigelloides
>Vibrio species:
     1] Vibrio cholera
     2] Vibrio parahaemolyticus
     3] Vibrio damsela
     4] Other

Campylobacter:  

  • Gram-negative, spiral (characteristic spiral/corkscrew appearance), motile and microaerophilic.
  • Oxidase-positive. 
  • Campylobacter jejuni: main cause of bacterial foodborne disease in many developed countries. 
  • Usual routes of transmission are fecal-oral, ingestion of contaminated food or water, and the eating of raw meat. 
  • Symptoms:  inflammatory, sometimes bloody, diarrhea, or dysentery syndrome. 

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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.   Listed dosages may need to be adjusted for renal dysfunction.  

Campylobacter fetus (Non-jejuni infections):
Infections are usually self-limited and antibiotics are rarely needed unless symptoms persist for more than 7-10 days.

  1. Limited to gastrointestinal tract / mild-moderate cases:
  2. Infections extending beyond the GI tract:
    • Ceftriaxone 1-2 grams IV q24h  (range: 1-2 grams q12-24h)
    • Ampicillin 1-2 grams IV every 4-6 hours
    • Gentamicin 5 mg/kg/day IV  (Adjust frequency based on estimated clearance)
    • Imipenem 500mg IV every 6 hours [Range: 250-1000 mg q6-8h]

 

Campylobacter jejuni:  Infections are usually self-limited and antibiotics are rarely needed unless severe disease is present.

  1. Gastroenteritis:
    • Erythromycin 500mg orally four times daily x 5 days.
    • Azithromycin 500mg orally once daily
    • Ciprofloxacin 500 mg orally q12h x 5 days (increasing resistance)
    • Gentamicin 5 mg/kg/day IV  (Adjust frequency based on estimated clearance)
    • Imipenem 500mg IV every 6 hours [Range: 250-1000 mg q6-8h]
    • Chloramphenicol 50-100 mg/kg/day in divided doses every 6 hours (Maximum daily dose is 4 grams e.g. 1 gram q6h)

 

Campylobacter