Retrospective Multicentric Study on Campylobacter spp. Bacteremia in France: The Campylobacteremia Study

Abstract

Background Campylobacter spp. bacteremia is a severe infection. A nationwide 5-year retrospective study was conducted to characterize its clinical features and prognostic factors. Methods Patients diagnosed with Campylobacter spp. bacteremia in 37 French hospitals participating in the surveillance network of the National Reference Center for Campylobacter and Helicobacter were included from January 1, 2015, to December 31, 2019. The goal was to analyze the effects of a delay of appropriate antibiotic therapy and other risk factors on 30-day mortality, antibiotic resistance, patient characteristics and prognosis according to the Campylobacter species. Findings Among the 592 patients, Campylobacter jejuni and Campylobacter fetus were the most commonly identified species (42.9 and 42.6%, respectively). The patients were elderly (median age 68 years), and most had underlying conditions, mainly immunodepression (43.4%), hematologic malignancies (25.9%), solid neoplasms (23%) and diabetes (22.3%). C. jejuni and Campylobacter coli were associated with gastrointestinal signs, and C. fetus was associated with secondary localizations. Among the 80 patients (13.5%) with secondary localizations, 12 had endocarditis, 38 vascular, 24 osteo-articular and 9 ascitic fluid infections. The thirty-day mortality rate was 11.7%, and an appropriate antibiotic treatment was independently associated with 30-day survival (odds ratio [OR]=0.47, 95% CI [0.24–0.93], p=0.03). The median efficient therapy initiation delay was quite short (2 days, IQR [0–4]) but it had no significant impact on 30-day mortality (p=0.78). Interpretation Campylobacter spp. bacteremia mainly occurred in elderly immunocompromised individuals with variable clinical presentations according to the species involved. Appropriate antimicrobial therapy was associated with improved 30-day survival.

Multicenter Retrospective Study of Vascular Infections and Endocarditis Caused by Campylobacter spp., France

“…Among patients with C. fetus bacteremia in the campylobacteremia study, 11.5% had a vascular infection and 4.4% had endocarditis. Furthermore, 11% of the 99 patients who underwent echocardiography had endocarditis, close to the rate described for S. aureus bacteremia ( 6 , 28 ). Those findings warrant the use of systematic transthoracic echocardiography in cases of C. fetus bacteremia.…”

“…A C. rectus infection occurred on a gastroduodenal artery in a neutropenic patient with diabetes who was co-infected with commensal bacteria of the oral cavity. As comparison, among the initial cohort of patients with bacteremia, C. jejuni (42.9%) and C. fetus (42.6%) were the most commonly identified species, followed by C. coli (6.8%) and C. ureolyticus (3.7%) ( 6 ). Among the 252 patients with C. fetus bacteremia, 29 (11.5%) patients had vascular localization, and 11 (4.4.%) had endocarditis.…”

“…Consistent with data on Campylobacter spp. bacteremia, male and elderly patients were predominantly affected, and most patients had underlying conditions, particularly cardiovascular conditions, diabetes, solid neoplasm, chronic renal failure, or hepatic failure ( 6 ). Of interest, although Campylobacter spp.…”

“…We conducted an ancillary study from the Campylobacteremia Project ( 6 ), a multicenter retrospective study conducted in 37 hospitals participating in the surveillance network of France’s National Reference Centre for Campylobacters and Helicobacters (NRCCH), along with other hospitals in France. The Campylobacteremia study included all patients with Campylobacter spp.…”

“…This complication is poorly described because of its scarcity, accounting for <1% of Campylobacter spp. infections but having substantial mortality rates (3%-28%) (4)(5)(6). Bacteremias can be complicated by secondary localizations in the joints, bones, soft tissues, arterial wall, and valves (5,7,8).…”