diease

Campylobacter


OVERVIEW OF Campylobacter :

The bacteria causing the campylobacter infection is the Campylobacter jejuni

 Campylobacter is an infection that is caused by the bacteria in the gut which leads to the dysfunction of the gut and also results in food poisoning like reactions. When this disease affects the person it is called as campylobacteriosis


STRUCTURE of Campylobacter :

Campylobacter is a gram negative bacteria which is spiral in shape. It is an microaerophilic organisms that is bacteria can survive within reduced oxygen concentration. It lacks fimbriae and also it is an non spore forming bacteria.

The outer membrane consist of lipopolysaccharide which are endotoxic. Membrane proteins are embedded on the outer membrane surface; they are antigenic and are used for invation of the host. 

The genome of Campylobacter jejuni consists of circular DNA


EPIDEMIOLOGY :

campylobacter provides the one of  the four  causes for diarrhoea globally. It is considered as the common factor for gastroenteritis.


CAUSES :

Contaminated food and water

Undercooked poultry and meats

Unpasteurized milk

Direct contact with the animals


PATHOPHYSIOLOGY :

When the Campylobacter enters the gut the HCl secreation in the gastric acid causes the difficulty for the bacteria to survive at the low PH. C. jejuni is rapidly killed by hydrochloric acid at pH 2.3, indicating that gastric acid is an effective barrier against infection . It can survive for 2 to 5 weeks in bovine milk or unpasteurized  milk and water stored at 4 degree celcius and causes the infection when human ingest these substances.  The campylobacter lacks fimbriae and finds difficult to attach with the gut mucosa. But it might use adhesins for the attachment.

Campylobacter gets attached to proximal part of the small intestine and secreate the toxins and activating the bowel movements and resulting in initiation of the diarrhoea.

Sometimes the campylobacter enters the epithelial tissue of the intestine and causes dysfunction of the intestine resulting in the bloody diarrhoea and causes inflammation of the gut cell.

They also enters the mesenteric lymph nodes and also lamina propria. the bacteria prevents the integration of the phagolysosomes, and the release of myeloperoxidase. And the bacteria is very much intelligent and it knows the way for its survival within the macrophages and it enters the reticuloendothelial cells that is nothing but the blood cell and causes septicemia.

Campylobacter increases the release of myoelectric potentials and causes the increase in bowel movements. These results in disordered peristalsis and disorderd flow which favour the multiplication of the bacteria.

Bacterial toxins in general have been conveniently classified as either membrane damaging, such as hemolysins and phospholipases, or intracellular acting. The toxins binds to the plasma membrane. The toxins produced by the campylobacter includes enterotoxin and cytotoxins.

Enterotoxin:

The enterotoxin enhances the activity of the adenyl cyclase in the gut mucosa and also  disrupts the activity of the ion transport in the small intestine. The enterotoxins are the heat labile proteins that is the action of those proteins are disrupted at the 56 degree celsius for 1 hour and 96 degree Celsius for 10 minutes.


ROUTES OF TRANSMISSION :

Drug resistant by transmision:

Since it is an zoonotic infection and mainly the bacteria depends upon the animals and birds as the source of infection. When antibiotic are given to the animals and bacteria they might start resistance to the bacteria. And also some uses these contaminated animals and birds faecal matters as the fertilizer in the farm. When these animals and birds are ingested by the human or the crop grown by using these contaminated fertilizer are ingested by the humans might cause antibiotic resistance in humans.


COMMON CLINICAL SIGNS AND SYMPTOMS :

  • Mild to severe diarrhea
  • Bloody diarrhea
  • Nausea
  • Stomach pain
  • Fever
  • Vomiting

 


DIAGNOSTIC :

Stool culture:

Campylobacter grows best on media containing selective antibiotics and in microaerobic conditions with 5% to 10% oxygen, 1% to 10% carbon dioxide, and some hydrogen. The  bacteria grows well in these environments.

Gram stain:

The stool is examined under the gram stain and the structure of the bacteria is seen. The bacteria is coma shaped or spiral shaped  gram negative bacilli.

Culture independent diagnostic test:(CIDT)

CIDT tests are generally more sensitive and have faster turnaround times than traditional culture-based diagnostics.  Reverse transcriptase polymerase reaction detects the bacteria earlier than anyother and it is done by amplification of the DNA of the bacterium.

 


TREATMENT AND PROGNOSIS :

Treatment:

Infection with the campylobacter is self limiting and it gets resolved within 2-3 weeks.

First step in the treatment is hydration and electrolyte imbalance in the form of IV infusion

Macrolides such as azithromycin, clarithromycin and erythromycin are first line of choice in human campylobacteriosis and the bacterias have developed resistant to the organisms.

Antimotility drugs such as loperamide , diphenoxylate with atropine or diphenoxin


PROGNOSIS :

Prognosis is excellent but it might depends upon the immune system respond by the patient

Recovery period:

 it takes atleast a week to get recover by administration of the antibiotics.


PREVENTION :

  • Prevention is based on control measures at all stages of the food chain, from agricultural production on a farm, to processing, manufacturing and preparation of foods both commercially and domestically.
  • In countries without adequate sewage disposal systems, faeces and articles soiled with faeces may need to be disinfected before disposal.
  • Measures to reduce the prevalence of Campylobacter in poultry include enhanced biosecurity to avoid transmission of Campylobacter from the environment to the flock of birds on the farm. This control option is feasible only where birds are kept in closed housing conditions.
  • Good hygienic slaughtering practices reduce the contamination of carcasses by faeces, but will not guarantee the absence of Campylobacter from meat and meat products. Training in hygienic food handling for abattoir workers and raw meat producers is essential to keep contamination to a minimum.
  • Prevention methods against infection in domestic kitchens are similar to those used against other foodborne bacterial diseases.
  • Bactericidal treatment, such as heating (for example, cooking or pasteurization) or irradiation, is the only effective method of eliminating Campylobacter from contaminated food


Recovery Period :

it takes atleast a week to get recover by administration of the antibiotics.

 


Medicines used in the Treatment :

They are purely bacteriostatic but it might be bacteriocidal when these drugs are given at the higher doses. Macrolides acts by inhibiting the protein synthesis in the bacteria. They bind to the P site of the 50s subunits

azithromycin

clarithromycin

 erythromycin

antimotility drugs:

loperamide

diphenoxylate with atropine

diphenoxin