campylobacter

• Genera and Species to be Considered

  • Campylobacter coli
  • Campylobacter sputorum biovar. sputorum
  • Campylobacter concisus
  • Campylobacter upsaliensis
  • Campylobacter curvus
  • Arcobacter cryaerophilus
  • Campylobacter fetus subsp. fetus
  • Arcobacter butzleri
  • Campylobacter fetus subsp. venerealis
  • Helicobacter pylori
  • Campylobacter gracilis
  • Helicobacter cinaedi
  • Campylobacter hyointestinalis subsp. hyointestinalis
  • Helicobacter fennelliae
  • Campylobacter jejuni subsp. doynei
  • Campylobacter jejuni subsp. jejuni
  • Campylobacter lari
  • Campylobacter rectus
  • Campylobacter showae

  
• Campylobacter and Campylobacter-like species

  • Have undergone changes in taxonomy
  • Were formerly classified with the vibrios because of their positive oxidase and characteristic microscopic morphology
  • DNA homology studies have shown that Campylobacter spp. do not belong with the vibrios
  • Unlike the vibrios, which are fermentative, most campylobacters are asaccharolytic

  
• Wolinella recta and Wolinella curva

  • Were transferred to the genus Campylobacter as C. rectus and C. curvus
• Campylobacters


  • Although they may appear to be strict anaerobes, they have been grown in a microaerophilic environment
  • Microaerophilic organisms require oxygen, but at a concentration less than that of room air; 5% is normally optimal
• Arcobacter and Sulfurospirillum


  • Were placed in the family Campylobacteraceae along with Camplyobacter

  
• Helicobacter and Wolinella


  • Are members of the family Helicobactereaceae
• Campylobacter spp. implicated in human infection

  • C. fetus
  • C. jejuni
  • C. coli
  • C. sputorum
  • C. concisus
  • C. curvus
  • C. rectus

  
• C. fetus


  Contains two subspecies, C. fetus subsp. fetus and C. fetus subsp. venerealis
• Patients infected with C. jejuni

  • Present with a diarrheal disease that begins with mild abdominal pain within 2 to 10 days after ingestion of the organisms
  • In most patients, the illness is self-limited and usually resolves in 2 to 6 days
  • Untreated patients can remain carriers for several months
• Other enteric Campylobacter infections (those caused by C. coli and C. lari)


  • Have similar clinical manifestations
• Campylobacter infection


  • Plays a role in GBS (Guillain-Barre Syndrome)
  • Many patients with GBS test positive for antibodies to Campylobacter
  • Antibodies produced during a Campylobacter infection bind to gangliosides found on peripheral nerves
  • Cross-reactivity with these nerve cells in an autoimmune response may be responsible for this debilitating nerve disorder
• H. pylori


  • Has been primarily linked to gastric infections
  • Once acquired, H. pylori colonizes the stomach for a long time and can cause a low-grade inflammatory process, producing a chronic superficial gastritis
  • Although it does not invade the gastric epithelium, the infection is recognized by the host immune system, which initiates an antibody response
  • Antibodies produced are not protective
  • H. pylori is also recognized as a major cause of type B gastritis, a chronic condition formerly associated primarily with stress and chemical irritants
• Long-term H. pylori infection resulting in chronic gastritis

  Is an important risk factor for gastric carcinoma resulting in H. pylori being classified as a carcinogen
• Other species of helicobacters associated with human gastroenteritis


  • H. cinaedi
  • H. fennelliae
  • H. canadensis
  • H. canis
  • H. pullorum
  • H. winghamensis
• H. cinaedi


  Has been isolated from the blood of patients with bacteremia and patients with HIV infection
• C. fetus subsp. fetus

  • Can be recovered in several routine blood culture media
• Campylobacter spp. that cause enteric illness


  • Are isolated from stool samples and rectal swabs, the less preferred specimen
  • If a delay in processing the stool specimen is anticipated, it can be placed in a transport medium such as Cary-Blair to maintain the viability of the organisms
  • A common stool transport medium, buffered glycerol saline, is toxic to enteric campylobacters and should therefore be avoided

  
• H. pylori


  • Can be recovered from gastric biopsy materials
  • Samples must be transported quickly to the laboratory
  • Stuart medium can be used to maintain the viability of the organisms if a delay in processing is anticipated
  • Tissue samples may also be placed in cysteine-Brucella broth with 20% glycerol and frozen at −70°C

  
• Campy-BAP


  • Is a commonly used medium to isolate C. jejuni and other enteric campylobacters

  
• Campy-BAP


  • Contains: Brucella agar base, 10% sheep red blood cells, and a combination of antimicrobials – vancomycin, trimethoprim, polymyxin B, amphotericin B, and cephalothin

  
• Other selective media that have been successful in recovering Campylobacter spp.

  • Butzler medium
  • Skirrow's medium
  • Medium V
  • Campy-CVA (cefoperazone-vancomycin-amphotericin B) medium

  
• Medium V


  • Modification of the original Butzler medium
  • Contains cefoperazone, rifampin, colistin, and amphotericin B
  • Seems to inhibit normal colon microbiota better than the original formulation
• Incubation at 37°C


  • Allows recovery of Campylobacter spp. that are inhibited at 42°C

  
• C. fetus subsp. fetus, C. rectus, and C. curvus


  • Can be isolated using routine culture media
• To recover H. pylori

  • A combination of a nonselective medium, such as CHOC agar or Brucella agar with 5% horse red blood cells, and a selective medium, such as Skirrow's agar, may be used
• Incubating stool cultures at 42°C

  • Allows C. jejuni and other enteric campylobacters to grow optimally
  • Inhibits growth of colon microbiota

  
• C. fetus subsp. fetus

  • Growth is suppressed at 42°C, so media should be incubated at 37°C to isolate this organism
• Enteric Campylobacter and Helicobacter spp.

  • Require a microaerophilic and capnophilic environment
  • The ideal atmospheric environment for Campylobacter spp. is a gas mixture of 5% O2, 10% CO2, and 85% N2
  • For Helicobacter spp., 5% to 10% O2 and 5% to 12% CO2
  • Except for C. rectus and C. curvus, a strict anaerobic environment does not support the growth of most Campylobacter spp.

  
• Methods used to obtain the required environment for campylobacters

  • GasPak EZ Gas Generating Container System
  • GasPak EZ Gas Generating Pouch System
  • Evacuation replacement system similar to that used to obtain a strict anaerobic condition
  • Candle jar may be used if none of these systems is available – however, this method provides the least ideal environmental condition
• Incubation time


  • Should be extended to 72 hours to isolate enteric Campylobacter spp. more efficiently
  • This allows facultative organisms present on the medium to reduce the O2 tension created by the candle to a more suitable concentration for campylobacters
• Presumptive Identification


  • Microscopic Morphology
• bacter spp.


  Gas mixture of 5% O2, 10% CO2, and 85% N2
• Helicobacter spp.


  5% to 10% O2 and 5% to 12% CO2

  
• Campylobacter spp.


  Except for C. rectus and C. curvus, a strict anaerobic environment does not support the growth of most

  
• Methods used to obtain the required environment for campylobacters

  1. GasPak EZ Gas Generating Container System

  2. GasPak EZ Gas Generating Pouch System

  3. Evacuation replacement system similar to that used to obtain a strict anaerobic condition

  4. Candle jar may be used if none of these systems is available – however, this method provides the least ideal environmental condition
• Incubation time


  Should be extended to 72 hours to isolate enteric Campylobacter spp. more efficiently
• This allows facultative organisms present on the medium to reduce the O2 tension created by the candle to a more suitable concentration for campylobacters
• Campylobacter spp.


  • Curved, non–spore-forming, gram-negative rods that measure approximately 0.2 to 0.9 μm × 0.5 to 5.0 μm
  • Enteric campylobacters may appear as long spirals or 'S' or seagull-wing shapes
  • May appear as coccobacilli in smears prepared from older cultures
  • On Gram-stained smears, these organisms stain poorly
  • Exhibit a characteristic "darting" motility on hanging drop preparations or when visualized under phase contrast microscopy

  
• Distilled water and saline

  Seem to inhibit motility
• Arcobacter spp.


  • Have a microscopic morphology similar to that of Campylobacter spp.