Campylobacter jejuni and the Expanding Spectrum of Related Infections

Campylobacters are among the most common causes of enteric infections in humans. In addition to being the most frequently identified bacterial cause of diarrhea in the United States and most other industrialized nations, campylobacter infections are hyperendemic among children in developing countries. It is surprising, given the scope of disease attributed to Campylobacter species today, that until the late 1970s the role of these organisms as human pathogens was largely unappreciated. Campylobacters were first recognized in the early decades of this century as causes of infectious abortion and infertility in sheep and cattle. The pathogenicity of these organisms for humans was reported in 1947, when Campylobacter fetus was isolated from a pregnant woman who had had a septic abortion. Over the next several years, campylobacters were occasionally isolated from blood. CSF, and other body fluids and were believed to be opportunistic pathogens. However, after the pioneering work of King, Campylobacter jejuni was isolated from diarrheal stools from humans in 1972, and the subsequent development of selective stool-culture media led to the recognition that campylobacters are a common cause of diarrhea in most parts of the world. Because nearly all reported Campylobacter isolates in the United States are C. jejuni, this review will focus on this organism. However, as methods of detection (e.g., culture on selective media and filtration techniques) have improved, the number of Campylobacter and related species implicated in human disease has increased. Thus a brief overview of these pathogens will also be offered.