Campylobacter jejuni: The hidden foodborne threat in your kitchen

Campylobacter jejuni is a spiral-shaped, Gram-negative bacterium that thrives in low-oxygen environments — meaning it grows best when oxygen levels are lower than those in the atmosphere.

Normal air has about 21% oxygen, but C. jejuni thrives at around 5% oxygen and 10% carbon dioxide.

The bacterium struggles to survive in regular atmospheric conditions. High oxygen levels can damage its cellular components.

How it spreads

C. jejuni thrives in the intestines of animals, particularly poultry, where it can exist without causing illness to its host.

The bacteria primarily spreads to humans through consumption of contaminated foods, especially undercooked chicken, unpasteurized milk, and contaminated water.

Cross-contamination in kitchens is a major transmission route, as C. jejuni easily transfers from raw meat to other foods via cutting boards, utensils, and unwashed hands.

C. jejuni is one of the most common causes of bacterial diarrheal illness worldwide.

North America, Europe, and Australia, have seen a dramatic increase in the incidence of campylobacteriosis over the last decade. Repeated and chronic infections can occur in children, even without symptoms. This can lead to deficits in early childhood development.

Another growing concern is the increasing antibiotic resistance observed in Campylobacter jejuni. Resistance to commonly used antibiotics, such as fluoroquinolones (e.g., ciprofloxacin), has been reported. Studies indicate that 28% of C. jejuni isolates were resistant to ciprofloxacin. This resistance complicates treatment options and underscores the importance of prudent antibiotic use.​

Understanding C. jejuni is crucial for public health and effective infection management.

While anyone can get infected, certain groups are more susceptible to severe illness from C.jejuni:​

• Older adults (65+): They may have weaker immune systems, making it harder to fight off infections.
• Use of proton-pump inhibitors: Reduction in stomach acid increases the risk of contracting jejuni infections
• Pregnant women: Pregnancy can alter the immune response, increasing vulnerability.
• People with weakened immune systems: This includes individuals with conditions like HIV/AIDS or those undergoing chemotherapy
• Young children: Their immune systems are still developing.
• Travelers to certain regions: Exposure to unfamiliar bacteria in food or water can increase risk.

Additionally, individuals who work with animals, especially poultry, are at higher risk due to potential exposure.

Common symptoms associated with Campylobacter jejuni infection, include:

• Diarrhea: Often the primary symptom, which can be watery or bloody
• Abdominal cramps and pain
• Fever
• Nausea and vomiting
• Muscle pain and headache
• Reactive arthritis
• Guillain-Barré syndrome (GBS): A rare but serious autoimmune condition that can follow infection. ​

These symptoms typically appear 2 to 5 days after exposure and can last about a week. While most cases are self-limiting, it’s important to monitor for severe or prolonged symptoms and seek medical attention if necessary.

Complications

• Guillain-Barré Syndrome (GBS): C. jejuni is the most frequently identified antecedent infection in GBS cases. The bacterium’s lipooligosaccharides can mimic human nerve gangliosides, leading to an autoimmune response that damages peripheral nerves. ​
• Reactive Arthritis: Approximately 1–2% of individuals with C. jejuni enteritis develop reactive arthritis, an inflammatory joint condition that can cause pain and swelling. ​
• Bacteremia: While rare, C. jejuni can enter the bloodstream, leading to bacteremia. This is more common in immunocompromised individuals and can result in severe systemic infections. ​
• Irritable Bowel Syndrome (IBS): Post-infectious IBS can develop after C. jejuni infection, characterized by chronic abdominal discomfort and altered bowel habits. ​

Campylobacter can be detected by isolating it from a clinical sample, like a stool specimen.

Molecular tests such as PCR assays and enzyme immunoassays offer high sensitivity and specificity for detecting C. jejuni.

Molecular tests have been shown to be superior in predictive value. However, culture tests are critical for assessing antibiotic resistance.

Most C. jejuni infections are self-limiting.

The primary treatment involves maintaining hydration and electrolyte balance.

• Oral rehydration solutions are commonly used
• Intravenous fluids may be necessary for severe dehydration

Antibiotics are generally reserved for the following situations:

• Severe cases
• High-risk patients (such as the elderly or immunocompromised)
• Symptoms persist beyond 7 days

Macrolides, like azithromycin, are often the first choice. Fluoroquinolones are less commonly recommended due to increasing resistance.

Preventing C. jejuni infections is a combination of personal safety precautions and implementing industrial safety measures

Personal safety practices

• Proper cooking: Ensure poultry and other meats are cooked to safe internal temperatures to kill bacteria
• Avoid cross-contamination: Use separate cutting boards and utensils for raw meat and other foods
• Hand hygiene: Wash hands thoroughly after handling raw meat
• Water Safety: Consume only treated or boiled water, especially in areas where water safety is uncertain
• Animal contact: Practice good hygiene after contact with animals, particularly in settings like petting zoos or farms

Safety in the food industry

• Biosecurity: Strict biosecurity protocols prevent the introduction and spread of Campylobacter in poultry and oyster farms
• Vaccination and feed additives: Research is ongoing into vaccines and feed additives that could reduce Campylobacter colonization in poultry

Campylobacter jejuni may be invisible to the naked eye, but its impact on public health is substantial.

Understanding this pathogen is crucial as it affects 1.5 million Americans yearly and shows increasing antibiotic resistance.

Simple prevention methods including thoroughly cooking poultry, avoiding cross-contamination, practicing good hand hygiene, and consuming only pasteurized dairy products can dramatically reduce your risk.

By implementing these kitchen safeguards today, you protect yourself and your family from this common yet potentially serious foodborne illness. Remember, when it comes to Campylobacter jejuni, awareness and prevention are your best defense.

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