Volume 29, Number 11—November 2023
CME ACTIVITY - Synopsis
Campylobacter fetus Invasive Infections and Risks for Death, France, 2000–2021
, Timothée Klopfenstein, Vincent Gendrin, Jean-baptiste Vuillemenot, Julie Plantin, Lynda Toko, Nour Sreiri, and Pierre-Yves Royer
Table 1
Baseline characteristics, clinical features, and laboratory, and imaging findings for patients with Campylobacter fetus infections, Nord Franche-Comté Hospital, Trévenans, France, 2000–2021*
| Characteristics | All patients, n = 33 | Patients without documented C. fetus bacteremia, n = 12† | Patients with documented C. fetus bacteremia, n = 21 |
p value |
|---|---|---|---|---|
| Baseline | ||||
| Sex | 0.7 | |||
| M | 18/33 (54) | 6/12 (50) | 12/21 (57) | |
| F | 15/33 (45) | 6/12 (50) | 9/21 (43) | |
| Age, y (SD) | 73 (±18) | 66 (±19) | 77 (±16) | 0.12 |
| Underlying comorbidities | 27/33 (82) | 8/12 (67) | 19/21 (90) | 0.2 |
| Immunosuppression | 13/33 (39) | 2/12 (16) | 11/21 (52) | 0.06 |
| Malignancy/cancers | 8/33 (24) | 1/12 (8.3) | 7/21 (33) | 0.2 |
| Transplantation | 0/33 | 0/12 | 0/21 | |
| Cirrhosis | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 |
| HIV infection | 0/33 | 0/12 | 0/21 | |
| Connective tissue disease‡ | 3/33 (9.0) | 1/12 (8.3) | 2/21 (9.5) | >0.9 |
| Other§ | 1/33 (3.0) | 0/12 (8.3) | 1/21 (29) | >0.9 |
| Prosthetic heart valves | 8/33 (24) | 4/12 (33) | 4/21 (19) | 0.4 |
| Renal failure | 7/33 (21) | 1/12 (8.3) | 6/21 (29) | 0.2 |
| Diabetes mellitus | 12/33 (36) | 5/12 (42) | 7/21 (33) | 0.7 |
| Cardiovascular disease¶ | 20/33 (61) | 5/12 (42) | 15/21 (71) | 0.14 |
| Recent abdominal surgery | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 |
| Pregnancy | 0/33 | 0/12 | 0/21 | |
| Contact with livestock/cattle | 0/31 | 0/11 | 0/20 | |
| Poultry consumption | 0/31 | 0/11 | 0/20 | |
| Recent travel# | 1/31 (3.2) | 1/11 (9.1) | 0/20 | 0.4 |
| Similar cases in household/entourage | 0/31 | 0/11 | 0/20 | |
| Recent abdominal trauma injury | 4/31 (13) | 2/11 (18) | 2/20 (10) | 0.6 |
| Transmission or contamination, food or pet |
2/31 (6.5) |
0/11 |
2/20 (10) |
0.5 |
| Clinical features | ||||
| Fever | 21/32 (66) | 8/11 (73) | 13/21 (62) | 0.7 |
| Headache | 1/32 (3.1) | 0/11 | 1/21 (4.8) | >0.9 |
| Asthenia/anorexia | 16/33 (48) | 4/12 (33) | 12/21 (57) | 0.3 |
| Abdominal pain | 11/33 (33) | 7/12 (58) | 4/21 (19) | 0.052 |
| Confusion | 8/31 (26) | 2/10 (20) | 6/21 (29) | >0.9 |
| Dyspnea, respiratory rate >22 cycles/min | 8/31 (26) | 1/10 (10) | 7/21 (33) | 0.2 |
| Hypotension, systolic pressure <100 mm Hg | 7/31 (23) | 1/10 (10) | 6/21 (29) | 0.4 |
| qSOFA score | 0.4 | |||
| 0 | 20/31 (65) | 8/10 (80) | 12/21 (57) | |
| 1 | 3/31 (10) | 1/10 (10) | 2/21 (10) | |
| 2 | 6/31 (19) | 0/10 | 6/21 (29) | |
| 3 | 2/31 (6.5) | 1/10 (10) | 1/21 (4.8) | |
| Sepsis: qSOFA ≥2 | 8/31 (26) | 1/10 (10) | 7/21 (33) | 0.22 |
| Diarrhea, n = 33 | ||||
| Total | 16/33 (48) | 10/12 (83) | 6/21 (29) | 0.004 |
| Liquid | 14/33 (42) | 9/12 (75) | 5/21 (24) | 0.009 |
| Bloody |
2/33 (6.1) |
1/12 (8.3) |
1/21 (4.8) |
>0.9 |
| Laboratory and imaging findings | ||||
| Leukocyte count, cells/mm3 (SD); reference range 4,000–10,000 cells/mm3 | 12,387 (6,665) | 9,949 (3,307) | 13,548 (7,571) | 0.076 |
| CRP, mg/L (SD), reference range <5 mg/L | 118 (79) | 120 (52) | 116 (93) | 0.9 |
| Peripheral blood culture | ||||
| No. (SD) | NA | NA | 2.52 (1.63) | NA |
| Negativation, d (SD) |
NA |
NA |
2.89 (3.14) |
NA |
| Transthoracic echocardiography** |
4/32 (12) |
1/11 (9.1) |
3/21 (14) |
>0.9 |
| 18F-FDG PET/CT | 3/32 (9.4) | 0/11 (0) | 3/21 (14) | 0.5 |
*Values are no./total (%) except as indicated. Boldface indicates p<0.05 or a significant trend defined by p<0.06. Blank cells for p values indicate no p value was calculated. 18F-FDG PET/CT, 18F-fluoro-deoxyglucose-positron emission tomography/computed tomography; CRP, C-reactive protein; qSOFA, quick sequential organ failure assessment; NA, not applicable. †Campylobacter fetus was isolated from 11 fecal cultures and from 1 bile fluid culture; only 1 patient had simultaneous positive peripheral blood and fecal cultures in which C. fetus was isolated with the same antimicrobial testing susceptibility pattern. ‡All patients with connective tissue diseases (bacteremia; n = 2) had multiple sclerosis. §Defined by hematologic diseases, long-term steroid therapy, or immunomodulatory treatment. ¶Defined by cardiac failure, arrhythmia, coronary heart disease, stroke, peripheral arterial obstructive disease and thromboembolic disease. #28-y-old patient sought care for bloody diarrhea without fever 8 d after a travel in Spain. **The 3 patients who underwent transthoracic echocardiography were different patients than those who underwent 18F-FDG PET/CT. No patient had both endocarditis and mycotic aneurysm.