Volume 29, Number 11—November 2023
CME ACTIVITY - Synopsis
Campylobacter fetus Invasive Infections and Risks for Death, France, 2000–2021
Table 2
Characteristics |
All patients, n = 33 | Patients with no C. fetus bacteremia, n = 12 | Patients with C. fetus bacteremia, n = 21 | p value | |
---|---|---|---|---|---|
Secondary localizations† | |||||
Site infection | |||||
Total | 7/33 (21) | 0/12 | 7/21 (33) | 0.03 | |
Mycotic aneurysm | 3/33 (9.0) | 0/12 | 3/21 (14.3) | 0.28 | |
Endocarditis | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 | |
Infection associated with a medical device | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 | |
Thrombophlebitis | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 | |
Bone or joint infection | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 | |
Skin or soft tissue/abscesses | 0/33 (0) | 0/12 | 0/21 (0) | NA | |
Meningitis |
0/33 (0) |
0/12 |
0/21 (0) |
NA |
|
Antimicrobial therapy | 0.6 | ||||
Amoxicillin | 0/29 (0) | 0/9 | 0/20 (0) | ||
Amoxicillin–clavulanic acid | 12/29 | 2/9 | 10/20 (50) | ||
Imipenem | 2/29 (6.9) | 0/9 | 2/20 (10) | ||
Gentamicin | 3/29 (10) | 0/9) | 3/20 (15) | ||
Azithromycin | 1/29 (3.4) | 1/9 (11) | 0/20 (0) | ||
Ciprofloxacin | 3/29 (10) | 2/9 (22) | 1/20 (5.0) | ||
Other |
11/29 (38) |
3/9 (33) |
8/20 (40) |
||
No. antimicrobial drugs/patient | 0.065 | ||||
0 | 4/29 (17) | 2/9 (22) | 2/20 (10) | ||
1 | 11/29 (38) | 5/9 (56) | 6/20 (30) | ||
2 | 10/29 (34) | 2/9 (22) | 8/20 (40) | ||
3 |
4/29 (14) |
0/9 |
4/20 (20) |
||
Dual-therapy regimens | |||||
Amoxicillin/clavulanic acid + gentamicin | 3/10 (30) | 0/2 | 3/8 (38) | ||
Amoxicillin/clavulanic acid + azithromycin | 1/10 (10) | 0/2 | 1/8 (12) | ||
Amoxicillin/clavulanic acid + ciprofloxacin | 2/10 (20) | 0/2 | 2/8 (25) | ||
Amoxicillin/clavulanic acid + doxycycline | 3/10 (30) | 2/2 (100) | 1/8 (12) | ||
Imipenem + gentamicin | 1/10 (10) | 0/2 | 1/8 (12) | ||
Treatment duration, d (SD) |
8 (8) |
5 (5) |
9 (8) |
0.2 |
|
Outcomes and mortality rates | |||||
Long-term complications, n = 33 | |||||
Total | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 | |
Aneurysmal rupture/aortic dissection | 1/33 (3.0) | 0/12 | 1/21 (4.8) | >0.9 | |
Acute coronary syndrome | 0/33 (0) | 0/12 | 0/21 (0) | NA | |
Irritable bowel syndrome | 0/33 (0) | 0/12 | 0/21 (0) | NA | |
GBS (polyradiculoneuritis) | 0/33 (0) | 0/12 | 0/21 (0) | NA | |
Surgery‡ | 5/31 (16.1) | 1/10 | 4/21 (19) | 0.6 | |
Relapse§ | 2/33 (6) | 0/12 | 2/21 (9.5) | 0.5 | |
Transfer to intensive care | 4/33 (12) | 0/12 | 4/21 (19) | 0.3 | |
Septic shock | 4/33 (12) | 0/11 | 4/21 (19) | 0.3 | |
Infection-related mortality | 6/29 (21) | 1/8 (12) | 5/21 (24) | 0.6 | |
30-day mortality rate¶ |
10/33 (30) | 3/12 (25) | 7/21 (33) | 0.9 |
*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. GBS, Guillain-Barré syndrome; NA, not applicable. †Mycotic aneurysm (n = 3) with infectious native aortic aneurysm (n = 2); prosthetic aortic valve and a positive culture of the aneurysm after surgery (n = 1); prosthetic valve endocarditis (n = 1) with typical oscillating vegetation (15 mm) confirmed by transthoracic echocardiography; abdominal aorta thrombophlebitis (n = 1); hematogenous medical device infection with a percutaneous implantable port-related infection (n = 1); osteoarticular (n = 1) with glenohumeral shoulder arthritis and a positive culture of the articular fluid after surgery, suggesting a contiguous infection. ‡Four patients with bacteremia caused by C. fetus underwent surgery: mycotic aneurysm (n = 2), endocarditis (n = 1), and septic arthritis (n = 1). §Two patients exhibited a relapse with fever after 26 and 50 d; the second patient died of septic shock during the second episode. The first patient received ciprofloxacin orally for 5 d, and the second patient received IV vancomycin for 7 d. ¶Among the 7 bacteremic patients who died, 2 died in the context of evolutive/expanding malignancy (independently of the bacteremia).