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Campylobacter Enteritis in the United States
A Multicenter Study
- MARTIN J. BLASER, M.D.;
- JOY G. WELLS, M.S.;
- ROGER A. FELDMAN, M.D.;
- ROBERT A. POLLARD, M.A.;
- JAMES R. ALLEN, M.D.; and
- THE COLLABORATIVE DIARRHEAL DISEASE STUDY GROUP*
Abstract
During a 15-month study, 8097 fecal specimens submitted to clinical microbiology laboratories at eight hospitals in different parts of the United States were examined. Campylobacter jejuni was isolated from 4.6%, Salmonella from 2.3%, and Shigella from 1.0%. Isolation rates for each pathogen were highest from stool specimens that were watery, bloody, or contained leukocytes. The peak isolation rate for C. jejuni was in persons ages 10 to 29 years; for Salmonella, in children younger than age 10 years; and for Shigella, in children ages 5 to 9 years. The clinical features of the three infections were nearly identical. In contrast, abdominal pain, bloody diarrhea, fever, tenesmus, and abnormal sigmoidsocopic findings were present significantly more often in patients infected with C. jejuni than in a control group of patients with diarrhea. Of patients with leukocytes in their stools and a history of fever, 45.9% were infected with one of the three pathogens. Use of laboratory and clinical findings defined groups with high or low risk of these three infections but could not accurately predict isolation. Fecal cultures had the highest yields when obtained from patients within 7 days from the onset of symptoms.
Article and Author Information
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▸From the Division of Bacterial Diseases and the Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control; Atlanta, Georgia.
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↵* Grant O. Westenfelder, M.D., Eileen Randall, Ph.D., Sharon L. Westenfelder, R.N., Sandra Stoll, R.N., and Lori Walsh, Evanston Hospital, Evanston, Illinois; Douglas C. Hubner, M.D., Mary McGarry, R.N., Connie Bourne, R.N., and Johnese McDonald, M.T., Hillcrest Medical Center, Tulsa, Oklahoma; Betty A. Forbes, Ph.D. and E.M. Britt, Ph.D., St. Joseph Mercy Hospital, Ann Arbor, Michigan; Marie Lucero, R.N., Edith Lees, R.N., Marvin P. Jones, M.T., Connie M. Sweat, M.T., Harriet L. Hardesty, M.T., and R.M. Sherwin, M.D., Penrose Hospital, Colorado Springs, Colorado; Marie Gustafson, R.N., Mary Bauman, M.D., and Peter C. Fuchs, M.D., Ph.D., St. Vincent Hospital and Medical Center, Portland, Oregon; James H. Tenney, M.D., Andrew G. Smith, Ph.D., Luis Cisneros, M.D., and Gerald Karwacki, M.D., University of Maryland Hospital, Baltimore, Maryland; James Brandt, M.S., John Lewis, Ph.D., and Harvey Elder, M.D., Loma Linda Hospital, Loma Linda, California; K.B. Sharma, M.D., Linda Herron, Eileen McCraney, Susie Saul, and Melideen Edwards, University Hospital, Augusta, Georgia; and James M. Hughes, M.D., Hospital Infections Program, Centers for Disease Control, Atlanta, Georgia.
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▸Requests for reprints should be addressed to Enteric Diseases Branch, Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333.
