Campylobacter fetus bloodstream infection: risk factors and clinical features.
In this paper, we report 21 cases of Campylobacter fetus bloodstream infection observed in our institution over a 9-year period. The median age of the patients was 78 years. Most of them (62%) had a significant underlying disease, such as diabetes, immunodeficiency or cardiovascular disease. The main clinical features were fever with (62% of cases) or without (38%) extra-intestinal symptoms. These included mycotic aneurysm of the abdominal aorta (24%) and cellulitis (19%). Antibiotic treatment was mainly based on amoxicilline-clavulanate (57%) or imipenem (21%), for a median duration of 28 days. A favourable outcome was observed in 72% of cases. Death directly attributable to infection was observed for three patients, due to the rupture of an infected aneurysm or relapsing bloodstream infection with septic shock. All patients initially treated with imipenem had a favourable outcome. This report adds evidence that C. fetus bloodstream infection should be suspected in elderly patients with fever, immunodeficiency and cardiovascular damages. Imipenem seems to be the most active drug, especially in severe cases.
Gazaigne
L
L
Unité de Contrôle Epidémiologie et Prévention de l'Infection, Laboratoire de Bactériologie, Service des Urgences, Hôpital Henri Mondor (AP-HP), Créteil, France.
Legrand
P
P
Renaud
B
B
Bourra
B
B
Taillandier
E
E
Brun-Buisson
C
C
Lesprit
P
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000382:microbiology* / Q000503:physiopathology*; D002169:Campylobacter Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology*; D002168:Campylobacter fetus / Q000302:isolation & purification*; D002318:Cardiovascular Diseases / Q000150:complications; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D016867:Immunocompromised Host; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D015378:Imipenem; D019980:Amoxicillin-Potassium Clavulanate Combination