title: Campylobacter bacteremia: clinical features and factors associated with fatal outcome.
abstract: BACKGROUND
  Campylobacter bacteremia is uncommon. The influence of underlying conditions and of the impact of antibiotics on infection outcome are not known.
  
  
  METHODS
  From January 2000 through December 2004, 183 episodes of Campylobacter bacteremia were identified in 23 hospitals in the Paris, France, area. The medical records were reviewed. Characteristics of bacteremia due to Campylobacter fetus and to other Campylobacter species were compared. Logistic regression analysis was performed to identify risk factors for fatal outcome within 30 days.
  
  
  RESULTS
  Most affected patients were elderly or immunocompromised. C. fetus was the most commonly identified species (in 53% of patients). The main underlying conditions were liver disease (39%) and cancer (38%). The main clinical manifestations were diarrhea (33%) and skin infection (16%). Twenty-seven patients (15%) died within 30 days. Compared with patients with bacteremia due to other Campylobacter species, patients with C. fetus bacteremia were older (mean age, 69.5 years vs. 55.6 years; P = .001) and were more likely to have cellulitis (19% vs. 7%; P = .03), endovascular infection (13% vs. 1%; P = .007), or infection associated with a medical device (7% vs. 0%; P = .02). Independent risk factors for death were cancer (odds ratio [OR], 5.1; 95% confidence interval [CI], 1.2-20.8) and asymptomatic infection (OR, 6.7; 95% CI, 1.5-29.4) for C. fetus bacteremia, the absence of prescription of appropriate antibiotics (OR, 12.2; 95% CI, 0.9-157.5), and prescription of third-generation cephalosporins (OR, 10.2; 95% CI, 1.9-53.7) for bacteremia caused by other species.
  
  
  CONCLUSIONS
  Campylobacter bacteremia occurs mainly in immunocompromised patients. Clinical features and risk factors of death differ by infection species.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France. jerome.pacanowski@sat.aphp.fr
authors.forename: Jérôme
authors.initials: J
authors.lastname: Pacanowski
authors.forename: Valérie
authors.initials: V
authors.lastname: Lalande
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Cherif
authors.initials: C
authors.lastname: Boudraa
authors.forename: Philippe
authors.initials: P
authors.lastname: Lesprit
authors.forename: Patrick
authors.initials: P
authors.lastname: Legrand
authors.forename: David
authors.initials: D
authors.lastname: Trystram
authors.forename: Najiby
authors.initials: N
authors.lastname: Kassis
authors.forename: Guillaume
authors.initials: G
authors.lastname: Arlet
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Mainardi
authors.forename: Florence
authors.initials: F
authors.lastname: Doucet-Populaire
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Meynard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology* / Q000401:mortality*; D002167:Campylobacter; D002169:Campylobacter Infections / Q000401:mortality*; D002168:Campylobacter fetus; D002648:Child; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D010297:Paris; D055815:Young Adult