title: Recrudescent Campylobacter jejuni infection in an immunocompetent adult following experimental infection with a well-characterized organism.
abstract: The recrudescence of infection with Campylobacter jejuni after appropriate antibiotic treatment has not been previously reported in an immunocompetent adult. We present the complete clinical, microbiologic, and immunologic evaluation of a closely monitored healthy male with recrudescent C. jejuni infection occurring in the absence of immunodeficiency following experimental infection with a well-characterized strain. After antibiotic treatment, the initial infection was clinically cleared and microbiologically undetectable. Subsequently, two episodes of recrudescence occurred, with no change in in vitro antibiotic sensitivity being detected. The immune responses of the individual were compared to those of other participants in the experimental infection study: innate immune responses, including fecal cytokines and C-reactive protein, were intact; however, measures of Campylobacter-specific adaptive immune responses were absent, including serum antibodies, antibody-secreting cells, and in vitro gamma interferon responses. No primary or secondary immunodeficiency was identified. Recrudescent Campylobacter infections after treatment may be more common than has previously been appreciated. This work adds to our understanding of the human immune response to natural Campylobacter infection and reiterates the importance of pathogen-specific adaptive immune responses to this globally important pathogen.
authors.affiliation: University of Vermont College of Medicine, Unit of Infectious Diseases and Vaccine Testing Center, 110 Stafford Hall, 95 Carrigan Drive, Burlington, VT 05405, USA. beth.kirkpatrick@uvm.edu
authors.forename: Shahida
authors.initials: S
authors.lastname: Baqar
authors.forename: David R
authors.initials: DR
authors.lastname: Tribble
authors.forename: Marya
authors.initials: M
authors.lastname: Carmolli
authors.forename: Katrin
authors.initials: K
authors.lastname: Sadigh
authors.forename: Frederic
authors.initials: F
authors.lastname: Poly
authors.forename: Chad
authors.initials: C
authors.lastname: Porter
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Larsson
authors.forename: Kristen K
authors.initials: KK
authors.lastname: Pierce
authors.forename: Patricia
authors.initials: P
authors.lastname: Guerry
authors.forename: Michael
authors.initials: M
authors.lastname: Darsley
authors.forename: Beth
authors.initials: B
authors.lastname: Kirkpatrick
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000097:blood; D000938:Antigen-Presenting Cells / Q000276:immunology; D002169:Campylobacter Infections / Q000188:drug therapy* / Q000382:microbiology*; D016123:Campylobacter jejuni / Q000187:drug effects / Q000302:isolation & purification*; D016207:Cytokines / Q000032:analysis; D005243:Feces / Q000737:chemistry; D041981:Gastrointestinal Tract / Q000276:immunology; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008826:Microbial Sensitivity Tests; D012008:Recurrence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D016207:Cytokines; D007371:Interferon-gamma