title: Demographic and clinical characteristics of Campylobacter bacteremia in children with and without predisposing factors.
abstract: BACKGROUND
  Campylobacter, a common cause of childhood gastroenteritis, rarely causes bacteremia, which is reported mainly in immune-compromised children. Our aim was to compare demographic and clinical characteristics of childhood campylobacter bacteremia (CB) between children with and without risk factors for CB.
  
  
  METHODS
  A retrospective, population-based study, conducted between 1989 and 2010. Risk factors were defined as immunodeficiency, malignancy, extreme prematurity or chronic diseases with malnutrition.
  
  
  RESULTS
  Seventy-six CB episodes (1 per child/month) were identified in 14 children with risk factors (30 episodes) and 46 children without risk factors (46 episodes). Children with risk factors were older (mean age 120.0±72.8 vs. 16.2±27.6 months) with higher proportion of males (90.0% vs. 60.9%), less gastrointestinal symptoms (43.3% vs. 69.9%) and higher hospitalization rates (96.7% vs. 69.6%) compared with children without risk factors. Campylobacter jejuni and Campylobacter coli (46/47 of identified species) were the most common species in both groups. Positive campylobacter stool cultures were found only in children without risk factors (0% vs. 38.5%). No mortality cases were observed. All isolates tested for antibiotic susceptibility were sensitive to macrolides and carbapenems.
  
  
  CONCLUSIONS
  Childhood CB is rare in southern Israel. The disease manifests as a single gastroenteritis complication in a previously healthy young child or as recurrent episodes in an older, immune-compromised child, usually without gastrointestinal symptoms. This disparity may reflect pathogenesis differences, with disease in the immune-competent being dependent on pathogen virulence, whereas disease in the immune-compromised being host dependent. Disease outcome is usually favorable, and macrolides remain the antibiotic treatment of choice.
authors.affiliation: From the Pediatric Infectious Disease Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Shalom
authors.initials: S
authors.lastname: Ben-Shimol
authors.forename: Adi
authors.initials: A
authors.lastname: Carmi
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D018912:Arabs / Q000706:statistics & numerical data; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology / Q000382:microbiology*; D002167:Campylobacter / Q000187:drug effects / Q000302:isolation & purification*; D002169:Campylobacter Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000208:ethnology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents