title: A severe case of persistent diarrhoea associated with Arcobacter cryaerophilus but attributed to Campylobacter sp. and a review of the clinical incidence of Arcobacter spp.
abstract: Although rarely, Arcobacter spp. have been associated with diarrhoea and bacteraemia. We report a persistent case in a healthy 26-year-old Spanish male of bloody diarrhoea, which was attributed to Campylobacter but in fact was caused by Arcobacter cryaerophilus, as determined by sequencing of the rpoB gene. The isolate was re-identified by matrix-assisted laser desorption ionization time of flight (MALDI-TOF) and genotyped for five putative virulence genes and for seven genes included in the Arcobacter multilocus sequence typing database. The low score obtained by MALDI-TOF indicates the need to complement the database with more isolates. Only the ciaB gene, which encodes for an invasin, was detected. Despite the isolate belonging to a new sequence type, three of the alleles (glnA, pgm and tkt) had been found previously in isolates from faeces of patients with diarrhoea. This study, together with the reviewed literature, indicates that Arcobacter can produce bacteraemia and that the isolation from patients with diarrhoea range from 0.11% to 1.25%. This study also demonstrates that Arcobacter species are confused with Campylobacter spp., as previously suggested. This is one of the factors that leads to underestimation of their incidence together with the use of inappropriate detection and identification methods.
authors.affiliation: Unitat de Microbiologia, Departament de Cièancies Mediques Básiques, Facultad de Medicina i Ciencias de la Salud, IISPV, Universidad Rovira i Virgili Sant Lorenzo 21, 43201, Reus, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Figueras
authors.affiliation: Unitat de Microbiologia, Departament de Cièancies Mediques Básiques, Facultad de Medicina i Ciencias de la Salud, IISPV, Universidad Rovira i Virgili Sant Lorenzo 21, 43201, Reus, Spain ; Laboratorio de Patología de Organismos Acuáticos y Biotecnolog\xEDa Acuícola, Facultad de Ciencias Biológicasl, Facultad de Ciencias Biológicas, Universidad Andrés Bello Viña del Mar, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Levican
authors.affiliation: Unitat de Microbiologia, Departament de Cièancies Mediques Básiques, Facultad de Medicina i Ciencias de la Salud, IISPV, Universidad Rovira i Virgili Sant Lorenzo 21, 43201, Reus, Spain ; Servei de Microbiologia, Hospital Universitari Sant Joan de Reus Reus, Spain, Tarragona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Pujol
authors.affiliation: Unitat de Microbiologia, Departament de Cièancies Mediques Básiques, Facultad de Medicina i Ciencias de la Salud, IISPV, Universidad Rovira i Virgili Sant Lorenzo 21, 43201, Reus, Spain ; Servei de Microbiologia, Hospital Universitari Sant Joan de Reus Reus, Spain, Tarragona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Ballester
authors.affiliation: ABS de La Selva del Camp Tarragona, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rabada Quilez
authors.affiliation: Servei de Microbiologia, Hospital Universitari Joan XXII Tarragona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Gomez-Bertomeu
keywords: Arcobacter; emerging or re-emerging diseases; gastrointestinal disease; persistent diarrhoea