CHU de Bordeaux, Infectious and Tropical Diseases Department, Bordeaux, France.
INSERM, Bordeaux Population Health Research Center, ISPED, University of Bordeaux, Bordeaux, France.
Clin Infect Dis. 2022 Sep 10;75(4):702-709. doi: 10.1093/cid/ciab983.
Campylobacter spp. bacteremia is a severe infection. A nationwide 5-year retrospective study was conducted to characterize its clinical features and prognostic factors.
The study included patients with Campylobacter spp. bacteremia diagnosed in 37 French hospitals participating in the surveillance network of the National Reference Center for Campylobacters and Helicobacters, from 1 January 2015 to 31 December 2019. The goal was to analyze the effects of a delay of appropriate antibiotic therapy and other risk factors on 30-day mortality rates, antibiotic resistance, patient characteristics, and prognosis according to the Campylobacter species.
Among the 592 patients, Campylobacter jejuni and Campylobacter fetus were the most commonly identified species (in 42.9% and 42.6%, respectively). The patients were elderly (median age 68 years), and most had underlying conditions, mainly immunodepression (43.4%), hematologic cancers (25.9%), solid neoplasms (23%), and diabetes (22.3%). C. jejuni and Campylobacter coli were associated with gastrointestinal signs, and C. fetus was associated with secondary localizations. Among the 80 patients (13.5%) with secondary localizations, 12 had endocarditis, 38 vascular, 24 osteoarticular, and 9 ascitic fluid infections. The 30-day mortality rate was 11.7%, and an appropriate antibiotic treatment was independently associated with 30-day survival (odds ratio, 0.47 [95% confidence interval, .24-.93]; P = .03). The median efficient therapy initiation delay was quite short (2 days [interquartile range, 0-4 days]) but it had no significant impact on the 30-day mortality rate (P = .78).
Campylobacter spp. bacteremia mainly occurred in elderly immunocompromised individuals with variable clinical presentations according to the species involved. Appropriate antimicrobial therapy was associated with improved 30-day survival.
弯曲菌属菌血症是一种严重的感染。本研究进行了一项全国性的 5 年回顾性研究，以描述其临床特征和预后因素。
本研究纳入了 2015 年 1 月 1 日至 2019 年 12 月 31 日期间在法国 37 家参与国家弯曲菌和螺杆菌参考中心监测网络的医院诊断为弯曲菌属菌血症的患者。目的是根据弯曲菌属菌种分析抗生素治疗延迟和其他危险因素对 30 天死亡率、抗生素耐药性、患者特征和预后的影响。
在 592 例患者中，最常见的菌种是空肠弯曲菌（42.9%）和胎儿弯曲菌（42.6%）。患者年龄较大（中位年龄 68 岁），大多数有基础疾病，主要为免疫抑制（43.4%）、血液系统恶性肿瘤（25.9%）、实体瘤（23%）和糖尿病（22.3%）。空肠弯曲菌和大肠弯曲菌与胃肠道症状有关，而胎儿弯曲菌与继发感染部位有关。在 80 例（13.5%）有继发感染部位的患者中，12 例患有心内膜炎，38 例血管感染，24 例骨关节感染，9 例腹水感染。30 天死亡率为 11.7%，适当的抗生素治疗与 30 天生存率独立相关（比值比，0.47[95%置信区间，0.24-0.93]；P=0.03）。有效治疗开始的中位延迟时间较短（2 天[四分位距，0-4 天]），但对 30 天死亡率无显著影响（P=0.78）。
弯曲菌属菌血症主要发生在年龄较大的免疫功能低下的个体中，临床表现因涉及的菌种而异。适当的抗菌治疗与 30 天生存率的提高有关。
