Campylobacteriosis, 2009

Campylobacter continues to be the most commonly reported bacterial enteric pathogen in Minnesota (Figure 2). There were 899 cases of culture-confirmed Campylobacter infection reported in 2009 (17.2 per 100,000 population). This is similar to the 886 cases reported in 2008 and to the median annual number of cases reported from 2001 to 2008 (median, 903 cases; range, 843 to 953). In 2009, 48% of cases occurred in people who resided in the metropolitan area. Of the 871 Campylobacter isolates confirmed and identified to species by MDH, 89% were C. jejuni and, 10% were C. coli.

The median age of cases was 34 years (range, 1 month to 92 years). Forty-six percent of cases were between 20 and 49 years of age, and 14% were 5 years of age or younger. Fifty-eight percent of cases were male. Sixteen percent of cases were hospitalized; the median length of hospitalization was 3 days. Forty-eight percent of infections occurred during June through September. Of the 818 (91%) cases for whom data were available, 159 (19%) reported travel outside of the United States during the week prior to illness onset. The most common travel destinations were Mexico (n=39), Europe (n=25), Central or South America or the Caribbean (n=20), and Asia (n=11).

There was one outbreak of campylobacteriosis identified in Minnesota in 2009. In February, an outbreak of C. jejuni infections was associated with a restaurant in Dakota County. Ten culture-confirmed and one probable patron-case was identified. Lettuce that had most likely been cross-contaminated from raw or undercooked chicken was identified as the source of the outbreak.

A primary feature of public health importance among Campylobacter cases was the continued presence of Campylobacter isolates resistant to fluoroquinolone antibiotics (e.g., ciprofloxacin), which are commonly used to treat campylobacteriosis. In 2009, the overall proportion of quinolone resistance among Campylobacter isolates tested was 23%. However, 70% of Campylobacter isolates from patients with a history of foreign travel during the week prior to illness onset, regardless of destination, were resistant to fluoroquinolones. Twelve percent of Campylobacter isolates from patients who acquired the infection domestically were resistant to fluoroquinolones.

In June 2009, a rapid test became commercially available for the qualitative detection of Campylobacter antigens in stool. Twenty-three patients were positive for Campylobacter by a rapid test conducted in a clinical laboratory in 2009. However, only 3 (13%) of the specimens were subsequently culture-confirmed, thus meeting the surveillance case definition for inclusion in MDH case counts totals.

Image of figure 2.

 

Updated Friday, 19-Nov-2010 15:16:34 CST