Campylobacter continues to be the most commonly reported bacterial enteric pathogen in Minnesota (Figure 2). There were 1,007 cases of culture-confirmed Campylobacter infection reported in 2010 (19.1 per 100,000 population). This represents a 12% increase from the 899 cases reported in 2009 and the median annual number of cases reported from 2001 to 2009 (median, 899 cases; range, 843 to 953). In 2010, 44% of cases occurred in people who resided in the metropolitan area. Of the 911 Campylobacter isolates sent, confirmed, and identified to species by MDH, 90% were C. jejuni and 9% were C. coli.
The median age of cases was 33 years (range, 3 months to 92 years). Thirty-nine percent of cases were between 20 and 49 years of age, and 12% were 5 years of age or younger. Fifty-nine percent of cases were male. Fifteen percent of cases were hospitalized; the median length of hospitalization was 3 days. Fifty percent of infections occurred during June through September. Of the 902 (90%) cases for whom data were available, 163 (18%) reported travel outside of the United States during the week prior to illness onset. The most common travel destinations were Mexico (n=36), Central or South America or the Caribbean (n=36), Europe (n=29), and Asia (n=16).
There were three outbreaks of campylobacteriosis identified in Minnesota in 2010, all during August. One outbreak of C. jejuni infection was associated with an office party in Dakota County. Two culture-confirmed and one probable case were identified. An item containing undercooked chicken or ready-to-eat foods cross-contaminated from undercooked chicken was identified as the most plausible source of the outbreak. A second outbreak of quinolone-resistant C. jejuni infections was associated with employees at a chicken processing plant in Pope County. Two culture-confirmed cases were identified. The third outbreak of C. jejuni infections was associated with raw milk consumption from a farm in Sibley County. Three culture-confirmed cases were identified.
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 2010, the overall proportion of quinolone resistance among Campylobacter isolates tested was 21%. However, 68% 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. Ten percent of Campylobacter isolates from patients who acquired the infection domestically were resistant to fluoroquinolones.
In June 2009, a non-culture based test became commercially available for the qualitative detection of Campylobacter antigens in stool. Two hundred eighty patients were positive for Campylobacter by a non-culture based test conducted in a clinical laboratory in 2010. However, only 114 (41%) of the specimens were subsequently culture-confirmed, thus meeting the surveillance case definition for inclusion in case totals.
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