Campylobacter continues to be the most commonly reported bacterial enteric pathogen in Minnesota (Figure 2). There were 995 cases of cultureconfi rmed Campylobacter infection reported in 2011 (18.8 per 100,000 population). This is similar to the 1,007 cases reported in 2010 but a 10% increase from the median annual number of cases reported from 2001 to 2010 (median, 903 cases; range, 843 to 1,007). In 2011, 47% of cases occurred in people who resided in the metropolitan area. Of the 915 Campylobacter isolates confi rmed and identified to species by MDH, 87% were C. jejuni and 11% were C. coli.
The median age of cases was 35 years (range, 3 weeks to 98 years). Forty-two percent of cases were between 20 and 49 years of age, and 13% were 5 years of age or younger. Fifty-four percent of cases were male. Seventeen percent of cases were hospitalized; the median length of hospitalization was 4 days. Fifty-two percent of infections occurred during June through September. Of the 931 (94%) cases for whom data were available, 158 (17%) reported travel outside of the United States during the week prior to illness onset. The most common travel destinations were Europe (n=42), Central or South America or the Caribbean (n=41), Asia (n=31), and Mexico (n=21).
There were three outbreaks of campylobacteriosis identified in Minnesota in 2011. In late Juneearly July, an outbreak of C. jejuni infections was associated with raw milk consumption from a farm in Benton County; 2 culture-confi rmed cases were identified. In July, an outbreak of quinolone-resistant C. coli infections was associated with raw milk consumption from a farm in Todd County ; 3 culture-confi rmed cases were identified. In July, an outbreak of C. jejuni infections was associated with masonry workers at a dairy farm; 2 culture-confi rmed cases were identified.
A primary feature of public health importance among Campylobacter cases was the continued presence of Campylobacter isolates resistant to fl uoroquinolone antibiotics (e.g., ciprofl oxacin), which are commonly used to treat campylobacteriosis. In 2011, the overall proportion of quinolone resistance among Campylobacter isolates tested was 27%. However, 80% of Campylobacter isolates from patients with a history of foreign travel during the week prior to illness onset, regardless of destination, were resistant to fl uoroquinolones. Sixteen 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. Three hundred seventy-seven patients were positive for Campylobacter by a non-culture based test conducted in a clinical laboratory in 2011. However, only 137 (36%) of the specimens were subsequently culture-confi rmed and therefore met the surveillance case defi nition for inclusion in MDH case count totals.
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