Campylobacter continues to be the most commonly reported bacterial enteric pathogen in Minnesota (Figure 3). There were 950 cases of cultureconfirmed Campylobacter infection reported in 2012 (17.8 per 100,000 population). This is a 5% decrease from the 995 cases reported in 2011 but a 5% increase from the median annual number of cases reported from 2002 to 2011 (median, 903 cases; range, 843 to 1,007). In 2012, 48% of cases occurred in people who resided in the metropolitan area. Of the 880 Campylobacter isolates confirmed and identified to species by MDH, 88% were C. jejuni and 10% were C. coli. The median age of cases was 38 years (range, 3 weeks to 96 years). Forty percent of cases were between 20 and 49 years of age, and 11% were 5 years of age or younger. Fifty-seven percent of cases were male. Eighteen percent of cases were hospitalized; the median length of hospitalization was 3 days. Forty-nine percent of infections occurred during June through September. Of the 887 (93%) cases for whom data were available, 148 (17%) reported travel outside of the United States during the week prior to illness onset. The most common travel destinations were Asia (n=41), Europe (n=38), Mexico (n=27), and Central or South America or the Caribbean (n=23). There were four outbreaks of campylobacteriosis identified in Minnesota in 2012. In May, an outbreak of C. jejuni infections was associated with raw milk served to elementary school students following a visit to a Wisconsin farm; 2 cultureconfirmed cases were identified. In July, an outbreak of C. jejuni and C. coli infections was associated with a private gathering in Hennepin County; 3 culture-confirmed cases were identified. In August, an outbreak of quinolone-resistant C. jejuni infections was associated with animal contact at a private farm in Olmsted County; 2 culture-confirmed cases were identified. In September, an outbreak of C. jejuni infections was associated with a restaurant in Dakota County; 2 cultureconfirmed 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 2012, the overall proportion of quinolone resistance among Campylobacter isolates tested was 25%. However, 74% 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. Fifteen percent of Campylobacter isolates from patients who acquired the infection domestically were resistant to fluoroquinolones. In June 2009, a culture-independent test became commercially available for the qualitative detection of Campylobacter antigens in stool. Three hundred seventy patients tested positive for Campylobacter by this test conducted in a clinical laboratory in 2012. However, only 128 (35%) of the specimens were subsequently culture-confirmed and therefore met the surveillance case definition for inclusion in MDH case count totals. Thus, this culture-independent test may give false positive findings.
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