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Background: Campylobacter jejuni is among the most frequent causes of bacterial gastroenteritis in Europe. Over 8,000 C. jejuni multilocus sequence typing sequence types (STs) have been described; ST-21 and ST-45 have been identified as the most frequent types in all human studies so far. In contrast to other STs, ST-22 has been associated with the Guillain-Barre syndrome and ST-677 was recently linked to severe systemic infections in Finland. We investigated risk factors associated with hospitalisation in individuals with C. jejuni infections acquired in Sweden.
Methods: A total of 1,075 individuals with domestically acquired C. jejuni infection diagnosed between November 2011 and October 2012 in Sweden were included in this retrospective cohort study. Typing data for the isolates as well as clinical data including hospitalisation dates and diagnosis codes for individuals with C. jejuni infection were obtained. Factors associated with hospitalisation and length of hospitalisation were investigated by multivariable analysis.
Results: A total of 289 individuals were hospitalised due to C. jejuni infection (26.8%); those with co-morbidities were over 14 times more likely to become hospitalised than those without (odds ratio [OR]: 14.39, 95% confidence interval [CI]: 6.84-30.26). Those with underlying co-morbidities were also hospitalised longer than those without (4.22 days vs. 2.86 days), although this was not statistically significant. C. jejuni ST257 (OR: 2.38; CI: 1.08-5.23), but not ST-22 or ST-677, was significantly associated with hospitalisation.
Conclusion: ST-677 was not associated with increased hospitalisation or a longer hospital stay in our study whilst ST-257 was. However, individuals with C. jejuni infections were generally more frequently hospitalised than previously demonstrated; this requires further consideration including possible targeted interventions.
Keywords: gastrointestinal pathogens; epidemiology; sequence type; Campylobacter
Campylobacter is the most common zoonotic bacterial cause of gastroenteritis in Europe with over 200,000 laboratory-confirmed cases occurring yearly (1). Although the prognosis of Campylobacter gastroenteritis is typically good, infections have been linked to systemic invasive disease and post-infectious complications such as reactive arthritis and GuillainBarre syndrome (GBS) (2,3). Data on campylobacteremia are rare, but it is known to occur mostly in the elderly and immunocompromised individuals (4, 5). In Sweden, more than 90% of the human Campylobacter gastroenteritis cases are due to C. jejuni (6).
Genotyping has shown C. jejuni to be genetically diverse (7). Multilocus sequence typing (MLST)...