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CAMPYLOBACTER JEJUNI

PATHOGEN SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Campylobacter jejuni

SYNONYM OR CROSS REFERENCE: Campylobacter jejuni subsp. jejuni, C. jejuni subsp. doylei Footnote 1. Formerly known as Campylobacter fetus subsp. jejuni Footnote 2. Disease known as Campylobacteriosis or Campylobacter enteritis.

CHARACTERISTICS: Campylobacter jejuni is a microaerobic, non-spore forming, gram-negative bacteria of the Campylobacteraceae family. They form motile, spiral shaped rods that are 0.2-0.9 μm wide and 0.5-5 μm long, and moves by a corkscrew-like motion Footnote 3. One unsheathed polar flagella is present at the end (or both ends) of the cell, which gives the bacterium a slender “S” shape, and this spiral appearance is its most distinguishable feature. C. jejuni grows slowly in culture and have an optimum growing temperature of 42°C Footnote 4. Old cultures or ones exposed to air for extended periods tend to become spherical or coccoid Footnote 1.

SECTION II - HAZARD IDENTIFICATION

PATHOGENICITY: Campylobacter jejuni cause gastroenteritis, with the most common symptom being diarrhea (sometimes bloody) that lasts 2-10 days, as well as mild to severe abdominal pain, fever, malaise, nausea and vomiting Footnote 5. Symptoms last for about a week but relapses occur in 5-10% of untreated cases Footnote 1, Footnote 4. Although a large number of campylobacter infections are asymptomatic and mild Footnote 4, many complications have been reported in young children and immunocompromised patients, including bacteremia, hepatitis, cholecystitis, pancreatitis, abortion, myocarditis and meningitis Footnote 1. C. jejuni has been associated with post-infection sequelae, most commonly Guillain-Barré syndrome and reactive arthritis Footnote 1, Footnote 4. All strains of C. jejuni possess a gene coding for cytolethal distending toxin, however not all strains produce it. The role of these toxins in disease is not known Footnote 6. Motility is required for full virulence, and some effectors associated with virulence are secreted through the flagellum.

EPIDEMIOLOGY: Infections occur worldwide, and are common in both developed and developing countries Footnote 1, Footnote 4. In developed countries, Campylobacter is the leading cause of bacteria gastroenteritis with the majority of these cases cause by C. jejuni ­ Footnote 7. Infections show seasonal trends, with most cases occurring in late summer/early fall in developed countries, although the reason for this pattern is not fully understood Footnote 8. Infection is primarily associated with handling and consumption of raw meat. The prevalence of campylobacter on chicken carcasses is very high and cross contamination can easily occur during food preparation. The majority of cases are sporadic with outbreaks accounting for only a small number of cases Footnote 1, Footnote 4, Footnote 9. However, there have been outbreaks caused by the distribution of water or milk, which have infected 3000 people at a time Footnote 6. In developing countries, infections are endemic with the majority of symptomatic cases occurring in young children. Asymptomatic cases in adults and children are common Footnote 4, Footnote 9.

HOST RANGE: C. jejuni subsp. jejuni: humans, cattle, wild birds, poultry, pigs, sheep, dogs, cats, water, mink, rabbits, and insects Footnote 1, Footnote 9. C. jejuni subsp doylei can be found in humans Footnote 1, Footnote 9.

INFECTIOUS DOSE: 500 organisms by ingestion Footnote 6, Footnote 10. One volunteer study found that 9000 bacteria were required to infect 50 percent of subjects Footnote 6.

MODE OF TRANSMISSION: Oral ingestion of bacteria from faecally contaminated food (primarily chicken) or drinking water is the main mode of transmission Footnote 4, Footnote 11. Contact with animals and their feces is also a source of infection Footnote 11.

INCUBATION PERIOD: 1 to 10 days Footnote 9.

COMMUNICABILITY: Low, person-to-person transmission is unusual Footnote 4.

SECTION III - DISSEMINATION

RESERVOIR: C. jejuni subsp. jejuni: humans, cattle, wild birds, poultry, pigs, sheep, dogs, cats, water, mink, rabbits, and insects Footnote 1, Footnote 9. C. jejuni subsp doylei can be found in humans Footnote 1, Footnote 9.

ZOONOSIS: Yes – Transmitted from a variety of animals (birds and mammals) Footnote 11.

VECTORS: Flies have been suggested as a possible vector Footnote 12.

SECTION IV - STABILITY AND VIABILITY

DRUG SUSCEPTIBILITY/RESISTANCE: Susceptible to macrolides, fluoroquinolones, aminoglycosides, chloramphenicol, nitrofurantoin, gentamicin, and tetracycline Footnote 1, Footnote 5.

DRUG RESISTANCE: Antibiotic resistance strains are emerging particularly to fluoroquinolones, macrolides, trimethoprim, beta lactam antibiotics, including penicillin and most cephalosporins, as well as to tetracycline, quinolone and kanamycin Footnote 6, Footnote 13, Footnote 14.

SUSCEPTIBILITY TO DISINFECTANTS: C. jejuni is susceptible to 10 mg/L iodophor, 1:50 000 quaternary ammonium compound, 0.15% phenolic compound, 70% ethyl alcohol or 0.125% glutaraldehyde all with a contact time of 1 minute or 5mg/L of hypochlorite with a contact time of 5 minutes Footnote 15.

PHYSICAL INACTIVATION: Inactivated by heat (70°C for 1 min) Footnote 16, hydrostatic pressure (450 MPa at 15°C for 30 s) Footnote 16 and gamma irradiation Footnote 17.

SURVIVAL OUTSIDE HOST: Campylobacter cells can enter a viable but nonculturable state (VBNC) when subject to stress. This is thought to improve their survival in the environment, as it has been observed to survive freezing for several months in frozen poultry, minced meat, and other cold food products Footnote 5, Footnote 18. Campylobacter can survive for many weeks in water at 4°C, but only a few days in water above 15°C Footnote 19.

SECTION V – FIRST AID / MEDICAL

SURVEILLANCE: Campylobacter infection can be confirmed by culturing and identification of bacteria from stool Footnote 20. Recent Campylobacter infections can be identified using serologic tests Footnote 20.

Note: All diagnostic methods are not necessarily available in all countries.

FIRST AID/TREATMENT: Treatment is primarily supportive as most infections are self-limiting Footnote 1, Footnote 21. However, antibiotic therapy may be required in more serious cases particularly in young, elderly or immunocompromised patients Footnote 22. Erythromycin is the drug of choice for treating Campylobacter gastroenteritis Footnote 20.

IMMUNIZATION: None.

PROPHYLAXIS: No drugs are available. Reducing faecal contamination of the carcass after slaughter can control the spread of the bacteria Footnote 5.

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: Yes, several cases have been reported for Campylobacter spp. Footnote 23.

SOURCES/SPECIMENS: Fecal samples, blood and specimens from animals Footnote 1.

PRIMARY HAZARDS: Ingestion or parenteral inoculation of bacteria Footnote 23, Footnote 24.

SPECIAL HAZARDS: May have adverse effects on the fetus if contracted during pregnancy Footnote 25.

SECTION VII – EXPOSURE CONTROLS / PERSONAL PROTECTION

RISK GROUP CLASSIFICATION: Risk Group 2 Footnote 26.

CONTAINMENT REQUIREMENTS: Containment Level 2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures.

PROTECTIVE CLOTHING: Lab coat. Gloves when direct skin contact with infected materials or animals is unavoidable. Eye protection must be used where there is a known or potential risk of exposure to splashes Footnote 27.

OTHER PRECAUTIONS: All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities Footnote 27.

SECTION VIII – HANDLING AND STORAGE

SPILLS: Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, starting at the perimeter and working towards the centre. Allow sufficient contact time before clean up Footnote 27.

DISPOSAL: Decontaminate all wastes that contain or have come in contact with the infectious organism by autoclave, chemical disinfection, gamma irradiation, or incineration before disposing Footnote 27.

STORAGE: The infectious agent should be stored in leak-proof containers that are appropriately labeled Footnote 27.

SECTION IX - REGULATORY AND OTHER INFORMATION

UPDATED: December 2011

PREPARED BY: Pathogen Regulation Directorate, Public Health Agency of Canada.

Although the information, opinions and recommendations contained in this Pathogen Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright ©
Public Health Agency of Canada, 2011
Canada

REFERENCES:

Footnote 1
Fitzgerald, C., & Nachamkin, I. (2007). Campylobacter and Arcobacter. In P. R. Murray (Ed.), Manual of Clinical Microbiology (9th ed., pp. 933-946). Washington D.C.: ASM Press.

Footnote 2
Griffiths, P. L., & Park, R. W. A. (1990). Campylobacters associated with human diarrhoeal disease. Journal of Applied Bacteriology, 69(3), 281-301.

Footnote 3
Borriello, S. P., Murray, P. R., & Funke, G. (2005). Enterococci. In S. P. Borriello, P. R. Murray & G. Funke (Eds.), Topley & Wilson's Microbiology & Microbial Infections (10th ed., pp. 883-902). Washington, DC, USA: Edward Arnold (Publishers) Ltd.

Footnote 4
Allos, B. M. (2001). Campylobacter jejuni infections: Update on emerging issues and trends. Clinical Infectious Diseases, 32(8), 1201-1206.

Footnote 5
Shakespeare, M. (2002). Zoonoses Pharmaceutical Press.

Footnote 6
Allos, B. M.Microbiology, pathogenesis, and epidemiology of Campylobacter infection. www.uptodate.com

Footnote 7
Galanis, E. (2007). Campylobacter and bacterial gastroenteritis. Canadian Medical Association Journal, 177(6), 570-571.

Footnote 8
Allos, B. M., & Blaser, M. J. (Eds.). (2009). Mandell, Douglas, and Bennett's Principles and Practices of Infectious Diseases. (7th ed.). USA: (c) Churchill Livingston, New York.

Footnote 9
Humphrey, T., O'Brien, S., & Madsen, M. (2007). Campylobacters as zoonotic pathogens: A food production perspective. International Journal of Food Microbiology, 117(3), 237-257.

Footnote 10
Robinson, D. A. (1981). Infective dose of Campylobacter jejuni in milk. British Medical Journal, 282(6276), 1584.

Footnote 11
Krauss, H., Schiefer, H. G., Weber, A., Slenczka, W., Appel, M., von Graevenitz, A., Enders, B., Zahner, H., & Isenberg, H. D. (2003). Bacterial Zoonoses. In H. Krauss, H. G. Schiefer, A. Weber, W. Slenczka, M. Appel, A. von Graevenitz, B. Enders, H. Zahner & H. D. Isenberg (Eds.), Zoonoses: Infectious Diseases Transmissible from Animals to Humans (Third ed., pp. 216-217). Washington, D.C.: ASM Press.

Footnote 12
Ekdahl, K., Normann, B., & Andersson, Y. (2005). Could flies explain the elusive epidemiology of campylobacteriosis? BMC Infectious Diseases, 5

Footnote 13
Alfredson, D. A., & Korolik, V. (2007). Antibiotic resistance and resistance mechanisms in Campylobacter jejuni and Campylobacter coli. FEMS Microbiology Letters, 277(2), 123-132.

Footnote 14
Gibreel, A., Tracz, D. M., Nonaka, L., Ngo, T. M., Connell, S. R., & Taylor, D. E. (2004). Incidence of antibiotic resistance in Campylobacter jejuni isolated in Alberta, Canada, from 1999 to 2002, with special reference to tet(O)-mediated tetracycline resistance. Antimicrobial Agents and Chemotherapy, 48(9), 3442-3450. doi:10.1128/AAC.48.9.3442-3450.2004

Footnote 15
Wang, W. L. L., Powers, B. W., Luechtefeld, N. W., & Blaser, M. J. (1983). Effects of disinfectants on Campylobacter jejuni. Applied and Environmental Microbiology, 45(4), 1202-1205.

Footnote 16
Lori, S., Buckow, R., Knorr, D., Heinz, V., & Lehmacher, A. (2007). Predictive model for inactivation of Campylobacter spp. by heat and high hydrostatic pressure. Journal of Food Protection, 70(9), 2023-2029.

Footnote 17
Radomyski, T., Murano, E. A., Olson, D. G., & Murano, P. S. (1994). Elimination of pathogens of significance in food by low-dose irradiation: A review. Journal of Food Protection, 57(1), 73-86.

Footnote 18
Murphy, C., Carroll, C., & Jordan, K. N. (2006). Environmental survival mechanisms of the foodborne pathogen Campylobacter jejuni. Journal of Applied Microbiology, 100(4), 623-632.

Footnote 19
Nachamkin, I., & Skirrow, M. B. (1998). Campylobacter, Arcobacter and Helicobacter. In A. Balows, & B. I. Duerden (Eds.), Topley & Wilson's Microbiology and Microbial Infections: Systematic Bacteriology (9th ed., pp. 1241). London: Arnold.

Footnote 20
Allos, B. M. (2011). Clinical manifestations, diagnosis and treatment of Campylobacter infection. www.uptodate.com

Footnote 21
Altekruse, S. F., Stern, N. J., Fields, P. I., & Swerdlow, D. L. (1999). Campylobacter jejuni - An emerging foodborne pathogen. Emerging Infectious Diseases, 5(1), 28-35.

Footnote 22
Luangtongkum, T., Jeon, B., Han, J., Plummer, P., Logue, C. M., & Zhang, Q. (2009). Antibiotic resistance in Campylobacter: Emergence, transmission and persistence. Future Microbiology, 4(2), 189-200.

Footnote 23
Collins, C. H., & Kennedy, D. A. (1999). Laboratory-acquired infections. Laboratory-acquired Infections: History, incidence, causes and prevention. (4th ed., pp. 12). Oxford, UK: Butterworth Heinemann.

Footnote 24
US Department of Health and Human Services. (1999). Biosafety in Microbiological and Biomedical Laboratories. In J. Y. Richmond, & R. W. McKinney (Eds.), (4th ed., pp. 118). Washington, D.C.: U.S. Government Printing Office.

Footnote 25
Collins, C. H., & Kennedy, D. A. (1999). Risk assessment. Laboratory-acquired Infections: History, incidences, causes and preventions (4th ed., pp. 225-239). Oxford , UK.: Butterworth Heninemann.

Footnote 26
Human Pathogens and Toxins Act. S.C. 2009, c. 24. Government of Canada, Second Session, Fortieth Parliament, 57-58 Elizabeth II, 2009, (2009).

Footnote 27
Public Health Agency of Canada. (2004). In Best M., Graham M. L., Leitner R., Ouellette M. and Ugwu K. (Eds.), Laboratory Biosafety Guidelines (3rd ed.). Canada: Public Health Agency of Canada.