The clinical importance of emerging Campylobacter species

Abstract

A growing number of Campylobacter species other than C. jejuni and C. coli have been recognized as emerging human and animal pathogens. Although C. jejuni continues to be the leading cause of bacterial gastroenteritis in humans worldwide, advances in molecular biology and development of innovative culture methodologies have led to the detection and isolation of a range of under-recognized and nutritionally fastidious Campylobacter spp., including C. concisus, C. upsaliensis and C. ureolyticus. These emerging Campylobacter spp. have been associated with a range of gastrointestinal diseases, particularly gastroenteritis, IBD and periodontitis. In some instances, infection of the gastrointestinal tract by these bacteria can progress to life-threatening extragastrointestinal diseases. Studies have shown that several emerging Campylobacter spp. have the ability to attach to and invade human intestinal epithelial cells and macrophages, damage intestinal barrier integrity, secrete toxins and strategically evade host immune responses. Members of the Campylobacter genus naturally colonize a wide range of hosts (including pets, farm animals and wild animals) and are frequently found in contaminated food products, which indicates that these bacteria are at risk of zoonotic transmission to humans. This Review presents the latest information on the role and clinical importance of emerging Campylobacter spp. in gastrointestinal health and disease.

Key Points

  • Members of the Campylobacter genus are ecologically diverse and readily colonize humans and animals

  • C. jejuni and C. coli are established pathogens in human gastroenteritis, but other Campylobacter species (the 'emerging' pathogens) also have a role in gastrointestinal and extragastrointestinal infections in humans

  • The pathogenic mechanisms used by emerging Campylobacter spp. are diverse, and include attachment and invasion, production of toxins that modulate host functions and evasion of host defense systems

  • Emerging Campylobacter spp. pose a substantial risk of zoonotic transmission as these species colonize pets, farm animals and wild animals, and can be found in contaminated food products

  • Ongoing epidemiological surveillance of emerging Campylobacter spp. is key to understanding the distribution and zoonosis of these potentially novel and emerging pathogens

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Figure 1: Colorized scanning electron microscopic images of a number of emerging Campylobacter species.
Figure 2: Proposed mechanisms of pathogenesis used by emerging Campylobacter species to colonize the intestinal tract or to spread to systemic sites.
Figure 3: Current methodological approaches used for the isolation of fastidious Campylobacter species.

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Acknowledgements

I am grateful to my colleagues who provided helpful suggestions for this Review article: R. O. Gilbert (Cornell University, USA), H. M. Mitchell and N. O. Kaakoush (The University of New South Wales, Australia), and P. Tourlomousis and D. Raghunathan (University of Cambridge, UK). I would also like to thank the Cambridge Commonwealth Trust and the Cambridge Australia Trust for their kind support. I apologize to my colleagues whose work was not cited in the Review owing to space limitations.

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Man, S. The clinical importance of emerging Campylobacter species. Nat Rev Gastroenterol Hepatol 8, 669–685 (2011). https://doi.org/10.1038/nrgastro.2011.191

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