Campylobacteriosis, 2006

Campylobacter continues to be the most commonly reported bacterial enteric pathogen in Minnesota. There were 899 cases of culture-confirmed Campylobacter infection reported in 2006 (17.4 per 100,000). This represents a 6.6% increase from the 843 cases reported in 2005, reversing a trend in which the number of Campylobacter cases had declined each year since 2000 (Figure 2). The median annual number of cases reported from 2001 to 2005 was 937 (range, 843 to 953). In 2006, 51% of cases occurred in people who resided outside the metropolitan area. Of the 853 Campylobacter isolates confirmed and identified to species by MDH, 91% were C. jejuni and 8% were C. coli.

The median age of case-patients was 33 years (range, 1 month to 93 years). Forty-five percent of cases were between 20 and 49 years of age, and 14% were 5 years of age or younger. Fifty-six percent of cases were male. Thirteen percent of case-patients were hospitalized; the median length of hospitalization was 2 days. Forty-five percent of infections occurred during June through September. Of the 791 (88%) case-patients for whom data were available, 151 (19%) reported travel outside of the United States during the week prior to illness onset. The most common travel destinations were Mexico (n=44), Asia (n=31), Central or South America or the Caribbean (n=34), and Europe (n=23). There were no outbreaks of campylobacteriosis in Minnesota identified in 2006; however, two cases were part of an outbreak in Wisconsin associated with unpasteurized cheese curds.

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 2006, the overall proportion of quinolone resistance among Campylobacter isolates tested was 18% (a slight decline from 2005). However, 60% of C. jejuni isolates from patients with a history of foreign travel during the week prior to illness onset, regardless of destination, were resistant to fluoroquinolones. This was also a slight decrease from 2005.

Domestically-acquired quinolone-resistant C. jejuni infections have increased in recent years. This increase likely is due largely to the use of fluoroquinolones in poultry (the primary source of Campylobacter for humans) in the United States, which began late in 1995. In 2006, as in 2005, 9% of C. jejuni isolates from patients who acquired the infection domestically were resistant to fluoroquinolones. Because of the public health risk associated with the use of fluoroquinolones in poultry, the U. S. Food and Drug Administration (FDA) withdrew the approval of enrofloxacin (a veterinary fluoroquinolone) for use in poultry in September 2005.

• For up to date information see>> Campylobacteriosis (Campylobacter)
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2006