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Recrudescent Campylobacter jejuni infection in an immunocompetent adult following experimental infection with a well-characterized organism.

ABSTRACT: The recrudescence of infection with Campylobacter jejuni after appropriate antibiotic treatment has not been previously reported in an immunocompetent adult. We present the complete clinical, microbiologic, and immunologic evaluation of a closely monitored healthy male with recrudescent C. jejuni infection occurring in the absence of immunodeficiency following experimental infection with a well-characterized strain. After antibiotic treatment, the initial infection was clinically cleared and microbiologically undetectable. Subsequently, two episodes of recrudescence occurred, with no change in in vitro antibiotic sensitivity being detected. The immune responses of the individual were compared to those of other participants in the experimental infection study: innate immune responses, including fecal cytokines and C-reactive protein, were intact; however, measures of Campylobacter-specific adaptive immune responses were absent, including serum antibodies, antibody-secreting cells, and in vitro gamma interferon responses. No primary or secondary immunodeficiency was identified. Recrudescent Campylobacter infections after treatment may be more common than has previously been appreciated. This work adds to our understanding of the human immune response to natural Campylobacter infection and reiterates the importance of pathogen-specific adaptive immune responses to this globally important pathogen.

SUBMITTER: Baqar S

PROVIDER: S-EPMC2812103 | biostudies-literature | 2010 Jan

REPOSITORIES: biostudies-literature

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Recrudescent Campylobacter jejuni infection in an immunocompetent adult following experimental infection with a well-characterized organism.

Baqar Shahida S Tribble David R DR Carmolli Marya M Sadigh Katrin K Poly Frederic F Porter Chad C Larsson Catherine J CJ Pierce Kristen K KK Guerry Patricia P Darsley Michael M Kirkpatrick Beth B

Clinical and vaccine immunology : CVI 20091118 1

The recrudescence of infection with Campylobacter jejuni after appropriate antibiotic treatment has not been previously reported in an immunocompetent adult. We present the complete clinical, microbiologic, and immunologic evaluation of a closely monitored healthy male with recrudescent C. jejuni infection occurring in the absence of immunodeficiency following experimental infection with a well-characterized strain. After antibiotic treatment, the initial infection was clinically cleared and mic ...[more]

PMID: 19923572

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Project description:Campylobacter jejuni infections are a leading cause of bacterial food-borne diarrhoeal illness worldwide, and Campylobacter infections in children are associated with stunted growth and therefore long-term deficits into adulthood. Despite this global impact on health and human capital, how zoonotic C. jejuni responds to the human host remains unclear. Unlike other intestinal pathogens, C. jejuni does not harbour pathogen-defining toxins that explicitly contribute to disease in humans. This makes understanding Campylobacter pathogenesis challenging and supports a broad examination of bacterial factors that contribute to C. jejuni infection. Here, we use a controlled human infection model to characterize C. jejuni transcriptional and genetic adaptations in vivo, along with a non-human primate infection model to validate our approach. We found that variation in 11 genes is associated with either acute or persistent human infections and includes products involved in host cell invasion, bile sensing and flagella modification, plus additional potential therapeutic targets. In particular, a functional version of the cell invasion protein A (cipA) gene product is strongly associated with persistently infecting bacteria and we identified its biochemical role in flagella modification. These data characterize the adaptive C. jejuni response to primate infections and suggest therapy design should consider the intrinsic differences between acute and persistently infecting bacteria. In addition, RNA sequencing revealed conserved responses during natural host commensalism and human infections. Thirty-nine genes were differentially regulated in vivo across hosts, lifestyles and C. jejuni strains. This conserved in vivo response highlights important C. jejuni survival mechanisms such as iron acquisition and evasion of the host mucosal immune response. These advances highlight pathogen adaptability across host species and demonstrate the utility of multidisciplinary collaborations in future clinical trials to study pathogens in vivo.

Project description:Campylobacter jejuni is considered as a chicken commensal. The gut microbiota and the immune status of the host may affect its colonization. Infectious bursal disease virus (IBDV) is an immunosuppressive virus of chickens, which allows secondary pathogens to invade or exacerbates their pathogenesis. To investigate the effect of IBDV-induced immunosuppression on the pathogenesis of C. jejuni, broiler chickens were inoculated with a very virulent (vv) strain of IBDV at 14 days post hatch followed by C. jejuni inoculation at 7 (Experiment A) or 9 (Experiment B) days post virus (IBDV) inoculation.vvIBDV-infection led to a depression in caecal lamina propria B lymphocytes and the anti-C. jejuni-antibody response starting at 14 days post C. jejuni inoculation (pbi). The C. jejuni-colonization pattern was comparable between mono-inoculated groups of both experiments, but it varied for vvIBDV?+?C. jejuni co-inoculated groups. In Experiment A significant higher numbers of colony forming units (CFU) of C. jejuni were detected in the caecum of co-inoculated birds compared to C. jejuni-mono-inoculated birds in the early phase after C. jejuni-inoculation. In Experiment B the clearance phase was affected in the co-inoculated group with significantly higher CFU at 21 days pbi compared to the mono-inoculated group (P?<?0.05). No major differences were seen in numbers local lamina propria T lymphocyte populations between C. jejuni-inoculated groups with or without vvIBDV-infection. Interestingly, both pathogens affected the microbiota composition. The consequences of these microflora changes for the host have to be elucidated further.Our data suggests that the timing between viral and bacterial infection might affect the outcome of C. jejuni colonization differently. Our results confirm previous studies that anti-Campylobacter-antibodies may specifically be important for the clearance phase of the bacteria. Therefore, as vvIBDV is widely distributed in the field, it may have a significant impact on the colonization and shedding rate of C. jejuni in commercial poultry flocks. Subsequently, successful IBDV-control strategies may indirectly also benefit the gut-health of chickens.

Dataset Information

Recrudescent Campylobacter jejuni infection in an immunocompetent adult following experimental infection with a well-characterized organism.

Publications

Recrudescent Campylobacter jejuni infection in an immunocompetent adult following experimental infection with a well-characterized organism.

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