Increasing Campylobacter infections, outbreaks, and antimicrobial resistance in the United States, 2004-2012

My take on the article

TL;DR: This study provides the first comprehensive update to the scientific understanding of campyloacteriosis in the US since 1987. Campylobacteriosis is a foodborne illness that causes typical gastrointestinal symptoms and is likely as prevalent as salmonellosis in the US; however, is much less studied. We analyzed all reported cases and outbreaks of campylobacteriosis in the US from 2004 - 2012. We also assesses the antibiotic resistance of Campylobacter isolates during the same timeframe. The incidence of camylobacteriosis, number of Campylobacter outbreaks, and ciprofloxacin resistance all increased during the study period. We also noted wide heterogeneity in the incidence of disease by state, race, age, and other factors. Because of the high prevalence of campylobactersiosis in the US, much greater attention is needed to research and control this disease.

Motivation: Campylobacteriosis is a foodborne illness that is surpringly understudied given its high prevalence. The last comprehensive paper on the topic was published in 1987, and it only covered a few states. Here, we set out to describe the epidemiology of the disease, its outbreaks, and the extent of resistance to several classes of drugs.

Methods: Multiple national disease surveillance and antibiotic resistance databased were synthesized for this project. State departments of public health supplied additional data whenever the federal databases were incomplete.

Results: The average annual incidence rate was 11.4 cases / 100,000 persons. We found substantial variation by state and age, with states in the West and children aged 0-4 having the highest incidence rates. Men had higher incidence rates than women across all age groups. Over the study period, annual incidence rates increased, with the increased being concentrated in Southern states and among adults over 60 years of age. Similarly, the number of (primarily foodborne and waterborne) outbreaks increased during 2004 - 2012. Finally, we found a higher proportion of ciprofloxacin-resistant isolates among domestic infections in later years.

Interpretation: The increasing rates of disease, outbreaks, and antibiotic resistance related to Campylobacter infections point to an urgent need for additional research into this very common infection. The hetergeneities we document suggest that different strategies for infection control may be needed for different states and population subgroups.

Article availability: The freely available article can be found here. If you have trouble accessing the article or wish to ask a question about it, please contact me.