Campylobacter species associated with diarrhoea in patients from a tertiary care centre of north India

Background & objectives: Most laboratories do not routinely distinguish the various Campylobacter species, though almost all Campylobacter species have been isolated from human faeces. The epidemiological and clinical aspects of its infection and the species involved in genesis of diarrhoea are least understood in the developing countries. The aim of the present study was to find out frequency of Campylobacter species isolated from patients with diarrhoea over a 12-year period and to analyse their features. Methods: Campylobacter strains isolated from stool samples of patients with diarrhoea were identified to the species level on appropriate media at 42 degreesC micro-aerobically. Patients' demography and clinical data were analyzed retrospectively; 25 Campylobacter jejuni strains were tested for toxin production and 23 strains were typed by Penner scheme. Results: A total of 62 strains were isolated from 59 patients and the various species were C jejuni 51 (82.3%), C. coli 8 (12.9%), C. lari 2 (3.2%), and C. upsaliensis 1 (1.6%). Children < 5 yr of age were most affected (34159; 57.6%), followed by patients in 15-30 yr of age (12/59; 20.3%). Presentation of watery diarrhoea was significantly more common than inflammatory diarrhoea (50/59, 84.7% vs 9/59, 15.3%; P < 0.001). Recurrence occurred in 3 (5.1%) patients. Majority of the infections resolved within one week; one HIV-positive patient had chronic diarrhoea. Two patients developed Guillain-Barre syndrome following Campylobacter infection. Twenty (80%) of 25 strains were toxigenic and 20 (87%) of 23 strains could be typed by Penner scheme. Interpretation & conclusion: In our patients, 4different Campylobacter species and various C. jejuni serotypes were involved in gastroenteritis, Majority of the infections were watery diarrhoea and iii children < 5 yr of age. There is a need of a population-based systematic study to know the epidemiology of whole spectrum of campylobacters in India.