장외감염을 일으킨 Campylobacter 균종과 환자의 임상상태

Abstract

Background : Extraintestinal infections due to Campylobacter species are rare and the culture of the organism is difficult because of its fastidious nature. This study assesses the clinical and bacteriological characteristics of Campylobacter extraintestinal infection. Methods : Patient's blood were cultured using Brewer thioglycollate medium (BTM) and tryptic soy broth(TSB) for 10 days. The joint fluid samples were cultured using blood agar, chocolate agar, and BTM for 48 hours. Presumptive identification of Campylobacter sp. was based on positive oxidase reaction and the typical cellular morphology. The biochemical characteristics and susceptibility to cephalothin and nalidixic acid were evaluated to differentiate species. Results : During the period of 1986~1993, Campylobacter sp. was isolated from 30 patients with extraintestinal infections at the Severance Hospital in Seoul, Korea. The diagnosis were: 28 cases of bacteremia, 27 with C. fetus subsp. fetus and one with C. jejuni subsp. jejuni; one case of septic arthritis of both hip joint with C. fetus subsp. fetus; and one case of bacteremia together with septic arthritis of elbow joint. The majority of the patients were ages of over 30 years. Twenty-one were males and 9 females. Most of the patients had one or more predisposing factors. Among the 25 patients, 18 improved with antimicrobial therapy. Among the 54 Campylobacter-positive blood specimens, 18 were positive both in TSB and BTM, 35 in TSB alone, and one in BTM alone. Conclusion : We concluded that Campylobacter can cause serious extraintestinal infections such as bacteremia as well as septic arthritis in patients with underlying disease. The majority of the infections is caused by C. fetus subsp. fetus, but occasionally by C. jejuni subsp. jejuni.