Philip J. Rettig

Campylobacter infections in human beings

BACTERIA belonging to the genus Campylobacter have been associated with a variety of veterinary diseases since McFadyean and Stockman ~ in 1913 and Theobald Smith in I9i8 ~ implicated Vibrio-like organisms in ovine and bovine infectious abortion. These organisms, formerly classified as Vibriofetus, have been extensively studied by those interested in animal diseases but have escaped the notice of investigators of human diseases until recently. In the last 30 years, an increased appreciation of the protean manifestations of human disease due to Campylobacter fetus combined with more sophisticated microbiologic methods have begun to uncover the true importance of this genus in human disease. Systemic campylobacteriosis may present as relapsing fever, endocarditis, meningitis, or septic thrombophlebitis. Studies in the present decade indicate that Campylobacterfetus may be the single most common bacterial cause of acute gastrointestinal infection in children and adults, exceeding Salmonella and Shigella in frequency. The relevant historical, taxonomic, microbiologic, and veterinary aspects of this genus and the spectrum of human disease associated with it are reviewed here.

Antibiotic Therapy of Fulminant E. coli K1 Sepsis in Infant Rabbits

Summary: A model of overwhelming E. coli K1 sepsis and early meningitis was developed in infant rabbits and used to compare clinical and bacteriologic efficacy of ampicillin, moxalactam, cephalothin and chloramphenicol. Intraperitoneal injection of 107 E. coli K1 into 1-or 2-wk-old rabbits produced a rapidly progressive infection which, if left untreated, produced bacteremia in 100% of animals, meningitis in 78%, and mortality in 100%. Therapy was initiated 4 h after ip infection at which time mean bacterial concentration (log10 CFU/ml) ranged from 4.4-4.8 in the blood and from 1.8-2.3 in the cerebral spinal fluid (CSF). Pre-treatment frequency of bacteremia (100%) and meningitis (17-23%) was similar for all experimental groups. Antibiotic concentrations in blood and CSF 2 h after a dose exceeded the E. coli minimum inhibitory concentration with the exception of CSF cephalothin, which was undetectable. Moxalactam, ampicillin, and chloramphenicol significantly reduced the incidence of bacteremia and meningitis relative to cephalothin or saline controls (P < 0.02). Mortality rates among the former three groups were high (64-82%) but significantly less than in saline or cephalothin-treated rabbits (100%). In this neonatal model of fulminant sepsis with early meningitis, moxalactam provided no therapeutic advantage over ampicillin or chloramphenicol.