Clinical Outcomes of Campylobacter Bacteremia: A Systematic Review with Meta-Analysis
Verena Zerbato, Stefano Guicciardi, Roberto Baldan, Chiara Fanelli, Lisa Fusaro, Alexandru Botan, Nicola Benvenuto, Giovanna Maria Nicolò, Luigi Principe, Dan Alexandru Toc, Mauro Giuffrè, Lory Saveria Crocé, Luca Frulloni, Abbas Yadegar, Stefano Di Bella, Alberto Enrico MaraoloPurpose: Campylobacter spp. are a common cause of acute enteric infections. In immunocompromised or elderly patients, they can lead to extraintestinal infections, including bacteremia. The clinical significance of Campylobacter bacteremia is not fully understood. Methods: We conducted a systematic review and meta-analysis on Campylobacter spp. bacteremia, including studies published up to June 2024. Results: Twenty-five retrospective observational studies, published between 1978 and 2024, were included. The studies involved a total of 2480 patients, with a mean age range across studies from 1 to 70 years; 62.45% were male. The pooled prevalence of Campylobacter species was: C. jejuni 60% [95% CI 0.45–0.73], C. coli 8% [95% CI 0.04–0.13], C. fetus 7% [95% CI 0.03–0.15], and other species 9% [95% CI 0.04–0.16]. Mortality was the primary outcome in 22 studies, with a pooled case-fatality risk of 5% [95% CI 0.03–0.09]. Univariate meta-regression showed higher mortality associated with C. fetus (β = 3.217, [95% CI 0.632–5.802], p = 0.017), immunocompromised status (β = 2.749, [95% CI 0.316–5.184], p = 0.029), and chronic liver disease (β = 5.072, [95% CI 0.424–9.720], p = 0.034). Regarding complications, secondary localizations (e.g., endovascular infections) showed a pooled prevalence of 9% [95% CI: 0.04–0.18]; relapses, 3% [95% CI 0.02–0.04]; endocarditis, 2% [95% CI 0.01–0.03]; and persistent bacteremia, 1% [95% CI 0.001–0.27]. Conclusion: Campylobacter spp. bacteremia shows a considerable risk of mortality and complications.