Campylobacter spp. bloodstream infections in immunocompetent vs. immunocompromised patients: A Multinational Cohort Study (2009-2024)
María Paniagua-García, José Manuel Bernal-Aznar, Effrossyni Gkrania-Klotsas, Isobel Soper, María Lluisa Pedro-Botet Montoya, Esteban A Reynaga, Adoración Valiente, María Carmen Domínguez-Jiménez, Andrea Lombardi, María Navarro, Fernando Cobo, Maristela Freire, Ana V Halperin, Laia Alsina, Marguax Garzaro, Silvia Castro Caruso Christ, Julia Laporte-Amargos, Enrique Ruiz de Gopegui-Bordes, Luis Martínez-Martínez, Maura S Oliveira, Victoria García-López, Francisco J Martinez-Marcos, Emilio Cendejas, Alfonso del Arco-Jiménez, Mónica Chávez-Caballero, Salvador López-Cardenas, Manuel Antonio Rodríguez-Iglesias, Carla A Alonso, Maddalena Giannella, Adelina Gimeno-Gascón, Pilar Sánchez-Suero, Silvia Jiménez-Jorge, Jerónimo Pachón, María E Pachón-Ibáñez, Elisa Cordero, Soraya Herrera-Espejo, Sonsoles Salto-Alejandre, Javier Díez de los Ríos, Miguel Blázquez Fraile, M Dolores Quesada, Miguel Ángel López-Zúñiga, Alba Royo-Moreno, Celia Martí-Castellote, Manuel Monsonis-Cabed, Guillem López de Egea, María Ángeles Galán-Ladero, Andrea Prolo-Acosta, José María García de Lomas-Guerrero, Gabriel Sena-Corrales, José Antonio Girón-González, Fátima Galán-Sánchez, Marcia Halpern, Mariana Fernández-Pittol, Mohamed Omar Mohamed-Balghata, Sofie Winderickx, Alberto Romero-PalaciosAbstract
Objectives
Campylobacter spp. bloodstream infections (BSIs) are an emerging clinical challenge, yet information on their clinical features remains limited. We aimed to evaluate their differential clinical characteristics and outcomes in immunocompetent (IC) and immunocompromised (ID) patients.
Methods
A multicenter, multinational, retrospective cohort study of consecutive Campylobacter spp. BSI between 2009 and 2024 was carried out. Demographics, Charlson Comorbidity Index (CCI), types of immunodeficiencies, clinical characteristics, and antimicrobial susceptibility were analyzed. Primary outcomes were relapse or reinfections and all-cause mortality.
Results
Two hundreds and sixty-one episodes were included, 89 (34.1%) in IC and 172 (65.9%) in ID patients. Among the 172 ID patients, 104 (60.5%) and 68 (39.5%) had humoral and non-humoral (primary or secondary), and 42 (24.4%) primary immunodeficiencies (PID). Patients with humoral-ID were younger (median years 40; IQR: 23–66), with lower CCI (2; IQR:1–5), and had higher frequency of previous Campylobacter spp. infection. Resistance rates to fluoroquinolones (75%) and macrolides (14.5%) were high. BSI relapse or reinfection occurred in 21 (8.0%) patients, mostly with humoral-ID (N=19, 18.3%), 11 (57.9%) of whom with PID. Thirty-day all-cause mortality occurred in 26 (9.9%) patients across the entire cohort; mortality was lower among humoral-ID (N=5, 4.8%) than in IC (N=12, 13.5%; p=0.05) patients.
Conclusions
Patients with humoral-ID and Campylobacter spp. BSI were younger, had fewer comorbidities, and C. coli represented the more frequent species. Relapse or reinfection was common in humoral-ID, particularly those with PID. The antimicrobial resistance in C. coli and C. jejuni arise a clinical concern.