Emerging Campylobacter spp.: the Tip of the Iceberg

Campylobacter jejuni is universally recognized as the most common bacterial cause of human gastroenteritis. This organism is also associated with septicemia, meningitis, and the post-infective sequelae of the Guillain-Barre syndrome and reactive arthritis. Interest is increasing in Campylobacter species other than C. jejuni and their roles in human and animal disease. However, these emerging campylobacteria are dramatically under-isolated because of the application of less than optimal laboratory protocols. A Cape Town protocol in which stool is filtered onto antibiotic-free culture media and incubated in a hydrogen-enriched, microaerobic atmosphere is a simple and cost-effective means of optimizing the recovery of all species of Campylobacter, as well as species of the related genera Arcobacter and Helicobacter, from stool, blood, and other clinical samples. Subsequent biochemical identification by means of a flowchart easily identifies presumptive Campylobacter isolates to the species level. As emerging Campylobacter spp. are dramatically under-isolated, the true disease potential of these organisms is unknown at present.