Campylobacter: the new leader in food-borne disease aetiology

In the genus Campylobacter there are 15 species, three of which are signifi cant human pathogens. The organism is a uniquely small, Gram-negative rod f ound primarily in zoonotic reservoirs from which humans can be infected. Di fferent clinical features ranging from watery diarrhoea to dysentery and su bsequent possible sequelae result from infection. Several immunodominant an tigens are now recognized and these have been exploited for use in epidemio logical typing methods and are gradually being analyzed to determine their role in pathogenesis. Although the nature of Campylobacter pathogenesis rem ains elusive, some information is now available on adherence, invasion and toxicity. Fortunately, clinical laboratory diagnosis is now routine and num erous molecular characterization procedures are potentially available. Vacc ine development is underway, but thus far, significant protection has not b een demonstrated. Fluoroquinolones remain the drugs of choice for severe ga stroenteritis, although resistance to these antibiotics and to the macrolid es, is beginning to emerge. (C) 2001 Lippincott Williams & Wilkins.