The following is a summary of “Clinical Features, Immunological Characteristics, and Treatment Outcomes of Campylobacter spp. Infections in Patients With Common Variable Immunodeficiency,” published in the November 2023 issue of Allergy and Clinical Immunology by Roa-Bautista, et al.

Campylobacter infections generally cause a short-term illness that goes away on its own after 5 to 7 days in people who don’t need antibiotics. But if one’s immune system doesn’t work right, you could end up with a long-lasting, serious illness that needs medicines and more harsh treatments. For a study, researchers sought a comprehensive description of Campylobacter spp. infections in patients diagnosed with common variable immunodeficiency (CVID). A group of 14 CVID patients with Campylobacter illness and 95 CVID controls who went to the immune department at a big major hospital were looked at in the past. Immunological, clinical, and microbial factors were measured in both groups, and the average follow-up time was 20 years. A new method was used to treat people with Campylobacter who did not have enough antibodies. 

Patients with Campylobacter had more CD21lowCD38low and intermediate B cells than controls (median 38.0% vs 14.2% and 5.4% vs 3.2%). They also had fewer CD19+ B cells (median 0.06 vs 0.18 × 109/L) and CD4+ T cells (0.41 vs 0.62 × 109/L). Over time, the number of B cells (median 0.02 vs. 0.14 × 109/L), CD4+ T cells (0.33 vs. 0.59 × 109/L), CD8+ T cells (0.26 vs 0.62 × 109/L), and natural killer cells (0.08 vs 0.18 × 109/L) in people who had Campylobacter also went down. A lot of microbes were resistant to antibiotics, especially macrolides and fluoroquinolones. After an average of 20 days for acute Campylobacter infections (resolved within 3 months of start) and 113 days for chronic Campylobacter infections (>3 months), the bacteria were gone, and the patient’s condition got better. 

7 got first-line treatment (azithromycin or chloramphenicol), 4 got second-line treatment (neomycin), and three got third-line treatment (a mix of tigecycline, chloramphenicol, and ertapenem; one got gentamicin because the bacteria were resistant to carbapenems). The study showed the immune system and clinical features of recurring Campylobacter infections in people with CVID. Their treatment method worked and should be tested on a bigger group of people.

Source: sciencedirect.com/science/article/pii/S2213219823007158