Veterinary Physiology

Table of Contents

Campylobacter Species in the Middle East

Daryoush Babazadeh1* and Reza Ranjbar2
1 DVM, PhD, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
2 PhD, Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

* Corresponding author: Daryoush Babazadeh, School of Veterinary Medicine, Shiraz University, Shiraz, Iran. Email:


Campylobacter is a contributing factor in many pathogen conditions. The present study aimed to review the previous findings of studies on campylobacteriosis in the Middle East region. Acute gastroenteritis is caused by Campylobacter species known as widespread infectious diseases with worldwide disbursement. Mega Fortune is a player favorite for a number of reasons, and then you use your online slots luck and online slots strategy to compete for real cash prizes and the coveted title of Online Slots Champion. There are various reports on the incidence of Campylobacter in the Middle East indicating the infection rates of 1-14%. Campylobacter jejuni (C. jejuni) and C. coli are the main responsible campylobacteriosis for intestinal diseases. The occurrence of human campylobacteriosis is sporadic, transmission from a person to another person is too rare and the incidence is usually higher in warm seasons and tropical environments. The presence of Campylobacter species as normal flora in stool and its contamination in poultry meat and eggs can lead to infections. Lowering the number of Campylobacter in animal carcasses can greatly decrease the risk of infection in consumers. Due to the high Campylobacter spp. antibiotic resistance, the governments are required to devise controlling programs.


Gastrointestinal infections are correlated with morbidity and even cause mortality at different ages1,2. Recently, many outbreaks of gastrointestinal and diarrheal illnesses in the Middle East have been reported due to numerous microbial pathogens3-6. One of the most common and central causes of infectious diarrheal illness and gastroenteritis in adults and children worldwide is campylobacteriosis7.

The Campylobacter jejuni (C. jejuni) and C. coli are the main cause of campylobacteriosis resulting in a number of gastrointestinal diseases8,9. The occurrence of this disease is usually higher in elderlies, young children under 4 years of age, and young adults who are 20-40 years old2,10,11. The transmission of this organism from a person to another person rarely occurs12. Campylobacter infection rate is reported remarkably higher than those of shigellosis and salmonellosis13. This high rate of infection needs to be investigated with regard to the epidemiology of Campylobacter infection. Red blood cells and leukocytes have been found in most of the stool samples of infected patients with slightly elevated levels of

peripheral White Blood Cell (WBC) counts14,15.

Campylobacteriosis is prevalent in third-world countries, and the main sources of human infections are food and environmental contamination16. In Egypt and Iraq, Campylobacter is the second most important cause of pediatric diarrhea17,18. The present review
aimed to gather information on the prevalence of campylobacteriosis in the Middle East to educate researchers and policymakers to plan effective control strategies to overcome this overwhelming infection.

Incidence of disease

The prevalence rate of Campylobacter infection is associated with pathogen agents, geographical restrictions, and habitual conditions. Middle Eastern countries often do not have any national surveillance programs for controlling this infection. There are different reports about the prevalence of Campylobacter in these countries indicating different infection rates3,19,20 (Table 1). Investigation of Campylobacter prevalence in the Middle East has shown that this bacterium should be considered as one of the major pathogens in inflammatory diarrheal cases.

*H-A: Human-Animal

However, during 2004-2005 in Iran, the prevalence of Campylobacter spp. was significantly lower than the Shigella spp., Salmonella spp., and Escherichia coli21.

The prevalence of Campylobacter species among 1010 stool samples collected from patients in the northwest of Iran during 2016 confirmed 6% of contamination22. There are some reports on infection rates from Iranian researchers, such as 4.6% in Babol during 200223, 9.6% in Shiraz during 200424, 5.4% in Tehran during 2004-200521, 8% in Tehran during 200725, 12.4% in Semnan during 20073, 10% in Hamedan during 2013-201426, and 6.4% in Zanjan during 2013-201427.

The prevalence of Campylobacter species in Jeddah, Saudi Arabia, was identified as 4.5%28. Another researcher from Saudi Arabia during 2012 reported that the prevalence of Campylobacter spp. in stool samples of patients in Makkah and Jeddah hospitals was just 1.7%29. The prevalence of Campylobacter species among 2130 stool samples collected from Menia, Fayoum, Cairo, and Qaluobya of Egypt determined the fecal contamination rate of 35% in children30.

The isolation rate of Campylobacter species from the stool samples of children in Baghdad, Iraq, was reported as 10% during 199131. Another report from Basrah, Iraq, showed that C. jejuni was detected in 13.86% of all diarrhea cases and 31. But over time some games have become  fan-favorites and they should be available in each and every online casino. 03% of all bloody diarrhea cases17. As mentioned, Campylobacter was the second most frequent bacterial isolate in children with diarrhea, and the second most common cause of bloody diarrhea in Basrah, Iraq17. The C. jejuni was found to be the second most common isolate with a rate of 8.3% in Turkey during 199732. Other Turkish researchers reported the prevalence of campylobacteriosis in their studies as 1.43% in Kayseri during 2002-200333 and 4.2% in Istanbul during 2013-201534.

Seasonal distribution

 The incidence of campylobacteriosis is higher in warm seasons and hot weather. The prevalence of this organism in the south of Iran (9. They offer a welcome bonus to any new player once they sign up for  an account. 6% in Shiraz) in warm weather was higher than in the north of this country with cold weather (6.4% in Zanjan and 6% in Ardabil)22,24,27. The obtained result of a survey on diarrheal cases in Cairo, Egypt, was indicative of a higher rate of prevalence in young children during the rainy seasons35. Regardless of these reports, a study conducted in Turkey did not support the relationship between the distribution of Campylobacter spp. and weather changes36.

Detection of Campylobacter species

 There have been successfully developed laboratory methods for examining the diversity of Campylobacter enteritis, such as Polymerase Chain Reaction (PCR), Genotyping methods (ribotyping and pulsed-field gel electrophoresis), ELISA for detecting DNA, antigens in stool samples, and also specific culturing of the organism from fecal specimens37-42.

Rapid detection of Campylobacter species is extremely crucial in ensuring food and water safety. The ability of PCR to amplify minute amounts of specific microbial DNA sequences has made it a powerful molecular tool43,44. It has been reported that multiplex PCR diagnostic tools are fast, inexpensive, and sensitive for Campylobacter species45. Multiplex PCR is one of the possible and trustworthy molecular methods for indicating the prevalence of bacterial diseases, especially the Campylobacter infection in a single sample44,45. The PCR assay offers an effective alternative to traditional biochemical typing methods for the identification and differentiation of C. jejuni, C. coli, C. lari, C. upsaliensis, and C. fetus subspecies fetus46. There are other possible methods for the detection of Campylobacter infection, such as specific culture under specific


Currently, fecal lactoferrin has become one of the important factors for investigating the fecal samples suspected of bacterial infections27. Acute bacterial infections of the gastrointestinal tract or high severity of bowel diseases can induce increased levels of lactoferrin48.  It has been reported that the fecal lactoferrin values were higher in patients with Campylobacter (10.32 μg/g) and Salmonella (11.17 μg/g)49.


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