SporadicCampylobacter jejuniInfections in Hawaii: Associations with Prior Antibiotic Use and Commercially Prepared Chicken

Campylobacter is the most common cause of bacterial foodborne illness in the United States, and Hawaii has the highest rate of Campylobacter jejuni infections in the nation. A case-control study was conducted to determine indigenous exposures that contribute to the high incidence of sporadic C. jejuni infection in Hawaii. A total of 211 case patients with diarrhea and confirmed Campylobacter infection was enrolled, along with 1 age- and telephone exchange-matched control subject for each patient. Participants were interviewed about illness, medicines, food consumption, food-handling practices, and exposure to animals. In matched logistic regression analyses, eating chicken prepared by a commercial food establishment in the 7 days before case illness onset (adjusted odds ratio [AOR], 1.8; P=.03) and consuming antibiotics during the 28 days before illness onset (AOR, 3.3; P=.03) were significant independent predictors of illness. Further study of the association of Campylobacter illness with commercially prepared chicken and prior antibiotic use is needed.