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Collántes-Fernández E, Fort MC, Ortega-Mora LM, Schares G. Trichomonas. PARASITIC PROTOZOA OF FARM ANIMALS AND PETS 2018. [PMCID: PMC7122547 DOI: 10.1007/978-3-319-70132-5_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The most widely known trichomonad in veterinary medicine is Tritrichomonas foetus. It is the etiologic agent of bovine tritrichomonosis, a sexually transmitted disease in extensively managed herds throughout many geographic regions worldwide. The same trichomonad species is also regarded as the causative agent of chronic diarrhea in the domestic cat, although more recent studies observed molecular differences between bovine- and feline-derived T. foetus. Trichomonosis in cats has a worldwide distribution and is mainly present among cats from high-density housing environments. Other trichomonads are found as inhabitants of the gastrointestinal tract in birds, such as Trichomonas gallinae. Particularly, Columbiformes, Falconiformes, Strigiformes, and wild Passeriformes can be severely affected by avian trichomonads. Diagnosis of trichomonosis is often complicated by the fragility of the parasite. To ensure valid test results, it is essential to collect and handle specimens in the right way prior to analysis. Cultivation tests, the specific amplification of parasites, or a combination of both test methods is the most efficient and most commonly used way to diagnose trichomonosis in animals. Bovine tritrichomonosis is mainly controlled by the identification and withdrawal of infected animals from bovine herds. The control of feline and avian trichomonosis relies mainly on preventive measures.
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Yu Z, Ruan Y, Zhou M, Chen S, Zhang Y, Wang L, Zhu G, Yu Y. Prevalence of intestinal parasites in companion dogs with diarrhea in Beijing, China, and genetic characteristics of Giardia and Cryptosporidium species. Parasitol Res 2017; 117:35-43. [PMID: 29150700 PMCID: PMC7088013 DOI: 10.1007/s00436-017-5631-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 09/20/2017] [Indexed: 11/30/2022]
Abstract
Companion animals including dogs are one of the important components in One Health. Parasites may cause not only diseases in pet animals but also many zoonotic diseases infecting humans. In this study, we performed a survey of intestinal parasites in fecal specimens (n = 485) collected from outpatient pet dogs with diarrhea in Beijing, China, for the entire year of 2015 by microscopic examination (all parasites) and SSU rRNA-based nested PCR detection (Giardia and Cryptosporidium). We observed a total of 124 (25.6%) parasite-positive specimens that contained one or more parasites, including Giardia duodenalis (12.8%), Cryptosporidium spp. (4.9%), Cystoisospora spp. (4.3%), trichomonads (4.3%), Toxocara canis (3.5%), Trichuris vulpis (0.6%), and Dipylidium caninum (0.2%). Among the 55 dog breeds, infection rates were significantly higher in border collies and bulldogs, but lower in poodles (p < 0.05). Risk factor analysis suggested that age was negatively correlated with the infection rate (p < 0.00001), while vaccination and deworming in the past 12 months could significantly reduce the parasite infections (p < 0.01). Among the 62 Giardia-positive specimens, 21 were successfully assigned into assemblages using glutamate dehydrogenase (gdh) and/or beta-giardin (bg) genes, including assemblage D (n = 15), C (n = 5), and F (n = 1). Among the 24 Cryptosporidium-positive specimens by SSU rRNA PCR, 20 PCR amplicons could be sequenced and identified as Cryptosporidium canis (n = 20). Collectively, this study indicates that parasites are a significant group of pathogens in companion dogs in Beijing, and companion dogs may potentially transmit certain zoonotic parasites to humans, particularly those with weak or weakened immunity.
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Affiliation(s)
- Zhongjia Yu
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China
| | - Yang Ruan
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China
| | - Mengjie Zhou
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China
| | - Siyuan Chen
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China
| | - Yinxin Zhang
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China
| | - Liya Wang
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China
| | - Guan Zhu
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4467, USA.
| | - Yonglan Yu
- College of Veterinary Medicine, China Agricultural University, Haidian District, Beijing, 100193, China.
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Abstract
The last estimated annual incidence of Trichomonas vaginalis worldwide exceeds that of chlamydia and gonorrhea combined. This critical review updates the state of the art on advances in T. vaginalis diagnostics and strategies for treatment and prevention of trichomoniasis. In particular, new data on treatment outcomes for topical administration of formulations are reviewed and discussed.
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More S, Bøtner A, Butterworth A, Calistri P, Depner K, Edwards S, Garin-Bastuji B, Good M, Gortázar Schmidt C, Michel V, Miranda MA, Nielsen SS, Raj M, Sihvonen L, Spoolder H, Stegeman JA, Thulke HH, Velarde A, Willeberg P, Winckler C, Baldinelli F, Broglia A, Candiani D, Beltrán-Beck B, Kohnle L, Bicout D. Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): Trichomonosis. EFSA J 2017; 15:e04992. [PMID: 32625289 PMCID: PMC7009924 DOI: 10.2903/j.efsa.2017.4992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Trichomonosis has been assessed according to the criteria of the Animal Health Law (AHL), in particular criteria of Article 7 on disease profile and impacts, Article 5 on the eligibility of trichomonosis to be listed, Article 9 for the categorisation of trichomonosis according to disease prevention and control rules as in Annex IV and Article 8 on the list of animal species related to trichomonosis. The assessment has been performed following a methodology composed of information collection and compilation, expert judgement on each criterion at individual and, if no consensus was reached before, also at collective level. The output is composed of the categorical answer, and for the questions where no consensus was reached, the different supporting views are reported. Details on the methodology used for this assessment are explained in a separate opinion. According to the assessment performed, trichomonosis can be considered eligible to be listed for Union intervention as laid down in Article 5(3) of the AHL. The disease would comply with the criteria as in sections 3, 4 and 5 of Annex IV of the AHL, for the application of the disease prevention and control rules referred to in points (c), (d) and (e) of Article 9(1). The animal species to be listed for trichomonosis according to Article 8(3) criteria is cattle as susceptible and reservoir.
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Okafor CC, Strickland LG, Jones BM, Kania S, Anderson DE, Whitlock BK. Prevalence of Tritrichomonas foetus in tennessee bulls. Vet Parasitol 2017; 243:169-175. [PMID: 28807288 DOI: 10.1016/j.vetpar.2017.06.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/11/2017] [Accepted: 06/25/2017] [Indexed: 10/19/2022]
Abstract
The prevalence of bovine trichomonosis (BT) in TN bulls was estimated through both active screening of bulls and review of previous laboratory records. During the active bull screening, preputial smegma specimens were collected from 458 TN beef bulls at 2 cattle slaughterhouses and 2 stockyards, which serve most beef bulls in TN, between March 2014 and June 2015. Each specimen was cultured for Tritrichomonas foetus (T. foetus) as well as evaluated microscopically every other day for seven days for any protozoa resembling T. foetus. An aliquot of the culture media from each specimen was used for DNA extraction and subsequent qPCR testing. Two specimens were considered suspect on microscopic evaluation, but all specimens were negative for T. foetus on qPCR. This suggests that the 2 specimens were most likely contaminated by fecal trichomonads. Retrospectively, 1979 T. foetus test records from 2 major TN diagnostic laboratories were reviewed between October 2013 and September 2016. True prevalence of BT in TN beef bulls was estimated at <0.01% from the laboratory records, although the county prevalence differed in 2 TN counties (Marshal: 0.09% and Bedford: 0.5%). Overall, the prevalence of BT in TN is low, and the current screening efforts to help control BT disease in TN are acceptable. Future efforts should focus on educating cattle stakeholders on the importance of optimal specimen collection and handling as well as routine testing for BT before cattle movement. In addition, cattle producers should be reminded of leading risk factors associated with BT in cattle.
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Affiliation(s)
- Chika C Okafor
- College of Veterinary Medicine, Biomedical and Diagnostic Sciences, University of Tennessee, 2407 River Dr., Knoxville, TN 37996, USA.
| | - Lew G Strickland
- Department of Animal Science, University of Tennessee, 2506 River Dr., Knoxville, TN 37996, USA; College of Veterinary Medicine, Large Animal Clinical Sciences, University of Tennessee, 2407 River Dr., Knoxville, TN 37996, USA.
| | - Brittni M Jones
- College of Veterinary Medicine, Large Animal Clinical Sciences, University of Tennessee, 2407 River Dr., Knoxville, TN 37996, USA.
| | - Stephen Kania
- College of Veterinary Medicine, Biomedical and Diagnostic Sciences, University of Tennessee, 2407 River Dr., Knoxville, TN 37996, USA.
| | - David E Anderson
- College of Veterinary Medicine, Large Animal Clinical Sciences, University of Tennessee, 2407 River Dr., Knoxville, TN 37996, USA.
| | - Brian K Whitlock
- College of Veterinary Medicine, Large Animal Clinical Sciences, University of Tennessee, 2407 River Dr., Knoxville, TN 37996, USA.
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56
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Clemmons BA, Reese ST, Dantas FG, Franco GA, Smith TPL, Adeyosoye OI, Pohler KG, Myer PR. Vaginal and Uterine Bacterial Communities in Postpartum Lactating Cows. Front Microbiol 2017. [PMID: 28642755 PMCID: PMC5463355 DOI: 10.3389/fmicb.2017.01047] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Reproductive inefficiency in cattle has major impacts on overall productivity of cattle operations, increasing cost of production, and impacting the sustainability of the cattle enterprise. Decreased reproductive success and associated disease states have been correlated with the presence of specific microbes and microbial community profiles, yet details of the relationship between microbial communities and host physiology are not well known. The present study profiles and compares the microbial communities in the bovine uterus and vagina using 16S rRNA sequencing of the V1-V3 hypervariable region at the time of artificial insemination. Significant differences (p < 0.05) between the vaginal and uterine communities were observed at the level of α-diversity metrics, including Chao1, Shannon's Diversity Index, and observed OTU. Greater clustering of vaginal OTU was apparent in principal coordinate analysis compared to uterine OTU, despite greater diversity in the vaginal community in both weighted and unweighted UniFrac distance matrices (p < 0.05). There was a significantly greater relative abundance of unassigned taxa in the uterus (p = 0.008), otherwise there were few differences between the overall community profiles. Both vaginal and uterine communities were dominated by Firmicutes, although the relative abundance of rRNA sequences corresponding to species in this phylum was significantly (p = 0.007) lower in the uterine community. Additional differences were observed at the genus level, specifically in abundances within Clostridium (p = 0.009), Anaerofustis (p = 0.018), Atopobium (p = 0.035), Oscillospira (p = 0.035), 5-7N15 (p = 0.035), Mycoplasma (p = 0.035), Odoribacter (p = 0.042), and within the families Clostridiaceae (p = 0.006), Alcaligenaceae (p = 0.021), and Ruminococcaceae (p = 0.021). Overall, the comparison revealed differences and commonalities among bovine reproductive organs, which may be influenced by host physiology. The increased abundance of unassigned taxa found in the uterus may play a significant biological role in the reproductive status of the animal. The study represents an initial dataset for comparing bacterial communities prior to establishment of pregnancy.
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Affiliation(s)
- Brooke A Clemmons
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Sydney T Reese
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Felipe G Dantas
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Gessica A Franco
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Timothy P L Smith
- U.S. Meat Animal Research Center, Agricultural Research Service, United States Department of Agriculture, Clay Center, NEUnited States
| | | | - Ky G Pohler
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
| | - Phillip R Myer
- University of Tennessee Institute of Agriculture, University of Tennessee, KnoxvilleTN, United States
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57
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Iriarte LS, Midlej V, Frontera LS, Moros Duarte D, Barbeito CG, de Souza W, Benchimol M, de Miguel N, Coceres VM. TfVPS32 Regulates Cell Division in the Parasite Tritrichomonas foetus. J Eukaryot Microbiol 2017; 65:28-37. [DOI: 10.1111/jeu.12424] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/10/2017] [Accepted: 04/20/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Lucrecia S. Iriarte
- Laboratorio de Parásitos Anaerobios; Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús (IIB-INTECH), CONICET-UNSAM; Chascomús B7130IWA Argentina
| | - Victor Midlej
- Laboratorio de Ultraestrutura Celular Hertha Meyer; Centro de Ciências da Saúde; Instituto de Biofísica Carlos Chagas Filho; Universidade Federal do Rio de Janeiro; Cidade Universitaria; Av. Carlos Chagas Filho 373 - G1-019 - Ilha do Fundão Rio de Janeiro RJ 21941-902 Brazil
| | - Lorena S. Frontera
- Laboratorio de Parásitos Anaerobios; Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús (IIB-INTECH), CONICET-UNSAM; Chascomús B7130IWA Argentina
| | - Daniel Moros Duarte
- Laboratorio de Parásitos Anaerobios; Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús (IIB-INTECH), CONICET-UNSAM; Chascomús B7130IWA Argentina
| | - Claudio G. Barbeito
- Histology and Embryology Department; Veterinary Medicine School; National University of La Plata (UNLP); P.O. Box 296 1900 La Plata Buenos Aires Argentina
| | - Wanderley de Souza
- Laboratorio de Ultraestrutura Celular Hertha Meyer; Centro de Ciências da Saúde; Instituto de Biofísica Carlos Chagas Filho; Universidade Federal do Rio de Janeiro; Cidade Universitaria; Av. Carlos Chagas Filho 373 - G1-019 - Ilha do Fundão Rio de Janeiro RJ 21941-902 Brazil
| | - Marlene Benchimol
- Laboratorio de Ultraestrutura Celular Hertha Meyer; Centro de Ciências da Saúde; Instituto de Biofísica Carlos Chagas Filho; Universidade Federal do Rio de Janeiro; Cidade Universitaria; Av. Carlos Chagas Filho 373 - G1-019 - Ilha do Fundão Rio de Janeiro RJ 21941-902 Brazil
- Universidade do Grande Rio, UNIGRANRIO; Rua Professor José de Souza Herdy 1160 - Jardim Vinte e Cinco de Agosto Duque de Caxias RJ 25070-000 Brazil
| | - Natalia de Miguel
- Laboratorio de Parásitos Anaerobios; Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús (IIB-INTECH), CONICET-UNSAM; Chascomús B7130IWA Argentina
| | - Veronica M. Coceres
- Laboratorio de Parásitos Anaerobios; Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús (IIB-INTECH), CONICET-UNSAM; Chascomús B7130IWA Argentina
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58
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Loureiro AP, Pestana C, Medeiros MA, Lilenbaum W. High frequency of leptospiral vaginal carriers among slaughtered cows. Anim Reprod Sci 2017; 178:50-54. [PMID: 28118946 DOI: 10.1016/j.anireprosci.2017.01.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 01/11/2017] [Accepted: 01/15/2017] [Indexed: 12/30/2022]
Abstract
Bovine leptospirosis is one of the most important reproductive diseases that compromise the productivity of cattle farming. However, the presence of the agent on vaginal environment is still poorly understood in cattle. Considering this context, the present study aimed to detect the presence of pathogenic Leptospira sp. in vaginal fluid (VF) of cows. VF and urine were collected from 254 cows from a slaughterhouse for bacteriological culture and PCR (lipL32 gene). Overall, eleven pure culture (4.3%) of leptospiral isolates were obtained. Leptospiral DNA was detected in 128 (50.4%) of VF samples and 81 (31.0%) of urine samples, while on 75 (29.5%) it was exclusively in VF and 28 (11.3%) only in the urine. Detection of leptospiral DNA and the recovery of viable leptospires from VF of a high number of cows without apparent symptoms highlight the role of vaginal carriers and indicate that venereal transmission (female-to-male) could occur in that species. Moreover, VF should be encouraged as a valuable sample for diagnosis of bovine genital leptospirosis.
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Affiliation(s)
- A P Loureiro
- Laboratório de Bacteriologia Veterinária, Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - C Pestana
- Laboratório de Tecnologia Recombinante, Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, Brazil
| | - M A Medeiros
- Laboratório de Tecnologia Recombinante, Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, Brazil
| | - W Lilenbaum
- Laboratório de Bacteriologia Veterinária, Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
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59
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Palomares R, Hurley D, Crum L, Rollin E, Collop T, Williard A, Felton J, Parrish J, Corbeil L. Serum, uterine, and vaginal mucosal IgG antibody responses against Tritrichomonas foetus after administration of a commercial killed whole T foetus vaccine in beef cows. Theriogenology 2017; 87:235-241. [DOI: 10.1016/j.theriogenology.2016.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/26/2016] [Accepted: 08/26/2016] [Indexed: 10/21/2022]
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60
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Liu J, Kanetake S, Wu YH, Tam C, Cheng LW, Land KM, Friedman M. Antiprotozoal Effects of the Tomato Tetrasaccharide Glycoalkaloid Tomatine and the Aglycone Tomatidine on Mucosal Trichomonads. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2016; 64:8806-8810. [PMID: 27934291 DOI: 10.1021/acs.jafc.6b04030] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The present study investigated the inhibitory effects of the commercial tetrasaccharide tomato glycoalkaloid tomatine and the aglycone tomatidine on three mucosal pathogenic protozoa that are reported to infect humans, cattle, and cats, respectively: Trichomonas vaginalis strain G3, Tritrichomonas foetus strain D1, and Tritrichomonas foetus strain C1. A preliminary screen showed that tomatine at 100 μM concentration completely inhibited the growth of all three trichomonads. In contrast, the inhibition of all three pathogens by tomatidine was much lower, suggesting the involvement of the lycotetraose carbohydrate side chain in the mechanism of inhibition. Midpoints of concentration-response sigmoid plots of tomatine on the three strains correspond to IC50 values, the concentration that inhibits 50% of growth of the pathogenic protozoa. The concentration data were used to calculate the IC50 values for G3, D1, and C1 of 7.9, 1.9, and 2.2 μM, respectively. The results show an approximately 4-fold variation from the lowest to the highest value (lowest activity). Although the inhibition by tomatine was not as effective as that of the medicinal drug metronidazole, the relatively low IC50 values for both T. vaginalis and T. foetus indicated tomatine as a possible natural alternative therapeutic for trichomoniasis in humans and food-producing (cattle and pigs) and domestic (cats) animals. Because tomatine has the potential to serve as a new antiprotozoan functional (medical) food, the distribution of this glycoalkaloid in tomatoes and suggestions for further research are discussed.
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Affiliation(s)
- Jenny Liu
- Department of Biological Sciences, University of the Pacific , Stockton, California 95211, United States
| | - Sierra Kanetake
- Department of Biological Sciences, University of the Pacific , Stockton, California 95211, United States
| | - Yun-Hsuan Wu
- Department of Biological Sciences, University of the Pacific , Stockton, California 95211, United States
| | - Christina Tam
- Foodborne Toxin Detection and Prevention, Agricultural Research Service, United States Department of Agriculture , Albany, California 94556, United States
| | - Luisa W Cheng
- Foodborne Toxin Detection and Prevention, Agricultural Research Service, United States Department of Agriculture , Albany, California 94556, United States
| | - Kirkwood M Land
- Department of Biological Sciences, University of the Pacific , Stockton, California 95211, United States
| | - Mendel Friedman
- Healthy Processed Foods Research, Agricultural Research Service, United States Department of Agriculture , Albany, California 94556, United States
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61
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Abstract
Campylobacter includes a group of genetically diverse species causing a range of diseases in animals and humans. The bacterium is frequently associated with two economically important and epidemiologically distinct reproductive diseases in ruminants: enzootic infectious infertility in cattle owing to Campylobacter fetus subsp. venerealis and abortions in sheep, goats, and cattle. Septic abortion, usually epizootic in sheep, has been historically associated with C. fetus subsp. fetus and to a lesser extent with Campylobacter jejuni. However, there has been a dramatic species shift in the etiology of Campylobacter abortions in recent years: C. jejuni has now replaced C. fetus subsp. fetus as the predominant cause of sheep abortion in the United States, which appears to be driven primarily by clonal expansion of a hypervirulent tetracycline-resistant C. jejuni clone. Here we provide a review on the recent advances in understanding the pathobiology of Campylobacter infections in animals, with an emphasis on the diseases in ruminants, covering epidemiology, pathogenesis, genomics, and control measures.
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Affiliation(s)
- Orhan Sahin
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa 50011;
| | - Michael Yaeger
- Department of Veterinary Pathology, Iowa State University, Ames, Iowa 50011;
| | - Zuowei Wu
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, Iowa 50011; ,
| | - Qijing Zhang
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, Iowa 50011; ,
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