Campylobacter spp. in Icelandic poultry operations and human disease

Attributing the human disease burden of foodborne infections to specific sources

Foodborne diseases are an important cause of human illness worldwide. Humans acquire these infections from a variety of sources and routes of transmission. Many efforts have been made in the last decades to prevent and control foodborne diseases, particularly foodborne zoonoses. However, information on the impact of these interventions is limited. To identify and prioritize successful food safety interventions, it is important to attribute the burden of human illness to the specific sources. Defining scientific concepts and harmonizing terminology for "source attribution" is essential for understanding and improving attribution methodologies and for sharing knowledge within the scientific community. We propose harmonized nomenclature, and describe the various approaches for human illness source attribution and their usefulness to address specific public health questions.

Advances in enteropathogen control in poultry production

Poultry meat has been associated frequently and consistently with the transmission of enteric pathogens, including Salmonella and Campylobacter. This association has resulted in the development of HACCP-based intervention strategies. These strategies (hurdles) begin with elite breeder flocks and filter down the production pyramid. These hurdles include those already established, such as biosecurity, vaccination, competitive exclusion, pre- and probiotics, feed and water control, and those more experimental, such as bacteriophage or immunoglobulin therapy. The reduction in enteropathogens entering the processing plant, which employs critical control points, further reduce the exposure of consumers to these organisms. The synergistic application of hurdles will result in an environment that is restrictive and detrimental to enteropathogen colonization and contamination.

Chickens and cattle as sources of sporadic domestically acquired Campylobacter jejuni infections in Finland

A substantial sampling among domestic human campylobacter cases, chicken process lots, and cattle at slaughter was performed during the seasonal peak of human infections. Campylobacter jejuni isolates (n = 419) were subtyped using pulsed-field gel electrophoresis with SmaI, and isolates representing overlapping types (n = 212) were further subtyped using KpnI for restriction. The SmaI/KpnI profiles of 55.4% (97/175) of the human isolates were indistinguishable from those of the chicken or cattle isolates. The overlapping SmaI/KpnI subtypes accounted for 69.8% (30/43) and 15.9% (32/201) of the chicken and cattle isolates, respectively. The occurrence of identical SmaI/KpnI subtypes with human C. jejuni isolates was significantly associated with animal host species (P < 0.001). A temporal association of isolates from chickens and patients was possible in 31.4% (55/175) of the human infections. Besides chickens as sources of C. jejuni in the sporadic infections, the role of cattle appears notable. New approaches to restrict the occurrence of campylobacters in other farm animals may be needed in addition to hygienic measures in chicken production. However, only about half of the human infections were attributable to these sources.

Danish strategies to control Campylobacter in broilers and broiler meat: facts and effects

Thermotolerant Campylobacter spp. have been the most common bacterial cause of human gastrointestinal disease in Denmark since 1999. In 2003, the Danish voluntary strategy to control Campylobacter was intensified. The focus was on biosecurity, allocation of meat from Campylobacter-negative broilers to the production of chilled products, and consumer information campaigns. From 2002 to 2007, the percentage of Campylobacter-positive broiler flocks at slaughter decreased from 43% to 27%. After processing, Campylobacter-positive samples of chilled broiler meat fell from 18% in 2004 to 8% in 2007. Furthermore, the number of registered human Campylobacter cases decreased by 12%; from 4379 cases in 2002 to 3865 cases in 2007. We believe that the observed decrease in the occurrence of Campylobacter in broilers and broiler meat and the coincidental fall in the number of registered human cases is, in part, a result of the implemented control strategy.

Survival at refrigeration and freezing temperatures of Campylobacter coli and Campylobacter jejuni on chicken skin applied as axenic and mixed inoculums

Campylobacter is considered to be the most common cause of bacterial diarrhoeal illness in the developed world. Many cases are thought to be acquired from consumption of undercooked poultry. The aim of this study was to compare the effect of the rate of cooling on the survival, at 4 degrees C and -20 degrees C, of Campylobacter coli and Campylobacter jejuni strains, inoculated on chicken skin from axenic culture or as mixed inoculums. Strains chilled in a domestic refrigerator varied in their tolerance to storage at 4 degrees C. Statistically significant differences between strains applied as axenic or mixed inoculums were observed for specific strain combinations using two-way ANOVA, including the enhanced survival of antibiotic resistant C. coli 99/367 at 4 degrees C. The use of rapid cooling (at -20 degrees C/min) enhanced the survival of all the Campylobacter strains chilled to 4 degrees C compared to standard refrigeration. Freezing to -20 degrees C reduced viable counts by 2.2-2.6 log10 CFU/cm(2) in 24 h. Rapid cooling to -20 degrees C (at -30 degrees C/min) enhanced the survival of C. coli 99/367 compared to freezing in a domestic freezer. Statistically significant interaction terms between specific strains were observed in mixed inoculums chilled to -20 degrees C by freezing in a domestic freezer and by rapid chilling to -20 degrees C. Rapid chilling of poultry, particularly for 4 degrees C storage may enhance survival of Campylobacter and although this is an issue that affects meat quality, it should be considered by poultry processors.

Campylobacter in housed broiler chickens: a longitudinal study of risk factors

Infections by Campylobacter spp. are a major cause of gastrointestinal disease in the United Kingdom. Most cases are associated with the consumption of chicken that has become contaminated during production. We investigated the epidemiology of Campylobacter spp. in chickens in a 3-year longitudinal study of flocks reared on 30 farms in the United Kingdom. We used Generalized Linear Mixed Effect Models (GLMM) to investigate putative risk factors associated with incidence and prevalence of flock infection arising from farm and flock management and local environmental conditions during rearing. We used survival analysis to investigate infection events and associated risk factors over the course of the study using two marginal models - the independent increment approach, which assumed that individual infection events were independent; and a conditional approach, which assumed that events were conditional on those preceding. Models of flock prevalence were highly overdispersed suggesting that infection within flocks was aggregated. The key predictors of flock infection identified from the GLMM analyses were mean temperature and mean rainfall in the month of slaughter and also the presence of natural ventilation. Mean temperature in the month of slaughter was also a significant predictor of flock infection, although the analyses suggested that the risk in flocks increased in a unimodal way in relation to temperature, peaking at 12 degrees C. The extent of pad burn was also identified as a predictor in these analyses. We conclude that predicting prevalence within flocks with linear modelling approaches is likely to be difficult, but that it may be possible to predict when flocks are at risk of Campylobacter infection. This is a key first step in managing disease and reducing the risks posed to the human food chain.

Broiler Campylobacter contamination and human campylobacteriosis in Iceland

To examine whether there is a relationship between the degree of Campylobacter contamination observed in product lots of retail Icelandic broiler chicken carcasses and the incidence of human disease, 1,617 isolates from 327 individual product lots were genetically matched (using the flaA short variable region [SVR[) to 289 isolates from cases of human campylobacteriosis whose onset was within approximately 2 weeks from the date of processing. When there was genetic identity between broiler isolates and human isolates within the appropriate time frame, a retail product lot was classified as implicated in human disease. According to the results of this analysis, there were multiple clusters of human disease linked to the same process lot or lots. Implicated and nonimplicated retail product lots were compared for four lot descriptors: lot size, prevalence, mean contamination, and maximum contamination (as characterized by direct rinse plating). For retail product distributed fresh, Mann-Whitney U tests showed that implicated product lots had significantly (P = 0.0055) higher mean contamination than nonimplicated lots. The corresponding median values were 3.56 log CFU/carcass for implicated lots and 2.72 log CFU/carcass for nonimplicated lots. For frozen retail product, implicated lots were significantly (P = 0.0281) larger than nonimplicated lots. When the time frame was removed, retail product lots containing Campylobacter flaA SVR genotypes also seen in human disease had significantly higher mean and maximum contamination numbers than lots containing no genotypes seen in human disease for both fresh and frozen product. Our results suggest that cases of broiler-borne campylobacteriosis may occur in clusters and that the differences in mean contamination levels may provide a basis for regulatory action that is more specific than a presence-absence standard.

Epidermal growth factor inhibits Campylobacter jejuni-induced claudin-4 disruption, loss of epithelial barrier function, and Escherichia coli translocation

Campylobacter jejuni is a leading cause of acute bacterial enteritis in humans. Poultry serves as a major reservoir of C. jejuni and is thought to act as a principal vehicle of transmission to humans. Epidermal growth factor (EGF) is a small amino acid peptide that exerts a broad range of activities on the intestinal epithelium. The aims of this study were to determine the effect of EGF on C. jejuni intestinal colonization in newly hatched chicks and to characterize its effects on C. jejuni-induced intestinal epithelial barrier disruption. White Leghorn chicks were treated with EGF daily, starting 1 day prior to C. jejuni infection, and were compared to control and C. jejuni-infected, EGF-treated chicks. Infected chicks shed C. jejuni in their feces throughout the study period. C. jejuni colonized the small intestine and cecum, disseminated to extraintestinal organs, and caused jejunal villus atrophy. EGF reduced jejunal colonization and dissemination of C. jejuni to the liver and spleen. In EGF-treated C. jejuni-infected chicks, villus height was not significantly different from that in untreated C. jejuni-infected chicks or controls. In vitro, C. jejuni attached to and invaded intestinal epithelial cells, disrupted tight junctional claudin-4, and increased transepithelial permeability. C. jejuni also promoted the translocation of noninvasive Escherichia coli C25. These C. jejuni-induced epithelial abnormalities were abolished by pretreatment with EGF, and the effect was dependent upon activation of the EGF receptor. These findings highlight EGF's ability to alter colonization of C. jejuni in the intestinal tract and to protect against pathogen-induced barrier defects.

Risk factors for infection with Campylobacter jejuni flaA genotypes

We aimed to explore Campylobacter genotype-specific risk factors in Australia. Isolates collected prospectively from cases recruited into a case-control study were genotyped using flaA restriction fragment-length polymorphism typing (flaA genotyping). Exposure information for cases and controls was collected by telephone interview. Risk factors were examined for major flaA genotypes using logistic and multinomial regression. Five flaA genotypes accounted for 325 of 590 (55%) cases - flaA-6b (n=129), flaA-6 (n=70), flaA-10 (n=48), flaA-2 (n=43), flaA-131 (n=35). In Australia, infections due to flaA-10 and flaA-2 were found to be significantly associated with eating non-poultry meat (beef and ham, respectively) in both case-control and inter-genotype comparisons. All major genotypes apart from flaA-10 were associated with chicken consumption in the case-control comparisons. Based on several clinical criteria, infections due to flaA-2 were more severe than those due to other genotypes. Thus genotype analysis may reveal genotype-specific niches and differences in virulence and transmission routes.

Systematic serotyping and riboprinting of Campylobacter spp. improves surveillance: experiences from two Danish counties

In order to monitor the distribution of subtypes of Campylobacter and to identify clusters, 975 isolates of Campylobacter spp., obtained from human infections occurring in two Danish counties, were studied during a 1-year period. The isolates were characterised by Penner serotyping and automated ribotyping. Pulsed-field gel electrophoresis (PFGE) profiling was used to confirm clustering of identical serotypes and ribotypes. The 975 isolates were divided into 48 serotypes, 210 ribotypes and 277 serotype-ribotype combinations. The overall distribution of serotypes and ribotypes was similar between the two counties. After taking into account the rare or common occurrence of subtypes, a model identified 43 clusters of subtypes during the study period. Clustered isolates represented 28% (273/975) of the study population, with clusters containing between three and 20 isolates. PFGE confirmed the validity of selected clusters identified by serotyping and ribotyping. The observed clustering of Campylobacter isolates, with identical types in time and place, indicates that common-source outbreaks of campylobacteriosis are more common than is usually thought.

Modelling of Campylobacter survival in frozen chicken meat

AIMS

To model the survival kinetics of Campylobacter jejuni on frozen chicken meat.

METHODS AND RESULTS

Three different types of chicken meat surface (skin, skinned muscle and cut muscle) were inoculated with stationary phase cells of C. jejuni (8 log(10) CFU cm(-2)) and frozen for 5 weeks at -20 degrees C. Bacterial numbers were determined weekly using two different methods of enumeration to quantify uninjured and injured cells. Analysis of variance of the results showed that the type of chicken surface and the method used to enumerate surviving cells were the most significant sources of variations in the numbers recovered (P < 0.0001), much more than the freezing time. To identify an appropriate model for the description of effects of freezing on survival over time, several models were fitted to the count data. Decay was found to be nonlinear. In general, survival was least on skin, better on skinned muscle and best on cut muscle. After 2 weeks, additional inactivation by freezing appeared to be negligible.

CONCLUSION

Because of the variability of survival it was not possible to fit and select a general model useful for all the different surfaces types.

SIGNIFICANCE AND IMPACT OF THE STUDY

The injured state of the cells leads to variability and the underestimation of bacterial survival. This is an essential factor for the assessment of Campylobacter-associated risk.

Cost-utility analysis to control Campylobacter on chicken meat: dealing with data limitations

The current article describes the economic evaluation of interventions to control Campylobacter on chicken meat by means of a cost-utility analysis. Apart from the methodology used, the main focus of this article is on data gaps and assumptions made, and their impact on results and conclusions. The direct intervention costs, the relative risk, the disease burden (expressed in disability-adjusted life years (DALYs)), and the costs of illness for the various interventions are necessary inputs for the cost-utility analysis. The cost-utility ratio (CUR) -- the measure for efficiency -- is expressed in net costs per avoided DALY. Most data gaps were of a biological order, but for some interventions, information on costs was also scarce. As a consequence, assumptions had to be made, which had some impact on the estimated CUR. A higher (lower) incidence of Campylobacter infections associated with chicken meat, higher (lower) effectiveness, and lower (higher) intervention costs, respectively, would result in absolute better (worse) CUR estimates. By taking the perspective of all consumers eating Dutch chicken meat, rather than only the Dutch society, absolute better CUR estimates could be obtained. Indirect costs or a shift toward non-Dutch chicken meat would both result in higher CUR estimates. Despite the assumptions made, three interventions showed for most of the applied sensitivity analyses relatively favorable CUR estimates: limiting fecal leakage during processing, carcass decontamination by dipping in a chemical solution, and the phage therapy. However, all three do have some clauses.

A farm-level study of risk factors associated with the colonization of broiler flocks with Campylobacter spp. in Iceland, 2001-2004

BACKGROUND

Following increased rates of human campylobacteriosis in the late 1990's, and their apparent association with increased consumption of fresh chicken meat, a longitudinal study was conducted in Iceland to identify the means to decrease the frequency of broiler flock colonization with Campylobacter. Our objective in this study was to identify risk factors for flock colonization acting at the broiler farm level.

METHODS

Between May 2001 and September 2004, pooled caecal samples were obtained from 1,425 flocks at slaughter and cultured for Campylobacter. Due to the strong seasonal variation in flock prevalence, analyses were restricted to a subset of 792 flocks raised during the four summer seasons. Flock results were collapsed to the farm level, such that the number of positive flocks and the total number of flocks raised were summed for each farm. Logistic regression models were fitted to the data using automated and manual selection methods. Variables of interest included manure management, water source and treatment, other poultry/livestock on farm, and farm size and management.

RESULTS

The 792 flocks raised during the summer seasons originated from 83 houses on 33 farms, and of these, 217 (27.4%) tested positive. The median number of flocks per farm was 14, and the median number of positive flocks per farm was three. Three farms did not have any positive flocks. In general, factors associated with an increased risk of Campylobacter were increasing median flock size on the farm (p

CONCLUSION

Limiting the average flock size, and limiting the number of houses built on new farms, are interventions that require investigation. Water may play a role in the transmission of Campylobacter, therefore the use of official water, and potentially, treating non-official water may reduce the risk of colonization. Manure management practices deserve further attention.

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MESH Headings

• Animal Husbandry/methods
• Animals
• Campylobacter/isolation & purification
• Campylobacter Infections/epidemiology
• Campylobacter Infections/etiology
• Campylobacter Infections/prevention & control
• Campylobacter Infections/veterinary
• Chickens
• Food Contamination/prevention & control
• Humans
• Iceland/epidemiology
• Logistic Models
• Manure/microbiology
• Population Density
• Poultry Diseases/epidemiology
• Poultry Diseases/etiology
• Poultry Diseases/prevention & control
• Prevalence
• Risk Factors
• Seasons
• Zoonoses

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Affiliation(s)

Michele T Guerin Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
Wayne Martin Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
Jarle Reiersen Reykjagarður hf, Fosshals 1, 112 Reykjavík, Iceland Agricultural Agency of Iceland, Austurvegur 64, 800 Selfoss, Iceland
Olaf Berke Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Bünteweg 2, D-30559 Hannover, Germany
Scott A McEwen Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
John-Robert Bisaillon Canadian Food Inspection Agency, Ottawa, Ontario, K2H 8P9, Canada
Ruff Lowman Canadian Food Inspection Agency, Ottawa, Ontario, K2H 8P9, Canada

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Campylobacter antimicrobial drug resistance among humans, broiler chickens, and pigs, France

We describe isolates from human Campylobacter infection in the French population and the isolates' antimicrobial drug resistance patterns since 1986 and compare the trends with those of isolates from broiler chickens and pigs from 1999 to 2004. Among 5,685 human Campylobacter isolates, 76.2% were C. jejuni, 17.2% C. coli, and 5.0% C. fetus. Resistance to nalidixic acid increased from 8.2% in 1990 to 26.3% in 2004 (p<10^-3), and resistance to ampicillin was high over time. Nalidixic acid resistance was greater for C. coli (21.3%) than for C. jejuni (14.9%, p<10^-3). C. jejuni resistance to ciprofloxacin in broilers decreased from 31.7% in 2002 to 9.0% in 2004 (p = 0.02). The patterns of resistance to quinolones and fluoroquinolones were similar between 1999 and 2004 in human and broiler isolates for C. jejuni. These results suggest a potential benefit of a regulation policy limiting use of antimicrobial drugs in food animals.

Prevalence of Campylobacter spp. in poultry and poultry products for sale on the Bulgarian retail market

The aim of this study was to investigate the presence of Campylobacter spp. in poultry and poultry products available for the consumers at retail markets in Bulgaria. Samples (n = 210) of poultry carcasses and poultry products for sale at the retail market in Bulgaria were analysed for the presence of Campylobacter spp., of these 35 frozen whole carcasses, 135 chilled poultry cuts (45 wing cuts, 45 thigh cuts and 45 fillet) and 40 thermally treated (ready-to-eat) poultry products. The results obtained showed that 35.2% of the frozen poultry carcasses for sale in the markets were Campylobacter contaminated. In the chilled poultry cuts Campylobacter was isolated at the highest percentage in wing- and thigh cuts, 91.1% and 88.9%, respectively. The fillet samples were contaminated by Campylobacter in 48.9% of cases. In the chilled poultry products as well as in the frozen carcasses C. jejuni (74.8%/70.3%) was the most commonly isolated Campylobacter species, with the remainder being C. coli (25.2%/29.7%). Campylobacter spp. were not detected in the thermally treated poultry products.

Decontamination of poultry carcasses using steam or hot water in combination with rapid cooling, chilling or freezing of carcass surfaces

The effects of the application of steam at atmospheric pressure for times up to 20 s on the numbers of inoculated Campylobacter jejuni and Escherichia coli on whole chicken carcasses were investigated in a pilot steam cabinet. Steam treatments reduced the numbers of C. jejuni AR6 by ca. 1.8, 2.6 and 3.3 log(10) cfu cm(-2) in 10, 12 and 20 s, respectively. Corresponding reductions in numbers of E. coli K12 were 1.7, 2.3 and 2.8 log(10) cfu cm(-2). However, such treatments caused the skin to shrink and change colour. The optimum treatment for maximum reductions of C. jejuni and E. coli, least skin shrinkage and change of colour was concluded to be <12 s. Further work was carried out to determine whether a modified air chilling system in combination with steam or hot water decontamination treatments could be used to reduce numbers of pathogens, particularly campylobacters, on the surface of poultry carcasses. Whole chicken carcasses inoculated with C. jejuni and E. coli were either not treated, treated with steam at atmospheric pressure for up to 10 s or treated with hot water at 80 degrees C for up to 20 s, then either chilled by crust freezing, chilled at 0 degrees C, or chilled at 15 degrees C, in a pilot chilling chamber. The optimum combination was treatment with water at 80 degrees C for 20 s followed by crust freezing, which reduced the numbers of C. jejuni and E. coli by ca. 2.9 and 3.2 log(10) cfu cm(-2), respectively, without extensive degradation of carcass appearance.

Campylobacters as zoonotic pathogens: a food production perspective

Campylobacters remain highly important zoonotic pathogens worldwide which infect an estimated 1% of the population of Western Europe each year. Certain campylobacters are also important in infections of animals, particularly of the reproductive tract, and some are involved in periodontal disease. This paper focuses, however, on the two species which are most important in food-borne infections of humans, Campylobacter (C.) jejuni and C. coli. Infection with these campylobacters is serious in its own right but can also have long-term sequelae such as reactive arthritis and Guillain-Barré syndrome. The pathogens are ubiquitous in nature and in domestic animals and, as a consequence, are found frequently in the environment and on many raw foods, of both plant and animal origin and bacterial numbers can be very high on certain key foods like raw poultry meat. Although all commercial poultry species can carry campylobacters, the risk is greater from chicken because of the high levels of consumption. Campylobacters are relatively 'new' zoonotic pathogens as routine culture from clinical specimens only became possible in the late 1970s. As a consequence there is much that still needs to be understood about the behaviour and pathogenicity of these highly important bacteria. In particular, and from a food industry/food safety perspective, it is important to better understand the behaviour of C. jejuni and C. coli in the food production environment, and how this affects their ability to survive certain food production processes. There is a belief that campylobacters are much more sensitive to hostile conditions than either salmonellas or Escherichia coli. Much of data to support this view have been derived from laboratory experiments and may not fully represent the natural situation. Studies are showing that campylobacters may be more robust than previously thought and thus may represent a greater challenge to food safety. We recommend that research is undertaken to better understand how campylobacters behave in the food chain and how responses to relevant conditions affect their ability to survive processing and their virulence. There is also a need to better understand the reasons why campylobacters are capable of frequent change, particularly in the expression of surface antigens.

Frequency and Enumeration of Campylobacter Species from Processed Broiler Carcasses by Weep and Rinse Samples

Frequency and numbers of Campylobacter spp. were assessed per freshly processed, contaminated broiler carcass. Campylobacter-positive flocks were identified by cecal sample analysis at slaughter. These flocks had been tested as Campylobacter negative at 4.1 +/- 0.9 d prior to slaughter. Levels of contamination were estimated using 2 sampling approaches per carcass: (1) free weep fluids and (2) whole-carcass, 100 mL of distilled water rinses. Estimations of counts were determined by directly plating dilutions of weeps and rinses onto Campy-Cefex agar and incubating the plates at 41.5 degrees C under microaerobic atmosphere. Confirmation was provided by latex agglutination to quantify levels per milliliter of weep and per 100 mL of rinse. Thirty-two slaughter groups ( approximately 20 carcasses per group) were compared from 2003 to 2004. The Campylobacter-positive weep frequency was 84.8%, whereas the frequency for rinse samples was 74.4% (P < 0.001). Enumeration of Campylobacter spp. on positive samples ranged from 0.70 to 6.13 log(10) cfu/mL of weep (geometric mean of 2.84) and from 2.30 to 7.72 log(10) cfu/100 mL of rinse (geometric mean of 4.38). The correlations between weep and rinse were 0.814 with 0.5 mL of rinse and 0.6294 when applying 0.1 mL of rinse The quantitative regression analyses for these 2 corresponding tests were log(10) rinse (for 0.5 mL of inoculum) = 1.1965 log(10) weep + 0.4979, and log(10) rinse (for 0.1 mL of inoculum) = 1.322 log(10) weep - 0.1521. FlaA SVR sequencing of isolates indicated that the same genotypes were found in weep and rinse samples. Weep and rinse sampling led to different proportions of Campylobacter-positive carcasses detection, but we demonstrated that this difference was reduced by increasing the amount of rinse fluid used for plating.

A seven-year survey of Campylobacter contamination in meat at different production stages in Belgium

The presence of Campylobacter was assessed in different samples of poultry, pork and beef meat and carcasses from slaughterhouses, production plants and retail level. An introductory study from 1997 to 1999, had the purpose of establishing the optimum dilution to detect changes in prevalence and allowed a semi-quantitative estimation of poultry and pork contamination. Following this, between 2000 and 2003, 4254 samples were taken in order to study the trends. The poultry matrixes represented the greatest number and the most highly contaminated samples, with 30.9% (in 0.01 g) positive samples, 18.7% (in 1 g), 46.9% (in 25 g) and 19.6% (in 0.01 g) for broiler carcasses, broiler fillets, prepared chicken and layer carcasses, respectively. Broiler carcasses and fillets sampled at retail level were significantly less contaminated than samples from production plants. Pork, beef and veal samples were rarely contaminated and, where contamination existed, it was at a low prevalence (maximum 5.0%). The high and unvarying prevalence of Campylobacter in poultry necessitates the implementation of intervention measures at the primary production level, in addition to methods of minimizing cross-contamination at the processing level. A survey plan in line with the present study could be used in the future to monitor the effects of the planned measures and performance objectives and to follow the evolution of Campylobacter contamination at all stages of the food chain, in accordance with European legislation.

Campylobacter spp. contamination of chicken carcasses during processing in relation to flock colonisation

The presence and numbers of campylobacters on chicken carcasses from 26 slaughter groups, originating from 22 single-house flocks and processed in four UK plants, were studied in relation to the level of flock colonisation determined by examining the caecal contents of at least ten birds per group. The prevalence of campylobacters on carcasses from five campylobacter-negative flocks processed just after other negative flocks was low (</=30%). Campylobacters were isolated from 90 to 100% of carcasses from three flocks which were partly colonised, with 5, 5 and 30% of caecal contents positive, and which were processed after fully colonised flocks. All carcasses from the remaining fully colonised flocks were contaminated with campylobacters, and they had significantly (P<0.001) higher numbers per carcass (average of 5.3 log(10) cfu; range: 1.3 to >8.0 log(10) cfu) than carcasses originating from low prevalence flocks (average of 2.3 log(10) cfu; range: <1.1 to 4.1 log(10) cfu). There was a reduction in the numbers of campylobacters on carcasses between plucking and chilling in eight of ten fully colonised flocks. In another eight flocks, a significant (P<0.001) decrease (0.8 log(10) cfu) in the number of campylobacters on carcasses from just before to after chilling was detected. Campylobacter spp. could be isolated from aerosols, particles and droplets in considerable numbers in the hanging-on, defeathering and evisceration areas but not in the chillers. This was the case even when campylobacters were not isolated from the target flock. Campylobacters on carcasses from two partly colonised flocks were either the same subtype, as determined by speciation, Multi-Locus Sequence Typing (MLST) and flaA Restricted Fragment Length Polymorphism (RFLP) typing, as those in the fully colonised flocks processed previously, although not necessarily the most prevalent ones; or were the same subtypes as those found in the caeca of the flock itself. The prevalences of the different campylobacter subtypes found on carcasses from two fully colonised flocks did not closely reflect those found in the caeca. MLST combined with flaA RFLP provided a good method for ascertaining the relatedness of strains isolated from carcasses and caecal contents. This study showed that carcass contamination is related to the within-flock prevalence of campylobacter colonisation, but that contamination from previously processed flocks was also significant, especially on carcasses from low prevalence flocks. Forced dry air cooling of carcasses reduced contamination levels.

Campylobacter spp. subtype analysis using gel-based repetitive extragenic palindromic-PCR discriminates in parallel fashion to flaA short variable region DNA sequence analysis

AIMS

The repetitive extragenic palindromic-PCR (rep-PCR) subtyping technique, which targets repetitive extragenic DNA sequences in a PCR, was optimized for Campylobacter spp. These data were then used for comparison with the established genotyping method of flaA short variable region (SVR) DNA sequence analysis as a tool for molecular epidemiology.

METHODS AND RESULTS

Uprime Dt, Uprime B1 or Uprime RI primers were utilized to generate gel-based fingerprints from a set of 50 Campylobacter spp. isolates recovered from a variety of epidemiological backgrounds and sources. Analysis and phenogram tree construction, using the unweighted pair group method with arithmetic mean, of the generated fingerprints demonstrated that the Uprime Dt primers were effective in providing reproducible patterns (100% typability, 99% reproducibility) and at placing isolates into epidemiological relevant groups. Genetic stability of the rep-PCR Uprime Dt patterns under nonselective, short-term transfer conditions revealed a Pearson's correlation approaching 99%. These same 50 Campylobacter spp. isolates were analysed by flaA SVR DNA sequence analysis to obtain phylogenetic relationships.

CONCLUSIONS

The Uprime Dt primer-generated rep-PCR phenogram was compared with a phenogram generated from flaA SVR DNA sequence analysis of the same isolates. Comparison of the two sets of resulting genomic relationships revealed that both methods segregated isolates into similar groups.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results indicate that rep-PCR analysis performed using the Mo Bio Ultra Clean Microbial Genomic DNA Isolation Kit for DNA isolation and the Uprime DT primer set for amplification is a useful and effective tool for accurate differentiation of Campylobacter spp. for subtyping and epidemiological analyses.

Distribution of Campylobacter genotypes on broilers during slaughter

The highly discriminatory genotyping methods now available for Campylobacter have enabled investigation of the diversity, origin, and route of transmission of this organism. In this study, we investigated the frequency of several genotypes of Campylobacter on chicken carcasses postchilling and on neck skin and cloacal swabs taken at slaughter. Campylobacter isolates recovered with and without enrichment from carcasses were subtyped by macrorestriction profiling. Subtyping 199 Campylobacter isolates from 36 carcasses revealed an average of 1.5 genotypes per carcass. The genotypes present on carcasses were, in most cases, also found in the cloacal samples taken at the beginning of the slaughter process. However, genotypes present on carcasses were, in some cases, not found in the corresponding cloacal samples but in cloacal samples of the preceding slaughter group and, in one case, from the preceding day. The genotypes present in cloacal samples were, with one exception, also found on the corresponding carcasses, indicating that most genotypes survive processing. In most cases, there was a difference of several bands between genotypes present in the same slaughter group, indicating different origins of the isolates rather than the occurrence of a recombination event. However, in two cases, a recombination event could have generated the difference in band patterns seen for two pairs of isolates with nearly identical band patterns, even after cleavage with a second restriction enzyme. The results indicate that individual Campylobacter-positive Swedish chicken carcasses, as well as whole carcass groups, are, in general, contaminated by one or two different genotypes.

Genetic variability of Campylobacter jejuni isolated from fresh and frozen broiler carcasses

AIMS

The aim of this study was to determine the genetic variability of Campylobacter jejuni isolates from poultry before and after freezing treatment in order to identify genotypes that would survive the treatment.

METHODS AND RESULTS

C. jejuni was isolated from both fresh and frozen halves of the same carcass after freezing for 2 or more than 20 days at -20 degrees C. From 36 carcasses, representing five unrelated flocks in Norway, a total of 209 isolates were included in the study. Thirty-two of the isolates were recovered with a qualitative method while the remaining 177 were isolated using a quantitative method. Isolates were genotyped with fluorescent amplified fragment length polymorphism using MfeI and BglII restriction enzymes. Nine different genotypes were identified, however, one genotype was shown to be dominant in three different flocks. This genotype and the dominant genotype of another flock were found among isolates from fresh and frozen broiler halves. They were also shown to be identical to genotypes frequently identified among strains isolated from humans, cattle and poultry flocks in previous years.

CONCLUSIONS

Freezing treatment or isolation method appeared not to select for a particular genotype.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of the present study indicate that the freezing tolerance of strains is not genotype dependent.

The influence of freezing and duration of storage on Campylobacter and indicator bacteria in broiler carcasses

In total, 215 commercially processed broiler carcasses were examined to determine optimum cultural enumeration, the effects of freezing, method of thawing, and duration of frozen storage on levels of Campylobacter spp. and fecal coliforms. Enumeration studies compared MPN procedures to direct plating onto selective mCCDA agar and indicated equivalency for quantitation of Campylobacter spp. Levels of Campylobacter and fecal coliforms were subsequently estimated by direct plating of carcass rinses. Freezing of naturally contaminated carcasses followed by storage at -20 degrees C for 31, 73, 122 and 220 days showed statistically significant (P< or =0.05) reductions in Campylobacter counts initially as compared with counts found on fresh product. Among 5 lots of broilers, levels of Campylobacter on carcasses were reduced by log mean values ranging from 0.65 to 2.87 after freezing and 31 days of storage. Similar reductions due to freezing were not observed for fecal coliforms counts. The level of Campylobacter was reduced by approximately one log immediately after freezing, and remained relatively constant during the 31-220 days of frozen storage. The levels were constant during 7 days of refrigerated storage. After 31 days of frozen storage there was a reduced rate in reduction of counts among broilers thawed at 7 degrees C as compared to thawing at 22 degrees C with either cultural method (MPN and mCCDA). These findings warrant consideration of the public health benefits related to freezing contaminated poultry prior to commercial distribution to reduce Campylobacter exposure levels associated with contaminated carcasses.

Analysis of Campylobacter spp. contamination in broilers from the farm to the final meat cuts by using restriction fragment length polymorphism of the polymerase chain reaction products

We investigated the genotype diversity and dynamics of Campylobacter jejuni and Campylobacter coli in six commercial broiler farms during rearing and abattoir processing. In total, 223 C. jejuni and 36 C. coli strains isolated (on farm, transportation crates, carcasses after defeathering, and chicken wing meat at the end of the processing line) were subtyped by PCR-RFLP based on flagellin (fla typing) gene. Eleven (C. jejuni) and four (C. coli) different RFLP patterns were found. Multiple C. jejuni genotypes were identified in five out of six farms (except Farm 5). Furthermore, a clear tendency for dominance of particular genotypes was observed in almost all farms except Farm 3. Although diverse C. jejuni genotypes were isolated on the farms and transport crates, they were not detected in chicken wing cuts at the end of the processing line. We also observed varied distribution of types in different sampling stages both at the farm level and the processing environment. However, the interpretation of such fluctuations is precarious as new types occurred on some occasions, particularly during processing. Our results show that chicken wing meat contamination resulted mainly from farm strain carryover, and that the carcasses were probably contaminated during processing. In addition, the new strain types observed were isolated more frequently after defeathering as compared to other processing steps. Therefore, this stage, in addition to evisceration, is one of the critical control points in the processing line to prevent cross-contamination and for controlling the spread of campylobacters.

Incidence trend and risk factors for campylobacter infections in humans in Norway

BACKGROUND

The objectives of the study were to evaluate whether the increase in incidence of campylobacteriosis observed in humans in Norway from 1995 to 2001 was statistically significant and whether different biologically plausible risk factors were associated with the incidence of campylobacteriosis in the different counties in Norway.

METHODS

To model the incidence of domestically acquired campylobacteriosis from 1995 to 2001, a population average random effect poisson model was applied (the trend model). To case data and assumed risk-factor/protective data such as sale of chicken, receiving treated drinking water, density of dogs and grazing animals, occupation of people in the municipalities and climatic factors from 2000 and 2001, an equivalent model accounting for geographical clustering was applied (the ecological model).

RESULTS

The increase in incidence of campylobacteriosis in humans in Norway from 1995 to 2001 was statistically significant from 1998. Treated water was a protective factor against Campylobacter infections in humans with an IRR of 0.78 per percentage increase in people supplied. The two-level modelling technique showed no evidence of clustering of campylobacteriosis in any particular county. Aggregation of data on municipality level makes interpretation of the results at the individual level difficult.

CONCLUSION

The increase in incidence of Campylobacter infections in humans from 1995 to 2001 was statistically significant from 1998. Treated water was a protective factor against Campylobacter infections in humans with an IRR of 0.78 per percentage increase in people supplied. Campylobacter infections did not appear to be clustered in any particular county in Norway.

Is the major increase in notified campylobacteriosis in New Zealand real?

Notifications of campylobacteriosis by New Zealand medical practitioners have increased steadily in the last two decades. To determine if this increase is real, as opposed to a surveillance artefact, we examined both available notification (1980-2003) and hospitalization data (1995-2003). The similarity in the temporal pattern of increasing hospitalizations for campylobacteriosis, with that of notifications, is suggestive that this increase is indeed real. Although some risk factors for this disease have been identified (e.g. uncooked poultry consumption) it is unclear what the likely causes of the increasing rates are. The overall disease burden is also high compared with other developed countries (an annual notification rate of 396 cases per 100000 population in 2003), with highest rates in children aged 1-4 years, males, Europeans, and those living in urban areas. Given the large disease burden, further research and intervention studies should be public health priorities in this country.

Risk factors for Campylobacter spp. colonization in broiler flocks in Iceland

We sampled 1,091 Icelandic broiler flocks at slaughter from May 2001 to December 2003 to determine the prevalence of, and investigate risk factors for the presence of, Campylobacter spp. at the flock level. Approximately 15% of the flocks were positive for Campylobacter spp.; most (95%) of the infected flocks being raised during the months of April-September. Based on the data from the latter months, and using multivariable logistic regression with random effects for herd, we found that the odds of a flock being positive for Campylobacter spp. increased with age and flock size. Additionally, vertical ventilation systems were strongly associated with positive flocks (OR=5.3). After controlling for these variables, we found no evidence of an effect of: year; company; Campylobacter being carried over from one flock to the next; time interval between flocks; using (at the hatcheries) eggs laid on the floor; density of bird housing, or the number of catch lots a flock was divided into for slaughtering purposes on the risk of a Campylobacter-positive flock.

Counts of Campylobacter spp. on U.S. broiler carcasses

Foodborne Campylobacter-associated gastroenteritis remains a public health concern, and the Centers for Disease Control and Prevention suggests that improperly handled poultry is the most important source of this human disease. In response to these concerns, 10 of the largest U.S. poultry integrators cooperatively determined the incidence and counts of Campylobacter on processed broiler carcasses. Prior to conducting the survey, laboratory personnel were trained in a direct Campy-Cefex plating procedure for enumeration of the organism. Before and after the survey enumeration, consistency in reporting was compared among the participating laboratories. Participating laboratories were able to consistently estimate inoculated concentrations of Campylobacter in carcass rinses. Within the central study, we determined the potential exposure of U.S. consumers to Campylobacter spp. associated with broiler carcasses during a 13-month period. Among each of the 13 participating poultry complexes, rinses from 25 randomly selected fully processed carcasses were sampled monthly from individual flocks. Among 4200 samples, approximately 74% of the carcasses yielded no countable Campylobacter cells. Campylobacter spp. were isolated from approximately 3.6% of all commercially processed broiler carcasses at more than 10(5) CFU per carcass. Acceptable counts of these organisms on raw poultry carcasses remain to be determined. Nevertheless, this survey indicates industry recognition of its responsibility to assess and reduce public exposure to Campylobacter through broiler chickens.

Campylobacter in poultry: filling an ecological niche

Epidemiological studies indicate that Campylobacter species may be responsible for the majority of cases of sporadic gastroenteritis in humans. These studies also suggest that poultry may be one of the most common sources of the bacteria for humans. Campylobacter and related genera in the family Campylobacteraceae are oral and intestinal commensals of vertebrates and some nonvertebrates, a characteristic that complicates rational approaches to controlling Campylobacter contamination of poultry. This review will discuss the phylogeny, genomics, and physiology of campylobacters with the intention of revealing how these organisms have evolved to fill their intestinal ecological niche in poultry and how their physiology must be understood in order to enact effective control strategies.

Fresh chicken as main risk factor for campylobacteriosis, Denmark

Increased consumption of fresh poultry in Denmark has contributed substantially to the increasing incidence of human campylobacteriosis.

We report the findings of a case-control study of risk factors for sporadic cases of human campylobacteriosis in Denmark. In 3 different analytical models, the main domestic risk factor identified was eating fresh, unfrozen chicken. Specifically, 28 of 74 domestically acquired case-patients were exposed to fresh chicken compared with 21 of 114 controls (multivariate matched odds ratio 5.8; 95% confidence interval 2.1–15.9). In contrast, a risk from eating other poultry, including previously frozen chicken, was only indicated from borderline significant 2-factor interactions. The marked increase in consumption of fresh, unfrozen poultry in Denmark during the 1990s likely contributed substantially to the increasing incidence of human campylobacteriosis in this period.

Occurrence of Campylobacter spp. in cecal contents among commercial broilers in iceland

Campylobacter jejuni remains the most frequently reported bacterial cause of human gastroenteritis in Nordic countries. The primary source of transmission to humans is suggested as mishandled raw poultry or consuming improperly prepared chicken. The focus of this report was to characterize the prevalence and cell numbers of the organism within the commercial Icelandic poultry industry. Commercial broiler flocks were sampled from May 2001 through 2003 in a total population study. At the slaughter plant, 40 randomly selected ceca were obtained from each flock, pooled into four samples containing 10 ceca each, and analyzed. Cell numbers and prevalence of Campylobacter spp. were estimated by direct plating of dilutions onto Campy-Cefex agar and incubating the plates at 42 degrees C under microaerobic atmosphere; colonies were confirmed as Campylobacter spp. by microscopy and latex agglutination to provide quantification of cell numbers per gm of cecal material. A total of 15.4% of the flocks carried the organism at at a maximum cell number of 8.1 x 10(7) cfu/g, having a mean raw count of colonized birds at 1.3 x 10(7) cfu/g (geometric mean of 1.5 x 10(6)). During the 3 years of sampling, the prevalence ranged from 17.6% to 17.3% to 12.7% for slaughter years 2001, 2002, and 2003, respectively. Isolation rates varied with numbers of catch lots (groups of birds taken for slaughter)/flock; with one catch lot/flock, the prevalence was 13.7%, with two 17.5%, and with three 33.3%. With increased flock size, isolation rates also increased; flocks of greater than 5,000 birds had a prevalence of 12.0% positive, 14.0% of flocks with 5,000-10,000 birds were positive, and 25.5% of flocks with more than 10,000 birds were positive for Campylobacter spp. Isolation rates varied with the processing lines: M was positive at 17.3%, B was positive at 10.1%, and G at 17.2%. Flocks were more frequently colonized in the warmer months, and younger birds were less frequently colonized than were older slaughtered birds. This study provides descriptive microbiology pertaining to Iceland broilers in a total population study.

Survival of Campylobacter on frozen broiler carcasses as a function of time

In the Norwegian Action Plan against Campylobacter in broilers, carcasses from flocks identified as positive before slaughter are either heat treated or frozen for 5 weeks to reduce the number of Campylobacter. The objective of this study was to estimate the effect of freezing time and predict the number of Campylobacter on naturally infected or contaminated broiler carcasses following freezing for 2, 4, 6, 8, 10, 13, 21, 35, and 120 days by nonparametric and parametric linear statistical models. From each of the five flocks, 27 carcasses were sampled. Each carcass was cut in two pieces along the chest bone. Half was put into the freezer (-20 degrees C), whereas the other was deskinned and quantitative culturing was conducted from a 10-g sample of the skin. Fifteen frozen halves were selected at random at each time point following freezing from 2 to 120 days, and skin samples from these were cultured quantitatively and qualitatively. In regard to the log reduction of Campylobacter, almost similar results were obtained using three statistical methods; median regression on the change in Campylobacter counts, zero-inflated negative binomial regression, and a Bayesian Markov chain Monte Carlo (decay) model on original counts. Overall, a 2-log reduction of Campylobacter was obtained after 3 weeks of freezing. Only a marginal extra effect was observed when extending the freezing to 5 weeks. Although freezing appears to be an efficient way to reduce the level of Campylobacter on broiler carcasses, in 80% of the carcasses Campylobacter could still be detected using quantitative culturing following 120 days of freezing. Based on the high number of zeros, these data should be modeled by a zero-inflated model. The best statistical fit in regard to goodness-of-fit measures was the zero-inflated negative binomial log link model, closely followed by the Poisson model. Thus, in our continued search for a better way to describe the data, we used the Poisson distribution in the mixed Bayesian decay models.

Effect of preslaughter events on prevalence of Campylobacter jejuni and Campylobacter coli in market-weight turkeys

The effects of events which occur prior to slaughter, such as loading, transport, and holding at an abattoir, on the prevalence of Campylobacter species, including Campylobacter jejuni and Campylobacter coli, were examined. Cloacal swabs from market-weight turkeys in each of five flocks were obtained on a farm prior to loading (time 1; 120 swabs per flock) and after transport and holding at the abattoir (time 2; 120 swabs per flock). A statistically significant increase in the overall prevalence of Campylobacter spp. was observed for cloacal swabs obtained from farm 3 following transport (P < 0.01). At time 2, an increase in the prevalence of C. coli was also noted for cloacal swabs from farms 3, 4, and 5 (P < 0.01). Neither the minimum time off of feed nor the distance transported from the farm to the abattoir was correlated with the increase in C. coli prevalence. Similarly, responses to an on-farm management questionnaire failed to detect any factors contributing to the observed changes in Campylobacter sp. prevalence. A SmaI macrorestriction analysis of Campylobacter sp. isolates recovered from flock 5 indicated that C. coli was more diverse than C. jejuni at both time 1 and time 2 (P < 0.01), based on a comparison of the Shannon indices of diversity and evenness.

Disease risks from foods, England and Wales, 1996-2000

Data from population-based studies and national surveillance systems were collated and analyzed to estimate the impact of disease and risks associated with eating different foods in England and Wales. From 1996 to 2000, an estimated 1,724,315 cases of indigenous foodborne disease per year resulted in 21,997 hospitalizations and 687 deaths. The greatest impact on the healthcare sector arose from foodborne Campylobacter infection (160,788 primary care visits and 15,918 hospitalizations), while salmonellosis caused the most deaths (209). The most important cause of indigenous foodborne disease was contaminated chicken (398,420 cases, risk [cases/million servings] = 111; case-fatality rate [deaths/100,000 cases] = 35, deaths = 141). Red meat (beef, lamb, and pork) contributed heavily to deaths, despite lower levels of risk (287,485 cases, risk = 24, case-fatality rate = 57, deaths = 164). Reducing the impact of indigenous foodborne disease is mainly dependent on controlling the contamination of chicken.

Flies and Campylobacter infection of broiler flocks

A total of 8.2% of flies caught outside a broiler house in Denmark had the potential to transmit Campylobacter jejuni to chickens, and hundreds of flies per day passed through the ventilation system into the broiler house. Our study suggests that flies may be an important source of Campylobacter infection of broiler flocks in summer.

Freezing: an underutilized food safety technology?

Freezing is an ancient technology for preserving foods. Freezing halts the activities of spoilage microorganisms in and on foods and can preserve some microorganisms for long periods of time. Frozen foods have an excellent overall safety record. The few outbreaks of food-borne illness associated with frozen foods indicate that some, but not all human pathogens are killed by commercial freezing processes. Freezing kills microorganisms by physical and chemical effects and possibly through induced genetic changes. Research is needed to better understand the physical and chemical interactions of various food matrices with the microbial cell during freezing and holding at frozen temperatures. The literature suggests that many pathogenic microorganisms may be sublethally injured by freezing, so research should be done to determine how to prevent injured cells from resuscitating and becoming infectious. Studies on the genetics of microbial stress suggest that the induction of resistance to specific stresses may be counteracted by, for example, simple chemicals. Research is needed to better understand how resistance to the lethal effect of freezing is induced in human pathogens and means by which it can be counteracted in specific foods. Through research, it seems possible that freezing may in the future be used to reliably reduce populations of food-borne pathogens as well as to preserve foods.

Application of host-specific bacteriophages to the surface of chicken skin leads to a reduction in recovery of Campylobacter jejuni

Retail poultry products are widely purported as the major infection vehicle for human campylobacteriosis. Numerous intervention strategies have sought to reduce Campylobacter contamination on broiler carcasses in the abattoir. This study reports the efficacy of bacteriophage in reducing the number of recoverable Campylobacter jejuni cells on artificially contaminated chicken skin.