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Cribb DM, Glass K, Lancsar EL, Stafford RJ, Wallace RL, Kirk MD, McLure AT. Burden and Cost of Campylobacter Risk Factors in Australia. Foodborne Pathog Dis 2024. [PMID: 39206520 DOI: 10.1089/fpd.2024.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Campylobacter is a globally important pathogen with well-studied risk factors, but the burden of risk factors has not been quantified. We quantified the cost of illness attributable to specific domestic risk factors for C. jejuni and C. coli in Australia. We used data from a 2018-2019 case-control study to estimate odds ratios and attributable fractions for risk factors. We used data on national incidence, hospitalization, and premature mortality to quantify burden. We then applied costs related to healthcare utilization, pain and suffering, premature mortality, and lost productivity to each risk factor. In Australia, C. jejuni caused 83.0% of campylobacteriosis infections and chicken consumption resulted in the highest attributable fraction (30.0%), costing approximately US$110 million annually. The excess burden of campylobacteriosis associated with the use of proton-pump inhibitors (PPIs) was US$45 million, with almost half these costs due to disease in adults over 65 years of age. Contact with young dogs (US$30 million) and chicken feces (US$10 million) also contributed to costs and burden. Campylobacteriosis is a significant cost to Australia, particularly because of lost productivity. Effective cross-sectoral interventions to improve chicken meat safety and reduce inappropriate use of PPIs might have substantial economic and human benefits.
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Affiliation(s)
- Danielle M Cribb
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Emily L Lancsar
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Russell J Stafford
- OzFoodNet, Communicable Diseases Branch, Queensland Health, Brisbane, Australia
| | - Rhiannon L Wallace
- Agassiz Research and Development Centre, Agriculture and Agri-Food Canada, Agassiz, Canada
| | - Martyn D Kirk
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Angus T McLure
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
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Shrestha S, Malla B, Haramoto E. High-throughput microfluidic quantitative PCR system for the simultaneous detection of antibiotic resistance genes and bacterial and viral pathogens in wastewater. ENVIRONMENTAL RESEARCH 2024; 255:119156. [PMID: 38759773 DOI: 10.1016/j.envres.2024.119156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/19/2024]
Abstract
Comprehensive data on bacterial and viral pathogens of diarrhea and studies applying culture-independent methods for examining antibiotic resistance in wastewater are lacking. This study aimed to simultaneously quantify antibiotic resistance genes (ARGs), class 1 integron-integrase (int1), bacterial and viral pathogens of diarrhea, 16S rRNA, and other indicators using a high-throughput quantitative PCR (HT-qPCR) system. Thirty-six grab wastewater samples from a wastewater treatment plant in Japan, collected three times a month between August 2022 and July 2023, were centrifuged, followed by nucleic acid extraction, reverse transcription, and HT-qPCR. Fourteen targets were included, and HT-qPCR was performed on the Biomark X9™ System (Standard BioTools). For all qPCR assays, R2 was ≥0.978 and the efficiencies ranged from 90.5% to 117.7%, exhibiting high performance. Of the 36 samples, 20 (56%) were positive for Norovirus genogroup II (NoV-GII), whereas Salmonella spp. and Campylobacter jejuni were detected in 24 (67%) and Campylobacter coli in 13 (36%) samples, with mean concentrations ranging from 3.2 ± 0.8 to 4.7 ± 0.3 log10 copies/L. NoV-GII detection ratios and concentrations were higher in winter and spring. None of the pathogens of diarrhea correlated with acute gastroenteritis cases, except for NoV-GII, suggesting the need for data on specific bacterial infections to validate bacterial wastewater-based epidemiology (WBE). All samples tested positive for sul1, int1, and blaCTX-M, irrespective of season. The less explored blaNDM-1 showed a wide prevalence (>83%) and consistent abundance ranging from 4.3 ± 1.0 to 4.9 ± 0.2 log10 copies/L in all seasons. sul1 was the predominant ARG, whereas absolute abundances of 16S rRNA, int1, and blaCTX-M varied seasonally. int1 was significantly correlated with blaCTX-M in autumn and spring, whereas it showed no correlation with blaNDM-1, questioning the applicability of int1 as a sole indicator of overall resistance determinants. This study exhibited that the HT-qPCR system is pivotal for WBE.
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Affiliation(s)
- Sadhana Shrestha
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, Yamanashi, 400-8511, Japan.
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, Yamanashi, 400-8511, Japan.
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, Yamanashi, 400-8511, Japan.
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Cribb DM, Moffatt CRM, Wallace RL, McLure AT, Bulach D, Jennison AV, French N, Valcanis M, Glass K, Kirk MD. Genomic and clinical characteristics of campylobacteriosis in Australia. Microb Genom 2024; 10:001174. [PMID: 38214338 PMCID: PMC10868609 DOI: 10.1099/mgen.0.001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
Campylobacter spp. are a common cause of bacterial gastroenteritis in Australia, primarily acquired from contaminated meat. We investigated the relationship between genomic virulence characteristics and the severity of campylobacteriosis, hospitalisation, and other host factors.We recruited 571 campylobacteriosis cases from three Australian states and territories (2018-2019). We collected demographic, health status, risk factors, and self-reported disease data. We whole genome sequenced 422 C. jejuni and 84 C. coli case isolates along with 616 retail meat isolates. We classified case illness severity using a modified Vesikari scoring system, performed phylogenomic analysis, and explored risk factors for hospitalisation and illness severity.On average, cases experienced a 7.5 day diarrhoeal illness with additional symptoms including stomach cramps (87.1 %), fever (75.6 %), and nausea (72.0 %). Cases aged ≥75 years had milder symptoms, lower Vesikari scores, and higher odds of hospitalisation compared to younger cases. Chronic gastrointestinal illnesses also increased odds of hospitalisation. We observed significant diversity among isolates, with 65 C. jejuni and 21 C. coli sequence types. Antimicrobial resistance genes were detected in 20.4 % of isolates, but multidrug resistance was rare (0.04 %). Key virulence genes such as cdtABC (C. jejuni) and cadF were prevalent (>90 % presence) but did not correlate with disease severity or hospitalisation. However, certain genes (e.g. fliK, Cj1136, and Cj1138) appeared to distinguish human C. jejuni cases from food source isolates.Campylobacteriosis generally presents similarly across cases, though some are more severe. Genotypic virulence factors identified in the literature to-date do not predict disease severity but may differentiate human C. jejuni cases from food source isolates. Host factors like age and comorbidities have a greater influence on health outcomes than virulence factors.
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Affiliation(s)
- Danielle M. Cribb
- National Centre for Epidemiology and Population Health, the Australian National University, Canberra, Australia
| | - Cameron R. M. Moffatt
- Queensland Health Forensic and Scientific Services, Coopers Plains, Brisbane, Australia
| | - Rhiannon L. Wallace
- Agriculture and Agri-Food Canada, Agassiz Research and Development Centre, Agassiz, British Columbia, Canada
| | - Angus T. McLure
- National Centre for Epidemiology and Population Health, the Australian National University, Canberra, Australia
| | - Dieter Bulach
- Melbourne Bioinformatics, The University of Melbourne, Melbourne, Australia
- Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Amy V. Jennison
- Queensland Health Forensic and Scientific Services, Coopers Plains, Brisbane, Australia
| | - Nigel French
- Tāwharau Ora|School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Mary Valcanis
- Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, the Australian National University, Canberra, Australia
| | - Martyn D. Kirk
- National Centre for Epidemiology and Population Health, the Australian National University, Canberra, Australia
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Zhang S, Shi J, Li X, Tiwari A, Gao S, Zhou X, Sun X, O'Brien JW, Coin L, Hai F, Jiang G. Wastewater-based epidemiology of Campylobacter spp.: A systematic review and meta-analysis of influent, effluent, and removal of wastewater treatment plants. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166410. [PMID: 37597560 DOI: 10.1016/j.scitotenv.2023.166410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
Campylobacter spp. is one of the four leading causes of diarrhoeal diseases worldwide, which are generally mild but can be fatal in children, the elderly, and immunosuppressed persons. The existing disease surveillance for Campylobacter infections is usually based on untimely clinical reports. Wastewater surveillance or wastewater-based epidemiology (WBE) has been developed for the early warning of disease outbreaks and the detection of the emerging new variants of human pathogens, especially after the global pandemic of COVID-19. However, the WBE monitoring of Campylobacter infections in communities is rare due to a few large data gaps. This study is a meta-analysis and systematic review of the prevalence of Campylobacter spp. in various wastewater samples, primarily the influent of wastewater treatment plants. The results showed that the overall prevalence of Campylobacter spp. was 53.26 % in influent wastewater and 52.97 % in all types of wastewater samples. The mean concentration in the influent was 3.31 ± 0.39 log10 gene copies or most probable number (MPN) per 100 mL. The detection method combining culture and PCR yielded the highest positive rate of 90.86 %, while RT-qPCR and qPCR were the two most frequently used quantification methods. In addition, the Campylobacter concentration in influent wastewater showed a seasonal fluctuation, with the highest concentration in the autumn at 3.46 ± 0.41 log10 gene copies or MPN per 100 mL. Based on the isolates of all positive samples, Campylobacter jejuni (62.34 %) was identified as the most prevalent species in wastewater, followed by Campylobacter coli (30.85 %) and Campylobacter lari (4.4 %). These findings provided significant data to further develop and optimize the wastewater surveillance of Campylobacter spp. infections. In addition, large data gaps were found in the decay of Campylobacter spp. in wastewater, indicating insufficient research on the persistence of Campylobacter spp. in wastewater.
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Affiliation(s)
- Shuxin Zhang
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia
| | - Jiahua Shi
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | - Xuan Li
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Ananda Tiwari
- Department of Health Security, Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, Finland
| | - Shuhong Gao
- State Key Laboratory of Urban Water Resource and Environment, School of Civil & Environmental Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
| | - Xu Zhou
- State Key Laboratory of Urban Water Resource and Environment, School of Civil & Environmental Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China
| | - Xiaoyan Sun
- School of Civil Engineering, Sun Yat-sen University, 519082 Zhuhai, China
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Brisbane, Australia
| | - Lachlan Coin
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Faisal Hai
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia
| | - Guangming Jiang
- School of Civil, Mining and Environmental Engineering, University of Wollongong, Australia; School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Australia.
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McLure A, Smith JJ, Firestone SM, Kirk MD, French N, Fearnley E, Wallace R, Valcanis M, Bulach D, Moffatt CRM, Selvey LA, Jennison A, Cribb DM, Glass K. Source attribution of campylobacteriosis in Australia, 2017-2019. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:2527-2548. [PMID: 37032319 PMCID: PMC10947381 DOI: 10.1111/risa.14138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 06/19/2023]
Abstract
Campylobacter jejuni and Campylobacter coli infections are the leading cause of foodborne gastroenteritis in high-income countries. Campylobacter colonizes a variety of warm-blooded hosts that are reservoirs for human campylobacteriosis. The proportions of Australian cases attributable to different animal reservoirs are unknown but can be estimated by comparing the frequency of different sequence types in cases and reservoirs. Campylobacter isolates were obtained from notified human cases and raw meat and offal from the major livestock in Australia between 2017 and 2019. Isolates were typed using multi-locus sequence genotyping. We used Bayesian source attribution models including the asymmetric island model, the modified Hald model, and their generalizations. Some models included an "unsampled" source to estimate the proportion of cases attributable to wild, feral, or domestic animal reservoirs not sampled in our study. Model fits were compared using the Watanabe-Akaike information criterion. We included 612 food and 710 human case isolates. The best fitting models attributed >80% of Campylobacter cases to chickens, with a greater proportion of C. coli (>84%) than C. jejuni (>77%). The best fitting model that included an unsampled source attributed 14% (95% credible interval [CrI]: 0.3%-32%) to the unsampled source and only 2% to ruminants (95% CrI: 0.3%-12%) and 2% to pigs (95% CrI: 0.2%-11%) The best fitting model that did not include an unsampled source attributed 12% to ruminants (95% CrI: 1.3%-33%) and 6% to pigs (95% CrI: 1.1%-19%). Chickens were the leading source of human Campylobacter infections in Australia in 2017-2019 and should remain the focus of interventions to reduce burden.
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Affiliation(s)
- Angus McLure
- National Centre for Epidemiology and Population HealthThe Australian National UniversityCanberraAustralia
| | - James J. Smith
- Food Safety Standards and Regulation, Health Protection BranchQueensland HealthBrisbaneAustralia
- School of Biology and Environmental Science, Faculty of ScienceQueensland University of TechnologyBrisbaneAustralia
| | - Simon Matthew Firestone
- Melbourne Veterinary School, Faculty of ScienceThe University of MelbourneMelbourneAustralia
| | - Martyn D. Kirk
- National Centre for Epidemiology and Population HealthThe Australian National UniversityCanberraAustralia
| | - Nigel French
- Infectious Disease Research Centre, Hopkirk Research InstituteMassey UniversityPalmerston NorthNew Zealand
- New Zealand Food Safety Science and Research Centre, Hopkirk Research InstituteMassey UniversityPalmerston NorthNew Zealand
| | - Emily Fearnley
- Department for Health and WellbeingGovernment of South AustraliaAdelaideAustralia
| | - Rhiannon Wallace
- Agassiz Research and Development Centre, Agriculture and Agri‐Food CanadaAgassizCanada
| | - Mary Valcanis
- The Doherty Institute for Infection and ImmunityMelbourneAustralia
- Microbiological Diagnostic Unit Public Health LaboratoryThe University of MelbourneMelbourneAustralia
| | - Dieter Bulach
- The Doherty Institute for Infection and ImmunityMelbourneAustralia
- Melbourne BioinformaticsThe University of MelbourneMelbourneAustralia
| | - Cameron R. M. Moffatt
- National Centre for Epidemiology and Population HealthThe Australian National UniversityCanberraAustralia
| | - Linda A. Selvey
- School of Public Health, Faculty of MedicineThe University of QueenslandBrisbaneAustralia
| | - Amy Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland HealthBrisbaneAustralia
| | - Danielle M. Cribb
- National Centre for Epidemiology and Population HealthThe Australian National UniversityCanberraAustralia
| | - Kathryn Glass
- National Centre for Epidemiology and Population HealthThe Australian National UniversityCanberraAustralia
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