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Buiatte ABG, Souza SSR, Costa LRM, Peres PABM, de Melo RT, Sommerfeld S, Fonseca BB, Zac Soligno NI, Ikhimiukor OO, Armendaris PM, Andam CP, Rossi DA. Five centuries of genome evolution and multi-host adaptation of Campylobacter jejuni in Brazil. Microb Genom 2024; 10:001274. [PMID: 39028633 PMCID: PMC11316555 DOI: 10.1099/mgen.0.001274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/03/2024] [Indexed: 07/21/2024] Open
Abstract
Consumption of raw, undercooked or contaminated animal food products is a frequent cause of Campylobacter jejuni infection. Brazil is the world's third largest producer and a major exporter of chicken meat, yet population-level genomic investigations of C. jejuni in the country remain scarce. Analysis of 221 C. jejuni genomes from Brazil shows that the overall core and accessory genomic features of C. jejuni are influenced by the identity of the human or animal source. Of the 60 sequence types detected, ST353 is the most prevalent and consists of samples from chicken and human sources. Notably, we identified the presence of diverse bla genes from the OXA-61 and OXA-184 families that confer beta-lactam resistance as well as the operon cmeABCR related to multidrug efflux pump, which contributes to resistance against tetracyclines, macrolides and quinolones. Based on limited data, we estimated the most recent common ancestor of ST353 to the late 1500s, coinciding with the time the Portuguese first arrived in Brazil and introduced domesticated chickens into the country. We identified at least two instances of ancestral chicken-to-human infections in ST353. The evolution of C. jejuni in Brazil was driven by the confluence of clinically relevant genetic elements, multi-host adaptation and clonal population growth that coincided with major socio-economic changes in poultry farming.
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Affiliation(s)
- Ana Beatriz Garcez Buiatte
- Molecular Epidemiology Laboratory, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
- Department of Biological Sciences, University at Albany, State University of New York, Albany, New York, USA
| | - Stephanie S. R. Souza
- Department of Biological Sciences, University at Albany, State University of New York, Albany, New York, USA
| | | | | | - Roberta Torres de Melo
- Molecular Epidemiology Laboratory, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Simone Sommerfeld
- Infectious Disease Laboratory, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | | | - Nicole I. Zac Soligno
- Department of Biological Sciences, University at Albany, State University of New York, Albany, New York, USA
| | - Odion O. Ikhimiukor
- Department of Biological Sciences, University at Albany, State University of New York, Albany, New York, USA
| | - Paulo Marcel Armendaris
- Federal Agriculture Defense Laboratory/RS - LFDA/RS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cheryl P. Andam
- Department of Biological Sciences, University at Albany, State University of New York, Albany, New York, USA
| | - Daise Aparecida Rossi
- Molecular Epidemiology Laboratory, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
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Gupta M, Monjazeb S, Rosser T, Santoro JD, Ahsan N. A Case of Pediatric Guillain-Barré Syndrome After Respiratory Syncytial Virus Infection. Pediatr Neurol 2023; 146:129-131. [PMID: 37481934 DOI: 10.1016/j.pediatrneurol.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/18/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023]
Abstract
We report a two-year-old girl whose progressive lower extremity weakness was masked by a respiratory presentation, only to be identified as having Guillain-Barré syndrome in the context of respiratory syncytial virus bronchiolitis. This case adds to the expanding literature of postinfectious demyelinating disorders in very young children, which seem to be unrelated to particular antigenic triggers.
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Affiliation(s)
- Megan Gupta
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California
| | - Sanaz Monjazeb
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California
| | - Tena Rosser
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California; Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jonathan D Santoro
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California; Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Nusrat Ahsan
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, California; Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California.
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Reyes-Vega MF, Soto-Cabezas MG, Soriano-Moreno AN, Valle-Campos A, Aquino-Peña F, Flores-Jaime N, Ordóñez-Ibargüen LA, Martel KS, Munayco CV. Clinical features of Guillain-Barré syndrome and factors associated with mortality during the 2019 outbreak in Peru. J Neurol 2023; 270:369-376. [PMID: 36098840 DOI: 10.1007/s00415-022-11331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Peru has suffered an increase of Guillain Barre Syndrome incidence since 2015, being the biggest outbreak during 2019. We aimed to describe the clinical features, outcomes, and factors associated with mortality among cases reported in the 2019 outbreak. METHODS Cross-sectional analysis of data from the National Surveillance of Guillain Barre Syndrome of the National Center for Control Disease and Prevention of Peru. We included all cases that met the Brighton criteria, level 1 to level 3. We used multivariable logistic regression to determinate factors associated with mortality. RESULTS Overall, 772 cases were analyzed (58.7% male; mean age, 41.7 ± 20.3). 86.0% of cases aged over 30 years. 71.4% had a respiratory or gastrointestinal infection in the last 4 weeks. Case fatality rate was 4.3% and 32.2% of survivors reported sequelae. Axonal subtypes were identified in 75.6% of cases with an available nerve conduction study (38.7%). Age and impaired function of cranial nerves were independently associated with mortality. CONCLUSIONS The 2019 outbreak of Guillain Barre syndrome in Peru was an unprecedented event that affected several regions of the country. Axonal damage was more frequent than demyelinating involvement, which is compatible with findings pointing to Campylobacter jejuni as the triggering agent. The case fatality rate was similar to that reported previously in Peru and other countries, but the high frequency of sequelae is striking.
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Affiliation(s)
- Mary F Reyes-Vega
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru.
| | - M Gabriela Soto-Cabezas
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
| | - Anderson N Soriano-Moreno
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
| | - Andree Valle-Campos
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
| | | | - Noemi Flores-Jaime
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
| | - Luis A Ordóñez-Ibargüen
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
| | - Kevin S Martel
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
| | - Cesar V Munayco
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud de Perú,, Calle Daniel Olaechea 199, Jesús María, 15072, Lima, Peru
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Quino W, Caro-Castro J, Mestanza O, Hurtado V, Zamudio ML, Cruz-Gonzales G, Gavilan RG. Emergence and Molecular Epidemiology of Campylobacter jejuni ST-2993 Associated with a Large Outbreak of Guillain-Barré Syndrome in Peru. Microbiol Spectr 2022; 10:e0118722. [PMID: 35972275 PMCID: PMC9603473 DOI: 10.1128/spectrum.01187-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/29/2022] [Indexed: 12/30/2022] Open
Abstract
Campylobacter jejuni infection is considered the most frequent factor associated with Guillain-Barré syndrome (GBS). In 2019, a large outbreak of GBS was detected in Peru, being associated with C. jejuni detected in stool samples from these patients. The aim of this study was to determine the molecular epidemiology of C. jejuni strains (ST-2993) associated with a large GBS outbreak in Peru. In this study, 26 C. jejuni strains belonging to the ST-2293, obtained from 2019 to 2020, were sequenced using Illumina technology. Five low-quality sequences were removed using bioinformatics, and 21 genomes (17 clinical strains and 4 chicken strains) were considered in the phylogenetic analysis and comparative genomics. Phylogenetic reconstruction, including genomes from international databases, showed a connection between Peruvian and Chinese GBS strains, both of them having lipooligosaccharides (LOS) locus genes related to molecular mimicry with gangliosides in peripheral nerves. Also, ST-2993 was detected in Amazon strains recovered many years before the 2019 outbreak, but with no epidemiological connection with GBS. Besides, a close relationship between human and chicken C. jejuni strains indicated chicken as one of the probable reservoirs. Finally, comparative genomics revealed differences between Chinese and Peruvian strains, including the presence of a prophage inserted into the genome. In conclusion, C. jejuni ST-2993 strains recovered from the GBS outbreak are closely related to Peruvian Amazon strains. Moreover, ST-2993 has been circulated in Peru since 2003 in the Peruvian Amazonia, showing the necessity to reinforce the epidemiological surveillance of C. jejuni to improve the prevention and control of future GBS outbreaks. IMPORTANCE This article describes the molecular epidemiology of C. jejuni strains (ST-2993) associated with a large Guillain-Barré Syndrome (GBS) outbreak in Peru, sequencing several strains recovered from GBS patients and chickens from 2019 to 2020. Phylogenetic analysis showed a connection between Peruvian and Chinese GBS strains, both of them having lipooligosaccharides (LOS) locus genes related to molecular mimicry with gangliosides in peripheral nerves. Also, ST-2993 strains were detected in isolates recovered many years before the 2019 outbreak, but with no epidemiological connection with GBS. Besides, a close relationship between human and chicken strains indicated those animals as a probable reservoir. This information will help to understand the real situation of GBS in Peru and its causal agent, C. jejuni ST-2993, showing the necessity to increase epidemiological tracking of these kinds of pathogens to detect them and avoid GBS outbreaks in the future.
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Affiliation(s)
- Willi Quino
- Laboratorio de Referencia Nacional de Enteropatógenos, Instituto Nacional de Salud, Lima, Perú
- Escuela Universitaria de Posgrado, Universidad Nacional Federico Villarreal, Lima, Perú
| | - Junior Caro-Castro
- Laboratorio de Referencia Nacional de Enteropatógenos, Instituto Nacional de Salud, Lima, Perú
| | - Orson Mestanza
- Laboratorio de Referencia Nacional de Enteropatógenos, Instituto Nacional de Salud, Lima, Perú
| | - Verónica Hurtado
- Laboratorio de Referencia Nacional de Enteropatógenos, Instituto Nacional de Salud, Lima, Perú
| | - María Luz Zamudio
- Laboratorio de Referencia Nacional de Enteropatógenos, Instituto Nacional de Salud, Lima, Perú
| | - Gloria Cruz-Gonzales
- Escuela Universitaria de Posgrado, Universidad Nacional Federico Villarreal, Lima, Perú
| | - Ronnie G. Gavilan
- Laboratorio de Referencia Nacional de Enteropatógenos, Instituto Nacional de Salud, Lima, Perú
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
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Florian IA, Lupan I, Sur L, Samasca G, Timiș TL. To be, or not to be… Guillain-Barré Syndrome. Autoimmun Rev 2021; 20:102983. [PMID: 34718164 DOI: 10.1016/j.autrev.2021.102983] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023]
Abstract
Guillain-Barré Syndrome (GBS) is currently the most frequent cause of acute flaccid paralysis on a global scale, being an autoimmune disorder wherein demyelination of the peripheral nerves occurs. Its main clinical features are a symmetrical ascending muscle weakness with reduced osteotendinous reflexes and variable sensory involvement. GBS most commonly occurs after an infection, especially viral (including COVID-19), but may also transpire after immunization with certain vaccines or in the development of specific malignancies. Immunoglobulins, plasmapheresis, and glucocorticoids represent the principal treatment modalities, however patients with severe disease progression may require supportive therapy in an intensive care unit. Due to its symptomology, which overlaps with numerous neurological and infectious illnesses, the diagnosis of GBS may often be misattributed to pathologies that are essentially different from this syndrome. Moreover, many of these require specific treatment methods distinct to those recommended for GBS, in lack of which the prognosis of the patient is drastically affected. Such diseases include exposure to toxins either environmental or foodborne, central nervous system infections, metabolic or serum ion alterations, demyelinating pathologies, or even conditions amenable to neurosurgical intervention. This extensive narrative review aims to systematically and comprehensively tackle the most notable and challenging differential diagnoses of GBS, emphasizing on the clinical discrepancies between the diseases, the appropriate paraclinical investigations, and suitable management indications.
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Affiliation(s)
- Ioan Alexandru Florian
- Department of Neurology, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania, Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Iulia Lupan
- Department of Molecular Biology, Babes Bolyai University, Cluj-Napoca, Romania.
| | - Lucia Sur
- Department of Pediatrics I, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Gabriel Samasca
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Teodora Larisa Timiș
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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