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García-Sánchez C, García-Rodríguez J, Ruiz-Carrascoso G. Clinical and microbiological findings of recurrent Campylobacter spp. gastroenteritis in a tertiary care hospital. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:257-262. [PMID: 36737370 DOI: 10.1016/j.eimce.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/22/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Campylobacter spp. is the leading cause of bacterial enteritis in industrialized countries, but the literature about its recurrence is scarce. The objective of this study is to analyze a case series of recurrent campylobacteriosis in adult and pediatric patients. METHODS During a two-year period, the demographic, clinical and microbiological data were collected retrospectively from patients who met the clinical criteria of recurrent Campylobacter spp. gastroenteritis. Enteropathogens were identified by a multiplex-PCR gastrointestinal pathogens panel. When Campylobacter spp. was detected, the stool sample was cultured in specific medium and tested for antibiotic susceptibility. RESULTS Twenty-four (2.03%) out of 1180 patients with Campylobacter spp. positive-PCR met the inclusion criteria. Thirteen patients suffered from underlying diseases, and 11 had no known risk factors but they were all pediatric patients. From the 24 patients were documented 70 episodes. One patient had two episodes of bacteremia. Coinfection/co-detection with other enteropathogens was found in 10 patients being Giardia intestinalis the most frequent. Twelve (22.6%) out of 53 isolates were resistant to macrolides. One patient had two isolates of multi-drug resistant C. coli, only susceptible to gentamicin. CONCLUSION The results suggest the presence of underlying diseases in most adult patients with recurrent Campylobacter spp. infections, particularly primary immunodeficiency. Most of the pediatric patients with recurrent campylobacteriosis lack of known risk factors. Concomitant detection with other enteropathogens was common. The resistance to macrolides was much higher as compared with previous reported rates.
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Pena-Fernández N, Kortabarria N, Hurtado A, Ocejo M, Fort M, Pérez-Cobo I, Collantes-Fernández E, Aduriz G. Biochemical and molecular characterization of Campylobacter fetus isolates from bulls subjected to bovine genital campylobacteriosis diagnosis in Spain. BMC Vet Res 2024; 20:131. [PMID: 38566185 PMCID: PMC10985941 DOI: 10.1186/s12917-024-03970-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Bovine genital campylobacteriosis (BGC) is caused by Campylobacter fetus subsp. venerealis (Cfv) including its biovar intermedius (Cfvi). This sexually transmitted disease induces early reproductive failure causing considerable economic losses in the cattle industry. Using a collection of well-characterized isolates (n = 13), C. fetus field isolates (n = 64) and saprophytic isolates resembling Campylobacter (n = 75) obtained from smegma samples of breeding bulls, this study evaluated the concordance of the most used phenotypic (H2S production in cysteine medium and 1% glycine tolerance) and molecular (PCR) methods for the diagnosis of BGC and assessed possible cross-reactions in the molecular diagnostic methods. RESULTS Characterization at the subspecies level (fetus vs. venerealis) of C. fetus isolated from bull preputial samples using phenotypic and molecular (PCR targeting nahE and ISCfe1) methods showed moderate concordance (κ = 0.462; CI: 0.256-0.669). No cross-reactions were observed with other saprophytic microaerophilic species or with other Campylobacter species that can be present in preputial samples. Whole genome sequencing (WGS) of discrepant isolates showed 100% agreement with PCR identification. For the differentiation of Cfv biovars, comparison of the H2S test (at 72 h and 5 days of incubation) and a PCR targeting the L-cysteine transporter genes showed higher concordance when H2S production was assessed after 5 days (72 h; κ = 0.553, 0.329-0.778 CI vs. 5 days; κ = 0.881, 0.631-1 CI), evidencing the efficacy of a longer incubation time. CONCLUSIONS This study confirmed the limitations of biochemical tests to correctly identify C. fetus subspecies and biovars. However, in the case of biovars, when extended incubation times for the H2S test (5 days) were used, phenotypic identification results were significantly improved, although PCR-based methods produced more accurate results. Perfect agreement of WGS with the PCR results and absence of cross-reactions with non-C. fetus saprophytic bacteria from the smegma demonstrated the usefulness of these methods. Nevertheless, the identification of new C. fetus subspecies-specific genes would help to improve BGC diagnosis.
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Affiliation(s)
- Nerea Pena-Fernández
- SERIDA, Servicio Regional de Investigación y Desarrollo Agroalimentario, Carretera de Oviedo, S/N, Villaviciosa, 33300, Spain
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), Parque Científico y Tecnológico de Bizkaia, P812, Derio, 48160, Spain
| | - Nekane Kortabarria
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), Parque Científico y Tecnológico de Bizkaia, P812, Derio, 48160, Spain
| | - Ana Hurtado
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), Parque Científico y Tecnológico de Bizkaia, P812, Derio, 48160, Spain
| | - Medelin Ocejo
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), Parque Científico y Tecnológico de Bizkaia, P812, Derio, 48160, Spain
| | - Marcelo Fort
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria S/N, Madrid, 28040, Spain
| | - Iratxe Pérez-Cobo
- Central Veterinary-Animal Health Laboratory (LCV), Ctra. Madrid-Algete Km. 8.00, Algete, 28110, Spain
| | - Esther Collantes-Fernández
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Ciudad Universitaria S/N, Madrid, 28040, Spain.
- Faculty of Veterinary Sciences, SALUVET-Innova S.L, Complutense University of Madrid, Ciudad Universitaria S/N, Madrid, 28040, Spain.
| | - Gorka Aduriz
- Department of Animal Health, NEIKER-Basque Institute for Agricultural Research and Development, Basque Research and Technology Alliance (BRTA), Parque Científico y Tecnológico de Bizkaia, P812, Derio, 48160, Spain.
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Schiaffino F, Parker CT, Garcia Bardales PF, Huynh S, Manzanares Villanueva K, Mourkas E, Pascoe B, Peñataro Yori P, Paredes Olortegui M, Houpt ER, Liu J, Cooper KK, Kosek MN. Novel rpsK / rpsD primer-probe assay improves detection of Campylobacter jejuni and Campylobacter coli in human stool. PLoS Negl Trop Dis 2024; 18:e0012018. [PMID: 38427700 PMCID: PMC10936861 DOI: 10.1371/journal.pntd.0012018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/13/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024] Open
Abstract
Campylobacter causes bacterial enteritis, dysentery, and growth faltering in children in low- and middle-income countries (LMICs). Campylobacter spp. are fastidious organisms, and their detection often relies on culture independent diagnostic technologies, especially in LMICs. Campylobacter jejuni and Campylobacter coli are most often the infectious agents and in high income settings together account for 95% of Campylobacter infections. Several other Campylobacter species have been detected in LMIC children at an increased prevalence relative to high income settings. After doing extensive whole genome sequencing of isolates of C. jejuni and C. coli in Peru, we observed heterogeneity in the binding sites for the main species-specific PCR assay (cadF) and designed an alternative rpsKD-based qPCR assay to detect both C. jejuni and C. coli. The rpsKD-based qPCR assay identified 23% more C.jejuni/ C.coli samples than the cadF assay among 47 Campylobacter genus positive cadF negative samples verified to have C. jejuni and or C. coli with shotgun metagenomics. This assay can be expected to be useful in diagnostic studies of enteric infectious diseases and be useful in revising the attribution estimates of Campylobacter in LMICs.
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Affiliation(s)
- Francesca Schiaffino
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, San Martin de Porres, Lima, Peru
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
| | - Craig T. Parker
- Agricultural Research Service, U.S. Department of Agriculture, Produce Safety and Microbiology Research Unit, Albany, California, United States of America
| | | | - Steven Huynh
- Agricultural Research Service, U.S. Department of Agriculture, Produce Safety and Microbiology Research Unit, Albany, California, United States of America
| | | | - Evangelos Mourkas
- Ineos Oxford Institute for Antimicrobial Research, Department of Biology, University of Oxford, Oxford, United Kingdom
| | - Ben Pascoe
- Ineos Oxford Institute for Antimicrobial Research, Department of Biology, University of Oxford, Oxford, United Kingdom
- Centre for Genomic Pathogen Surveillance, Big Data Institute, University of Oxford, Oxford, United Kingdom
| | - Pablo Peñataro Yori
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
- Asociacion Benefica Prisma, Iquitos, Peru
| | | | - Eric R. Houpt
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
| | - Jie Liu
- School of Public Health, Qingdao University, Qingdao, China
| | - Kerry K. Cooper
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, Arizona, United States of America
- The BIO5 Institute, University of Arizona, Tucson, Arizona, United States of America
| | - Margaret N. Kosek
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America
- Asociacion Benefica Prisma, Iquitos, Peru
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García JA, Farace PD, Gioffre AK, Romeo F, Verna A, Mendez MA, Morsella C, Aller JF, Signorini M, Paolicchi FA. Bovine campylobacteriosis in heifer: pathogenesis study and insights in the conventional and molecular diagnosis in an experimental bovine model and field cases. Vet Res Commun 2024; 48:113-124. [PMID: 37548875 DOI: 10.1007/s11259-023-10193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/04/2023] [Indexed: 08/08/2023]
Abstract
Campylobacter fetus spp. is a bacterium associated to reproductive losses in cattle worldwide. It is a venereal infectious disease known as bovine campilobacteriosis, with high impact mainly in countries with extensive production systems. Here, we show pathogenesis and diagnostic methods for Campylobacter fetus detection in cervico-vaginal mucus (CVM) samples from heifers experimentally infected and field cases from herds with low reproductive performance by campylobacteriosis infection. Bacterial culture, direct immunofluorescence test and qPCR were used as diagnostic methods to evaluate detection of C. fetus. In the experimental model 30 Aberdeen Angus and crossbred heifers and 4 Aberdeen Angus bulls for natural mating were assigned to 3 groups experimentally challenged with C. fetus subsp. fetus (Cff), C. fetus subsps venerealis (Cfv) and C. fetus subsp venerealis biovar intermedius (Cfvi), respectively, and a negative control group, all followed for 9 months. Also, field samples of CVM and aborted fetuses were recollected from seven beef cattle farms. Bacteriological culture had the higher C. fetus detection rate in CVM being the most appropriate, followed by qPCR (with commercial extraction DNA kit), direct immunofluorescence test and qPCR (with in-house extraction DNA method), in both, experimental model and field cases. From experimental model after natural mating, 62.5% and 25% heifers got pregnant from Cff and Cfvi groups, respectively, while from Cfv no pregnancy was detected. The strain more frequently detected was Cfvi, followed by Cff and Cfv. Colonization of Cff in female genital tract with high number of carriers and presence in aborted fetuses was evidenced, suggesting a high risk to bovine reproductive health. Bacteriemia was not detected after genital infection. Given the low detection rate of either test, we suggest the use of both, PCR based methods and bacterial culture could result in higher detection rate in farms with endemic campylobacteriosis.
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Affiliation(s)
- Juan A García
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina.
| | - Pablo D Farace
- Instituto de Agrobiotecnología y Biología Molecular, Instituto Nacional de Tecnología Agropecuaria, Consejo Nacional de Investigaciones Científicas y Técnicas (IABIMO INTA-CONICET), Hurlingham, Buenos Aires, Argentina
| | - Andrea K Gioffre
- Instituto de Agrobiotecnología y Biología Molecular, Instituto Nacional de Tecnología Agropecuaria, Consejo Nacional de Investigaciones Científicas y Técnicas (IABIMO INTA-CONICET), Hurlingham, Buenos Aires, Argentina
| | - Florencia Romeo
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina
| | - Andrea Verna
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina
| | - María A Mendez
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina
| | - Claudia Morsella
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina
| | - Juan F Aller
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina
| | - Marcelo Signorini
- Instituto de Investigación de la Cadena Láctea (INTA - CONICET), Rafaela, Santa Fe, Argentina
| | - Fernando A Paolicchi
- Instituto de Innovación para la Producción Agropecuaria y el Desarrollo Sostenible (IPADS INTA-CONICET), Balcarce, Buenos Aires, 7620, Argentina
- Facultad de Ciencias Agrarias, Universidad Nacional de Mar del Plata, Balcarce, Buenos Aires, Argentina
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5
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Benedetti G, Holm Hansen C, Tølbøll Svendsen A, Grimstrup Joensen K, Sørensen G, Engsbro AL, Torpdahl M, Møller Nielsen E, Ethelberg S. The effect of changing diagnostic method from culture to PCR on the number of episodes of human campylobacteriosis in Denmark: a retrospective study (2015-2022). Microbiol Spectr 2024; 12:e0341823. [PMID: 38063356 PMCID: PMC10783023 DOI: 10.1128/spectrum.03418-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/13/2023] [Indexed: 01/13/2024] Open
Abstract
IMPORTANCE This study is important because it shows the potential epidemiological silence associated with the use of culture as the primary diagnostic method for the laboratory identification of human campylobacteriosis. Also, we show how polymerase chain reaction methods are associated with a systematic increase in the number of human campylobacteriosis episodes as reported by routine disease surveillance. These findings are operationally relevant and have public health implications because they tell how crucial it is to consider changes in diagnostic methods, e.g., in the epidemiological analysis of historical data and in the interpretation of future data in light of the past. We also believe that this study highlights how the synergy between microbiology and epidemiology is essential for disease surveillance.
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Affiliation(s)
- Guido Benedetti
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Christian Holm Hansen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Anna Tølbøll Svendsen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Medicine, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Gitte Sørensen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anne Line Engsbro
- Department of Clinical Microbiology, Zealand University Hospital, Slagelse, Denmark
- Hvidovre University Hospital, Hvidovre, Denmark
| | - Mia Torpdahl
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Eva Møller Nielsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Steen Ethelberg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
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6
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Lenherr A, Boughdad S, Prior JO, Lalonde MN, Filippidis P. Infective aortitis and subacute myocarditis due to Campylobacter fetus. Int J Infect Dis 2024; 138:113-114. [PMID: 38016501 DOI: 10.1016/j.ijid.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Affiliation(s)
- Anaelle Lenherr
- Internal Medicine Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sarah Boughdad
- Nuclear Medicine and Molecular Imaging Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - John O Prior
- Nuclear Medicine and Molecular Imaging Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Paraskevas Filippidis
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Guo YT, Hsiung CA, Wu FT, Chi H, Huang YC, Liu CC, Huang YC, Lin HC, Shih SM, Huang CY, Chang LY, Ho YH, Lu CY, Huang LM. Clinical manifestations and risk factors of campylobacter gastroenteritis in children in Taiwan. Biomed J 2023; 46:100590. [PMID: 37001586 PMCID: PMC10711181 DOI: 10.1016/j.bj.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Campylobacteriosis is a common cause of bacterial gastroenteritis worldwide. This study aimed to investigate the potential risk factors, clinical and laboratory manifestations of children with campylobacteriosis under five years old in Taiwan. METHODS This retrospective case-control study was conducted in ten major hospitals in Taiwan from 2014 to 2017. Laboratory tests and stool specimen were collected and analyzed together with questionnaire survey. Multivariate stepwise logistic regression model was used for identification of risk factors. RESULTS A total of 64 campylobacteriosis cases were included with a median age of 25 months. We observed a less prolonged vomiting (p = 0.047), more bloody (p < 0.001) and mucoid (p = 0.005) stools, and lower AST levels (p = 0.020) in patients with campylobacteriosis. Lower parental educational attainment (p < 0.001), direct contact with acute gastroenteritis patients (p < 0.001), as well as diarrhea in the mutually cared children (p = 0.007) were linked to campylobacteriosis. Consumption of municipal water (p < 0.001), milk (OR 0.34, 95% CI 0.118-0.979), and soft beverages (OR 0.41, 95% CI 0.192-0.888) were identified as protective factors, while consuming takeout food (p = 0.032) and seafood (p = 0.019) increased risk of campylobacteriosis. CONCLUSIONS Shorter vomiting duration, bloody and mucoid stool, and less elevated AST levels are manifestations suggestive of campylobacteriosis. Risk factors of campylobacteriosis were low parental educational attainment, direct contact with acute gastroenteritis patients, diarrhea in mutually cared children, takeout food and seafood intake. Potential protective factors include municipal water, milk, and soft beverage intake.
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Affiliation(s)
- Yen-Ting Guo
- Department of Medical Education, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chao A Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Fang-Tzy Wu
- Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Taipei, Taiwan
| | - Hsin Chi
- Department of Pediatrics, Mackay Children's Hospital, Mackay Medical College, Taipei, Taiwan
| | - Yhu-Chering Huang
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chuan Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiao-Chuan Lin
- Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan
| | - Shu-Man Shih
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ching-Yi Huang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Luan-Yin Chang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Huai Ho
- Division of Infectious Disease, Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
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Navarrete-Welton A, Francis ER, Gohh R, Farmakiotis D. Campylobacter Infection-Associated Acute Pancreatitis in a Renal Transplant Recipient. R I Med J (2013) 2023; 106:13-15. [PMID: 37643334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Immunocompromised individuals (patients with cancer, diabetes, HIV/AIDS, transplant recipients) and pregnant women are at greater risk of complicated foodborne illness than the general population. Though rare, Campylobacter enteritis-associated acute pancreatitis has not been reported in an immunocompromised host to our knowledge. Herein, we describe a case of Campylobacter infection-associated pancreatitis in a renal transplant recipient. This case highlights the need for food safety education for the immunocompromised, emphasizes the role of health care providers in encouraging adherence to food safety guidelines, and stresses the need to maintain broad infectious differentials for immunocompromised patient populations, even for conditions which are not commonly associated with an infectious etiology.
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Affiliation(s)
| | - Elizabeth R Francis
- Internal Medicine Residency Program, The Warren Alpert Medical School of Brown University/ Lifespan Hospitals, Providence, RI
| | - Reginald Gohh
- Medical Director of Division of Organ Transplantation, Professor of Medicine, The Warren Alpert Medical School of Brown University/Lifespan Hospitals, Providence, RI
| | - Dimitrios Farmakiotis
- Director of Transplant and Oncology Infectious Diseases, Associate Professor of Medicine, The Warren Alpert Medical School of Brown University/Lifespan Hospitals, Providence, RI
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Levican A, Varela C, Porte L, Weitzel T, Briceño I, Guerra F, Mena B, Hinton A. Head-to-head comparison of CAMPYAIR aerobic culture medium versus standard microaerophilic culture for Campylobacter isolation from clinical samples. Front Cell Infect Microbiol 2023; 13:1153693. [PMID: 37384222 PMCID: PMC10293832 DOI: 10.3389/fcimb.2023.1153693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/24/2023] [Indexed: 06/30/2023] Open
Abstract
Campylobacter spp. are considered the most frequent cause of acute gastroenteritis worldwide. However, outside high-income countries, its burden is poorly understood. Limited published data suggest that Campylobacter prevalence in low- and middle-income countries is high, but their reservoirs and age distribution are different. Culturing Campylobacter is expensive due to laboratory equipment and supplies needed to grow the bacterium (e.g., selective culture media, microaerophilic atmosphere, and a 42°C incubator). These requirements limit the diagnostic capacity of clinical laboratories in many resource-poor regions, leading to significant underdiagnosis and underreporting of isolation of the pathogen. CAMPYAIR, a newly developed selective differential medium, permits Campylobacter isolation without the need for microaerophilic incubation. The medium is supplemented with antibiotics to allow Campylobacter isolation in complex matrices such as human feces. The present study aims to evaluate the ability of the medium to recover Campylobacter from routine clinical samples. A total of 191 human stool samples were used to compare the ability of CAMPYAIR (aerobic incubation) and a commercial Campylobacter medium (CASA, microaerophilic incubation) to recover Campylobacter. All Campylobacter isolates were then identified by MALDI-TOF MS. CAMPYAIR showed sensitivity and specificity values of 87.5% (95% CI 47.4%-99.7%) and 100% (95% CI 98%-100%), respectively. The positive predictive value of CAMPYAIR was 100% and its negative predictive value was 99.5% (95% CI 96.7%-99.9%); Kappa Cohen coefficient was 0.93 (95% CI 0.79-1.0). The high diagnostic performance and low technical requirements of the CAMPYAIR medium could permit Campylobacter culture in countries with limited resources.
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Affiliation(s)
- Arturo Levican
- Tecnología Médica, Facultad de Ciencias, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Carmen Varela
- Laboratorio Clínico, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Lorena Porte
- Laboratorio Clínico, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Thomas Weitzel
- Laboratorio Clínico, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Isabel Briceño
- Laboratorio Clínico, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | - Francisco Guerra
- Laboratorio Clínico, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | - Benjamín Mena
- Laboratorio Clínico, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | - Arthur Hinton
- Poultry Microbiological Safety and Processing Research Unit, U.S. National Poultry Research Center, Agricultural Research Service, Athens, GA, United States
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10
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Cho H, Lee SH, Lee JH, Lee SJ, Park SC. Epidemiologic and Clinical Features of Campylobacter Enteritis Before and During COVID-19 in Korea. J Korean Med Sci 2023; 38:e67. [PMID: 36880108 PMCID: PMC9988435 DOI: 10.3346/jkms.2023.38.e67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/06/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND With the increase in meals at home due to coronavirus disease 2019 (COVID-19), the pattern and incidence of enteritis seemed to change. Some types of enteritis, such as Campylobacter enteritis, appear to have increased. Our study aimed to evaluate the change in the trend of enteritis, especially Campylobacter enteritis, before COVID-19 (2016-2019) and at the present time during COVID-19 in South Korea. METHODS We analyzed data from the Health Insurance Review and Assessment Service. From 2016 to 2020, the International Classification of Diseases codes related to enteritis were examined to distinguish bacterial and viral enteritis and the trends of each were analyzed. The aspects of enteritis, before and after the COVID-19 outbreak, were compared. RESULTS Both bacterial and viral enteritis declined in all age groups from 2016 to 2020 (P < 0.001). In 2020, the reduction rate of viral enteritis was higher than that of bacterial enteritis. However, unlike other causes of enteritis, even after COVID-19, Campylobacter enteritis increased in all age groups. An increase of Campylobacter enteritis in 2020 was particularly noticeable in children and adolescents. The prevalence of viral and bacterial enteritis was higher in urban areas than in rural areas (P < 0.001). Campylobacter enteritis was more common in the rural areas (P < 0.001). CONCLUSION Although the prevalence of bacterial and viral enteritis have decreased in COVID-19, Campylobacter enteritis has increased in all age groups and in rural areas compared to urban areas. Recognizing that the trend of Campylobacter enteritis before and during COVID-19 is helpful for future public health measures and interventions.
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Affiliation(s)
- Hyunseok Cho
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sang Hoon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jung Ho Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sung Joon Lee
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sung Chul Park
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
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11
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Garcia Bardales PF, Schiaffino F, Huynh S, Paredes Olortegui M, Peñataro Yori P, Pinedo Vasquez T, Manzanares Villanueva K, Curico Huansi GE, Shapiama Lopez WV, Cooper KK, Parker CT, Kosek MN. "Candidatus Campylobacter infans" detection is not associated with diarrhea in children under the age of 2 in Peru. PLoS Negl Trop Dis 2022; 16:e0010869. [PMID: 36251729 PMCID: PMC9612815 DOI: 10.1371/journal.pntd.0010869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/27/2022] [Accepted: 10/05/2022] [Indexed: 12/24/2022] Open
Abstract
A working hypothesis is that less common species of Campylobacter (other than C. jejuni and C. coli) play a role in enteric disease among children in low resource settings and explain the gap between the detection of Campylobacter using culture and culture independent methods. "Candidatus Campylobacter infans" (C. infans), was recently detected in stool samples from children and hypothesized to play a role in Campylobacter epidemiology in low- and middle-income countries (LMIC). This study determined the prevalence of C. infans in symptomatic and asymptomatic stool samples from children living in Iquitos, Peru. Stool samples from 215 children with diarrhea and 50 stool samples from children without diarrhea under the age of two were evaluated using a multiplex qPCR assay to detect Campylobacter spp. (16S rRNA), Campylobacter jejuni / Campylobacter coli (cadF gene), C. infans (lpxA), and Shigella spp. (ipaH). C. infans was detected in 7.9% (17/215) symptomatic samples and 4.0% (2/50) asymptomatic samples. The association between diarrhea and the presence of these targets was evaluated using univariate logistic regressions. C. infans was not associated with diarrhea. Fifty-one percent (75/146) of Campylobacter positive fecal samples were negative for C. jejuni, C. coli, and C. infans via qPCR. Shotgun metagenomics confirmed the presence of C. infans among 13 out of 14 positive C. infans positive stool samples. C infans explained only 20.7% of the diagnostic gap in stools from children with diarrhea and 16.7% of the gap in children without diarrhea. We posit that poor cadF primer performance better explains the observed gap than the prevalence of atypical non-C. jejuni/coli species.
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Affiliation(s)
| | - Francesca Schiaffino
- Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, United States of America
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, San Martin de Porres, Lima, Peru
| | - Steven Huynh
- Agricultural Research Service, U.S. Department of Agriculture, Produce Safety and Microbiology Research Unit, Albany, California, United States of America
| | | | - Pablo Peñataro Yori
- Asociacion Benefica Prisma, Iquitos, Peru
- Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, United States of America
| | | | | | | | | | - Kerry K. Cooper
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, Arizona, United States of America
- * E-mail: (KKC); (MNKI)
| | - Craig T. Parker
- Agricultural Research Service, U.S. Department of Agriculture, Produce Safety and Microbiology Research Unit, Albany, California, United States of America
| | - Margaret N. Kosek
- Asociacion Benefica Prisma, Iquitos, Peru
- Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, United States of America
- * E-mail: (KKC); (MNKI)
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12
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Tarroni A, Repetto M, Malfatto EN, Burgarello C, Caputo C, Ciabattoni M, Garneri D, Ferraro S, Tallone I, Tosetti F, Vigo EC, Anselmo M, Lillo F, Koroveshi B. [Campylobacter: a vintage pathogen to the fore]. G Ital Nefrol 2022; 39:2022-vol4. [PMID: 36073337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Campylobacteriosis is caused by Gram bacteria. Most common species are C. jejuni and C. coli. Campylobacteriosis is a rare cause of sepsis, and in some European countries it is more common than salmonellosis, becoming a public health problem. We have treated a 66-year-old patient, hypertensive, ischemic cardiopathic, scheduled for coronary angiography, hospitalized with AKI, in a state of shock after some days of acute diarrhea. Because of the pathogen's seasonal nature and the patient's clinical features, in addition to common coproculture also Campylobacter has been sought, and found. Treated with volume repletion and antibiotics, within one week normal kidney functions were fully restored. He had a coronary angiography a week after being discharged from the hospital.
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Affiliation(s)
- Alice Tarroni
- ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi
| | - Monica Repetto
- ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi
| | | | - Claudio Burgarello
- ASL 2 SSR Liguria, Laboratorio di Patologia Clinica, Sezione Microbiologia
| | - Carmela Caputo
- ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi
| | | | - Debora Garneri
- ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi
| | | | - Ilaria Tallone
- ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi
| | - Fanny Tosetti
- ASL 2 SSR Liguria, Struttura Complessa Nefrologia e Dialisi
| | | | - Marco Anselmo
- ASL 2 SSR Liguria, Struttura Complessa Malattie Infettive
| | - Flavia Lillo
- ASL 2 SSR Liguria, Laboratorio di Patologia Clinica, Sezione Microbiologia
| | - Brisejda Koroveshi
- ASL 2 SSR Liguria, Laboratorio di Patologia Clinica, Sezione Microbiologia
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13
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Zacher B, Czogiel I. Supervised learning using routine surveillance data improves outbreak detection of Salmonella and Campylobacter infections in Germany. PLoS One 2022; 17:e0267510. [PMID: 35511793 PMCID: PMC9070876 DOI: 10.1371/journal.pone.0267510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
The early detection of infectious disease outbreaks is a crucial task to protect population health. To this end, public health surveillance systems have been established to systematically collect and analyse infectious disease data. A variety of statistical tools are available, which detect potential outbreaks as abberations from an expected endemic level using these data. Here, we present supervised hidden Markov models for disease outbreak detection, which use reported outbreaks that are routinely collected in the German infectious disease surveillance system and have not been leveraged so far. This allows to directly integrate labeled outbreak data in a statistical time series model for outbreak detection. We evaluate our model using real Salmonella and Campylobacter data, as well as simulations. The proposed supervised learning approach performs substantially better than unsupervised learning and on par with or better than a state-of-the-art approach, which is applied in multiple European countries including Germany.
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Affiliation(s)
- Benedikt Zacher
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- * E-mail:
| | - Irina Czogiel
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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14
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Abstract
Campylobacter rectus is a campylobacterium considered to be a primary periodontal pathogen. Thus, C. rectus has rarely been isolated from extraoral specimens, especially in the thoracic region. We herein report a case of thoracic empyema in which Campylobacter infection was suspected after Gram staining of the pleural effusion, and C. rectus was isolated using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Fusobacterium nucleatum was also detected. Molecular identification was performed using polymerase chain reaction amplification and a sequencing analysis of the 16S rRNA gene. Estimation of the causative bacteria using Gram staining led to the proper culture and identification of the causative bacteria.
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Affiliation(s)
- Ryoichi Matsumoto
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Daisuke Himeji
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Ritsuya Shiiba
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Atsushi Yamanaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Gen-Ichi Tanaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Akira Sata
- Department of Clinical Laboratory, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Shoji Awano
- Department of Clinical Laboratory, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Hiroko Ogawa
- Department of Clinical Laboratory, Miyazaki Prefectural Miyazaki Hospital, Japan
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15
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Abstract
Early-onset sepsis caused by Gram-negative spiral organisms is rarely reported, with Campylobacter fetus being a better known causative agent than other Campylobacter species. We report the case of a 2-day-old girl who presented with hematochezia and bacteremia caused by Campylobacter jejuni. She was born full-term. Her family ate undercooked chicken, and Campylobacter enteritis was diagnosed before her birth.
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Affiliation(s)
- Shinsuke Mizuno
- From the Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Koji Yokoyama
- From the Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Takayuki Nukada
- From the Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yuka Ikeda
- From the Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Shigeto Hara
- From the Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
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16
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Dorsch MA, Casaux ML, Calleros L, Aráoz V, Caffarena RD, Monesiglio C, Barcellos M, da Silva Silveira C, Perdomo Y, Banchero G, Uzal FA, Fraga M, Giannitti F. Placentitis and abortion caused by a multidrug resistant strain of Campylobacter fetus subspecies fetus in a sheep in Uruguay. Rev Argent Microbiol 2022; 54:25-30. [PMID: 33875294 DOI: 10.1016/j.ram.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/27/2021] [Accepted: 02/28/2021] [Indexed: 01/02/2023] Open
Abstract
Campylobacter fetusfetus (Cff) is a major infectious cause of abortion in sheep worldwide, and an opportunistic human pathogen. Information on Cff as an ovine abortifacient in South America is limited. We describe a case of abortion caused by a multidrug resistant strain of Cff in a sheep in Uruguay. In August 2017, 3/57 pregnant ewes (5.3%) aborted whithin one week. Histopathologic examination of the placenta of an aborted ewe revealed severe neutrophilic and fibrinonecrotizing placentitis with vasculitis and thrombosis of the chorionic arterioles. Cff was isolated on microaerobic culture in Skirrow agar, and further confirmed by 16S rDNA PCR amplification and sequencing, and endpoint and real time PCR assays. Antimicrobial sensitivity testing revealed resistance to tetracyclines, nalidixic acid, telithromycin and clindamycin. Other abortifacients were not detected. Further studies are necessary to determine the geographic distribution, ecology, epidemiology, economic impact, and antimicrobial resistance of Cff in sheep flocks in Uruguay.
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Affiliation(s)
- Matías A Dorsch
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - María L Casaux
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Lucía Calleros
- Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Virginia Aráoz
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Rubén D Caffarena
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay; Facultad de Veterinaria, Universidad de la República, Montevideo, Uruguay
| | - Cecilia Monesiglio
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Maila Barcellos
- Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Caroline da Silva Silveira
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Yisell Perdomo
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Georgget Banchero
- Programa Nacional de Investigación en Producción de Carne y Lana, Instituto Nacional de Investigación Agropecuaria (INIA), Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Francisco A Uzal
- California Animal Health and Food Safety (CAHFS), San Bernardino Laboratory, University of California-Davis, San Bernardino, CA, USA
| | - Martín Fraga
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Federico Giannitti
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA), Ruta 50 Km 11, Estación Experimental La Estanzuela, Colonia, Uruguay.
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17
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Shionoya K, Tonozuka R, Itoi T, Sofuni A, Tsuchiya T, Ishii K, Tanaka R, Mukai S, Nagai K, Yamamoto K, Nakamura I. Severe Acute Cholangitis and Bacteremia Due to Campylobacter jejuni: A Case Report and Review of the Literature. Intern Med 2021; 60:3737-3741. [PMID: 34024858 PMCID: PMC8710384 DOI: 10.2169/internalmedicine.7380-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Campylobacter jejuni is common cause of enteritis, but biliary infection rarely reported. An 82-year-old woman with pancreatic head cancer underwent endoscopic biliary drainage for malignant biliary obstruction. She was subsequently admitted for management of diarrhea. C. jejuni was identified in stool culture. Her symptoms resolved temporarily without antibiotics but flared up with a fever a few days later. She was diagnosed with acute cholangitis and bacteremia with C. jejuni. Endoscopic biliary drainage and antimicrobial administration improved her symptoms. As complications of C. jejuni diarrhea are rare, antibiotics are not necessarily indicated but sometimes are needed to prevent complications.
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Affiliation(s)
- Kento Shionoya
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Ryosuke Tonozuka
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Atsushi Sofuni
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Takayoshi Tsuchiya
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Kentaro Ishii
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Reina Tanaka
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Shuntaro Mukai
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Kazumasa Nagai
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Kenjiro Yamamoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan
| | - Itaru Nakamura
- Department of Infection Prevention and Control, Tokyo Medical University, Japan
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18
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Kano Y. Campylobacter enterocolitis: the importance of macroscopic and microscopic examination of stool. BMJ Case Rep 2021; 14:e246552. [PMID: 34725067 PMCID: PMC8562537 DOI: 10.1136/bcr-2021-246552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Yasuhiro Kano
- Department of General Internal Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
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19
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Ondrikova N, Clough HE, Douglas A, Iturriza-Gomara M, Larkin L, Vivancos R, Harris JP, Cunliffe NA. Differential impact of the COVID-19 pandemic on laboratory reporting of norovirus and Campylobacter in England: A modelling approach. PLoS One 2021; 16:e0256638. [PMID: 34432849 PMCID: PMC8386829 DOI: 10.1371/journal.pone.0256638] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background The COVID-19 pandemic has impacted surveillance activities for multiple pathogens. Since March 2020, there was a decline in the number of reports of norovirus and Campylobacter recorded by England’s national laboratory surveillance system. The aim is to estimate and compare the impact of the COVID-19 pandemic on norovirus and Campylobacter surveillance data in England. Methods We utilised two quasi-experimental approaches based on a generalised linear model for sequential count data. The first approach estimates overall impact and the second approach focuses on the impact of specific elements of the pandemic response (COVID-19 diagnostic testing and control measures). The following time series (27, 2015–43, 2020) were used: weekly laboratory-confirmed norovirus and Campylobacter reports, air temperature, conducted Sars-CoV-2 tests and Index of COVID-19 control measures stringency. Results The period of Sars-CoV-2 emergence and subsequent sustained transmission was associated with persistent reductions in norovirus laboratory reports (p = 0.001), whereas the reductions were more pronounced during pandemic emergence and later recovered for Campylobacter (p = 0.075). The total estimated reduction was 47% - 79% for norovirus (12–43, 2020). The total reduction varied by time for Campylobacter, e.g. 19% - 33% in April, 1% - 7% in August. Conclusion Laboratory reporting of norovirus was more adversely impacted than Campylobacter by the COVID-19 pandemic. This may be partially explained by a comparatively stronger effect of behavioural interventions on norovirus transmission and a relatively greater reduction in norovirus testing capacity. Our study underlines the differential impact a pandemic may have on surveillance of gastrointestinal infectious diseases.
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Affiliation(s)
- Nikola Ondrikova
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- Institute for Risk & Uncertainty, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
| | - Helen E. Clough
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
| | - Amy Douglas
- Gastrointestinal Pathogens Unit, National Infection Service, Public Health England, London, United Kingdom
| | | | - Lesley Larkin
- Gastrointestinal Pathogens Unit, National Infection Service, Public Health England, London, United Kingdom
| | - Roberto Vivancos
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
- Field Service, National Infection Service, Public Health England, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - John P. Harris
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- North West Health Protection Team, Public Health England, Liverpool, United Kingdom
| | - Nigel A. Cunliffe
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, United Kingdom
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20
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Young P, Tarce P, Adhikary S, Connolly J, Crawshaw T, Ghorashi SA. Evaluation of high-resolution melt curve analysis for rapid differentiation of Campylobacter hepaticus from other species in birds. PLoS One 2021; 16:e0251328. [PMID: 33984000 PMCID: PMC8118346 DOI: 10.1371/journal.pone.0251328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/24/2021] [Indexed: 11/18/2022] Open
Abstract
Spotty liver disease (SLD) is a bacterial disease of chicken, causing mortalities and reduction in egg production, hence, contributing to economic loss in the poultry industry. The causative agent of SLD has only recently been identified as a novel Campylobacter species, Campylobacter hepaticus. Specific primers were designed from the hsp60 gene of Campylobacter hepaticus and PCR followed by high-resolution melt curve analysis was optimised to detect and differentiate three species of Campylobacter (Campylobacter coli, Campylobacter jejuni and Campylobacter hepaticus). The three Campylobacter species produced a distinct curve profile and was differentiated using HRM curve analysis. The potential of the PCR-HRM curve analysis was shown in the genotyping of 37 Campylobacter isolates from clinical specimens from poultry farms. PCR-HRM curve analysis of DNA extracts from bile samples or cultures from bile samples, were identified as Campylobacter hepaticus and confirmed by DNA sequencing. The DNA sequence analysis of selected samples from each of the three HRM distinctive curves patterns showed that each DNA sequence was associated with a unique melt profile. The potential of the PCR-HRM curve analysis in genotyping of Campylobacter species was also evaluated using faecal specimens from 100 wild birds. The results presented in this study indicate that PCR followed by HRM curve analysis provides a rapid and robust technique for genotyping of Campylobacter species using either bacterial cultures or clinical specimens.
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Affiliation(s)
- Petrina Young
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Pol Tarce
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Sadhana Adhikary
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Joanne Connolly
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Tim Crawshaw
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
- School of Veterinary Sciences, Massey University, Tennent Drive, Palmerston North, New Zealand
| | - Seyed A. Ghorashi
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
- * E-mail:
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21
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Donner V, Croxatto A, Tissot F. [Invasive Campylobacter infections]. Rev Med Suisse 2021; 17:722-725. [PMID: 33852206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Campylobacter genus encompasses many species, among which C. jejuni, C. coli and C. fetus are the main human pathogens. C. jejuni/coli frequently cause self-limited enteritis in immunocompetent hosts and are seldomly associated with bacteriemia. C. fetus is less common as a human pathogen. It is rarely identified in fecal samples but can sometimes be isolated in blood samples from patients with comorbidities or immunosuppression. Campylobacter fetus bacteriemia is remarkable since it is associated with endovascular and deep-seated infections.
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Affiliation(s)
- Viviane Donner
- Service des maladies infectieuses, Département de médecine interne, CHUV, 1011 Lausanne
| | | | - Frédéric Tissot
- Service des maladies infectieuses, Département de médecine interne, CHUV, 1011 Lausanne
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Ramos AP, Leonhard SE, Halstead SK, Cuba MA, Castañeda CC, Dioses JA, Tipismana MA, Abanto JT, Llanos A, Gourlay D, Grogl M, Ramos M, Rojas JD, Meza R, Puiu D, Sherman RM, Salzberg SL, Simner PJ, Willison HJ, Jacobs BC, Cornblath DR, Umeres HF, Pardo CA. Guillain-Barré Syndrome Outbreak in Peru 2019 Associated With Campylobacter jejuni Infection. Neurol Neuroimmunol Neuroinflamm 2021; 8:e952. [PMID: 33547152 PMCID: PMC8057064 DOI: 10.1212/nxi.0000000000000952] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/23/2020] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To identify the clinical phenotypes and infectious triggers in the 2019 Peruvian Guillain-Barré syndrome (GBS) outbreak. METHODS We prospectively collected clinical and neurophysiologic data of patients with GBS admitted to a tertiary hospital in Lima, Peru, between May and August 2019. Molecular, immunologic, and microbiological methods were used to identify causative infectious agents. Sera from 41 controls were compared with cases for antibodies to Campylobacter jejuni and gangliosides. Genomic analysis was performed on 4 C jejuni isolates. RESULTS The 49 included patients had a median age of 44 years (interquartile range [IQR] 30-54 years), and 28 (57%) were male. Thirty-two (65%) had symptoms of a preceding infection: 24 (49%) diarrhea and 13 (27%) upper respiratory tract infection. The median time between infectious to neurologic symptoms was 3 days (IQR 2-9 days). Eighty percent had a pure motor form of GBS, 21 (43%) had the axonal electrophysiologic subtype, and 18% the demyelinating subtype. Evidence of recent C jejuni infection was found in 28/43 (65%). No evidence of recent arbovirus infection was found. Twenty-three cases vs 11 controls (OR 3.3, confidence interval [CI] 95% 1.2-9.2, p < 0.01) had IgM and/or IgA antibodies against C jejuni. Anti-GM1:phosphatidylserine and/or anti-GT1a:GM1 heteromeric complex antibodies were strongly positive in cases (92.9% sensitivity and 68.3% specificity). Genomic analysis showed that the C jejuni strains were closely related and had the Asn51 polymorphism at cstII gene. CONCLUSIONS Our study indicates that the 2019 Peruvian GBS outbreak was associated with C jejuni infection and that the C jejuni strains linked to GBS circulate widely in different parts of the world.
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Affiliation(s)
- Ana P. Ramos
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sonja E. Leonhard
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Susan K. Halstead
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mireya A. Cuba
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Carlos C. Castañeda
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jose A. Dioses
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Martin A. Tipismana
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jesus T. Abanto
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alejandro Llanos
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Dawn Gourlay
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Max Grogl
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mariana Ramos
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jesus D. Rojas
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rina Meza
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Daniela Puiu
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rachel M. Sherman
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steven L. Salzberg
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Patricia J. Simner
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Hugh J. Willison
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bart C. Jacobs
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - David R. Cornblath
- From the Departamento de Medicina (A.P.R., M.A.C., C.C.C., J.A.D., M.A.T., J.T.A., H.F.U.), Servicio de Neurología y Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú; Department of Neurology (S.E.L.) and Department of Neurology and Department of Immunology (B.C.J.), Erasmus MC, University Medical Center Rotterdam, Netherlands; Institute of Infection, Immunity and Inflammation (S.K.H., D.G., H.J.W.), University of Glasgow, United Kingdom; Departamento de Enfermedades Infecciosas Tropicales y Dermatológicas (A.L.), Hospital Cayetano Heredia, Lima, Perú; U.S. Naval Medical Research Unit-6 (M.G., M.R., J.D.R., R.M.), Lima, Peru; Center for Computational Biology (D.P., R.M.S., S.L.S.), Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD; and Department of Pathology (P.J.S.), Department of Neurology (D.R.C.), and Department of Neurology and Department of Pathology (C.A.P.), Johns Hopkins University School of Medicine, Baltimore, MD
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Nishikubo M, Nasu S, Maruoka H, Kawabata T, Ikeda M, Nishioka H. Sequential breast implant infections due to Campylobacter fetus subsp. fetus. J Infect Chemother 2021; 27:1080-1083. [PMID: 33563526 DOI: 10.1016/j.jiac.2021.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
Campylobacter jejuni and Campylobacter coli are the leading causes of bacterial intestinal infections worldwide, while Campylobacter fetus subsp. fetus (C. fetus) has been reported to cause extraintestinal infections, including medical device implant infections. However, breast implant infections have rarely been reported. We describe the case of a 64-year-old woman with breast implant infection and vertebral osteomyelitis due to C. fetus. The patient recovered by surgical removal of the infected left implant and was treated with antibiotics for 6 weeks. However, two weeks after the completion of antibiotics, she experienced an infection in the right implant due to C. fetus, which had developed quinolone resistance with a G91T mutation during the treatment course. This case showed that C. fetus can cause breast implant infections, and although the infection may appear to be unilateral initially, the possibility of sequential contralateral infection should be considered.
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Affiliation(s)
- Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan; Department of General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Hayato Maruoka
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomoya Kawabata
- Department of Plastic Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Mika Ikeda
- Department of Plastic Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Hiroaki Nishioka
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan.
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Wadie B, Abdel-Fattah MA, Yousef A, Mouftah SF, Elhadidy M, Salem TZ. In Silico Characterization of Toxin-Antitoxin Systems in Campylobacter Isolates Recovered from Food Sources and Sporadic Human Illness. Genes (Basel) 2021; 12:genes12010072. [PMID: 33430508 PMCID: PMC7826846 DOI: 10.3390/genes12010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
Campylobacter spp. represents the most common cause of gastroenteritis worldwide with the potential to cause serious sequelae. The ability of Campylobacter to survive stressful environmental conditions has been directly linked with food-borne illness. Toxin-antitoxin (TA) modules play an important role as defense systems against antimicrobial agents and are considered an invaluable strategy harnessed by bacterial pathogens to survive in stressful environments. Although TA modules have been extensively studied in model organisms such as Escherichia coli K12, the TA landscape in Campylobacter remains largely unexplored. Therefore, in this study, a comprehensive in silico screen of 111 Campylobacter (90 C.
jejuni and 21 C.
coli) isolates recovered from different food and clinical sources was performed. We identified 10 type II TA systems belonging to four TA families predicted in Campylobacter genomes. Furthermore, there was a significant association between the clonal population structure and distribution of TA modules; more specifically, most (12/13) of the Campylobacter isolates belonging to ST-21 isolates possess HicB-HicA TA modules. Finally, we observed a high degree of shared synteny among isolates bearing certain TA systems or even coexisting pairs of TA systems. Collectively, these findings provide useful insights about the distribution of TA modules in a heterogeneous pool of Campylobacter isolates from different sources, thus developing a better understanding regarding the mechanisms by which these pathogens survive stressful environmental conditions, which will further aid in the future designing of more targeted antimicrobials.
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Affiliation(s)
- Bishoy Wadie
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, October Gardens, 6th of October City, Giza 12578, Egypt; (B.W.); (A.Y.); (S.F.M.)
| | - Mohamed A. Abdel-Fattah
- Department of Agricultural Biotechnology, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt;
| | - Alshymaa Yousef
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, October Gardens, 6th of October City, Giza 12578, Egypt; (B.W.); (A.Y.); (S.F.M.)
| | - Shaimaa F. Mouftah
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, October Gardens, 6th of October City, Giza 12578, Egypt; (B.W.); (A.Y.); (S.F.M.)
| | - Mohamed Elhadidy
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, October Gardens, 6th of October City, Giza 12578, Egypt; (B.W.); (A.Y.); (S.F.M.)
- Department of Bacteriology, Mycology, and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt
- Correspondence: (M.E.); (T.Z.S.); Tel.: +20-1220786861 (M.E.); +20-1014114122 (T.Z.S.)
| | - Tamer Z. Salem
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, October Gardens, 6th of October City, Giza 12578, Egypt; (B.W.); (A.Y.); (S.F.M.)
- Department of Microbial Genetics, AGERI, ARC, Giza 12619, Egypt
- Correspondence: (M.E.); (T.Z.S.); Tel.: +20-1220786861 (M.E.); +20-1014114122 (T.Z.S.)
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Gordat K, Kosyra M, Sadkowska-Todys M. Campylobacteriosis in Poland in 2018-2019. Przegl Epidemiol 2021; 75:656-664. [PMID: 35543598 DOI: 10.32394/pe.75.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Campylobacteriosis is a zoonotic disease caused by bacteria of the genus Campylobacter. This disease usually presents with symptoms of acute gastroenteritis. The majority of Campylobacter infections are usually acquired through consumption of contaminated water or food, less frequently through direct contact with an infected animal or person. In Poland, campylobacteriosis is notifiable disease, according to the EU deffinition implemented in the polish surveillance system. AIM OF THE STUDY The aim of this study is to assess epidemiological situation of campylobacteriosis in Poland in years 2018-2019 and compare it to previous years. MATERIALS AND METHODS The study was based on data from the bulletins 'Infectious Diseases and Poisonings in Poland' for 2018-2019 issued by the National Institute of Public Health NIH - National Research Institute and data submitted to the System for Registration of Epidemiological Interwiews (SRWE) by District Sanitary and Epidemiological Stations. RESULTS In Poland 726 cases of Campylobacterosis were reported in 2018 and 715 in 2019. There was a decrease in the number of reported cases in comparision to 2017 by 17% and 19% in 2018 and 2019 respectively. Cases of campylobacteriosis were reported in all voivodeships, with the highest incidence in both described years in Lubuskie voivodeship. Campylobacteriosis was diagnosed in patients in all age groups but the majority of patients were children under the age of 4. The most frequently identified species was Campylobacter jejuni. SUMMARY AND CONCLUSIONS Data on the number of campylobacteriosis infections in Poland for 2018 and 2019, demonstrate a stabilized epidemiological situation regarding this disease entity in the country. The high hospitalization rate of patients diagnosed with campylobacteriosis, demonstrates the need to implement microbiological diagnostics in cases of suspected disease. Data show a much lower incidence rate of campylobacteriosis in Poland, compared to other EU countries, which suggests potential underestimation of the actual number of infected case.
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Affiliation(s)
- Katarzyna Gordat
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Marta Kosyra
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Małgorzata Sadkowska-Todys
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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Ilktac M, Ongen B. Molecular Typing of Campylobacter jejuni and Campylobacter coli of Human Strains Isolated in Turkey Over an Eight-Year Period. Clin Lab 2020; 66. [PMID: 32162883 DOI: 10.7754/clin.lab.2019.190613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Campylobacter spp. is one of the leading causes of bacterial foodborne infections worldwide. In this study, we aimed to investigate the genetic diversity of 341 Campylobacter strains isolated in Turkey. METHODS Campylobacter spp. was identified by phenotypical methods and PCR. Species level identification was carried out by the hippurate hydrolysis test and PCR. C. jejuni and C. coli strains were typed by using flaA-RFLP and PFGE. RESULTS Of 341 strains, 300 (88%), 37 (10.8%), and four were identified as C. jejuni, C. coli, and non-jejuni/non-coli, respectively. The hippurate hydrolysis test misidentified 12% of 341 strains. The typeabilities of flaA-RFLP and PFGE were 100% for C. coli, whereas those of flaA-RFLP and PFGE for C. jejuni were 99.3% and 99%, respectively. The discriminatory power of the combination of PFGE and flaA-RFLP was determined to be higher than either method alone for both C. jejuni and C. coli. Both of the strains were so diverse that 80% and 64% of C. jejuni and C. coli genotypes included only one strain, respectively. In two patients, Campylobacter strains that were isolated from the first stool samples were C. jejuni where as those isolated from the second samples, collected eight and 20 days after the collection of the first samples, were C. coli. C. jejuni strains that were recovered from two different stool samples of two patients, collected 1 - 2 days apart, were found to be genetically different. CONCLUSIONS Species identification of Campylobacter strains should be done using molecular methods. Combination of two methods is prerequisite for increasing the accuracy of molecular typing. Mixed or subsequent infection by different Campylobacter species and C. jejuni of different genotypes should not be underestimated.
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Pye J, Galuppo L, Whitcomb MB, Clothier K, Byrne B. Isolation of Campylobacter fetus subspecies fetus from an abdominal abscess in an adult mare. Can Vet J 2020; 61:1307-1311. [PMID: 33299249 PMCID: PMC7659885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 12-year-old Warmblood mare was referred for evaluation of behavioral changes not explained by general physical examination or lameness evaluation. Transrectal ultrasound examination was performed to determine if the behavioral changes were related to ovarian abnormalities, and a large abscess was found near the base of the cecum. Laparoscopic-guided aspiration and lavage of the abscess cavity followed by injection of benzyl penicillin G was carried out. Culture of the lavage sample yielded Campylobacter fetus subspecies fetus, an organism not previously reported as an etiological agent in abdominal abscesses in horses. The mare was treated after surgery with an extended course of antibiotics (minocycline per os q12h for 10 days followed by enrofloxacin per os q24h for 42 days). The mare resumed work in competitive eventing 10 months after surgery, and the behavioral complaints had resolved according to the owner. Key clinical message: We describe the diagnosis and treatment of a mare with an abdominal abscess from which Campylobacter fetus subspecies fetus was cultured. This organism has not previously been reported as an etiological agent in abdominal abscesses in horses.
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Affiliation(s)
- Jannah Pye
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye), Department of Surgical and Radiological Sciences (Galuppo, Whitcomb), Department of Pathology, Microbiology & Immunology (Clothier, Byrne), School of Veterinary Medicine, University of California - Davis, One Shields Avenue, Davis, California 95616, USA
| | - Larry Galuppo
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye), Department of Surgical and Radiological Sciences (Galuppo, Whitcomb), Department of Pathology, Microbiology & Immunology (Clothier, Byrne), School of Veterinary Medicine, University of California - Davis, One Shields Avenue, Davis, California 95616, USA
| | - Mary Beth Whitcomb
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye), Department of Surgical and Radiological Sciences (Galuppo, Whitcomb), Department of Pathology, Microbiology & Immunology (Clothier, Byrne), School of Veterinary Medicine, University of California - Davis, One Shields Avenue, Davis, California 95616, USA
| | - Kirsten Clothier
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye), Department of Surgical and Radiological Sciences (Galuppo, Whitcomb), Department of Pathology, Microbiology & Immunology (Clothier, Byrne), School of Veterinary Medicine, University of California - Davis, One Shields Avenue, Davis, California 95616, USA
| | - Barbara Byrne
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye), Department of Surgical and Radiological Sciences (Galuppo, Whitcomb), Department of Pathology, Microbiology & Immunology (Clothier, Byrne), School of Veterinary Medicine, University of California - Davis, One Shields Avenue, Davis, California 95616, USA
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28
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Adnan M, Gao X, Bai X, Newbern E, Sherwood J, Jones N, Baker M, Wood T, Gao W. Potential Early Identification of a Large Campylobacter Outbreak Using Alternative Surveillance Data Sources: Autoregressive Modelling and Spatiotemporal Clustering. JMIR Public Health Surveill 2020; 6:e18281. [PMID: 32940617 PMCID: PMC7530686 DOI: 10.2196/18281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/10/2020] [Accepted: 06/13/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over one-third of the population of Havelock North, New Zealand, approximately 5500 people, were estimated to have been affected by campylobacteriosis in a large waterborne outbreak. Cases reported through the notifiable disease surveillance system (notified case reports) are inevitably delayed by several days, resulting in slowed outbreak recognition and delayed control measures. Early outbreak detection and magnitude prediction are critical to outbreak control. It is therefore important to consider alternative surveillance data sources and evaluate their potential for recognizing outbreaks at the earliest possible time. OBJECTIVE The first objective of this study is to compare and validate the selection of alternative data sources (general practice consultations, consumer helpline, Google Trends, Twitter microblogs, and school absenteeism) for their temporal predictive strength for Campylobacter cases during the Havelock North outbreak. The second objective is to examine spatiotemporal clustering of data from alternative sources to assess the size and geographic extent of the outbreak and to support efforts to attribute its source. METHODS We combined measures derived from alternative data sources during the 2016 Havelock North campylobacteriosis outbreak with notified case report counts to predict suspected daily Campylobacter case counts up to 5 days before cases reported in the disease surveillance system. Spatiotemporal clustering of the data was analyzed using Local Moran's I statistics to investigate the extent of the outbreak in both space and time within the affected area. RESULTS Models that combined consumer helpline data with autoregressive notified case counts had the best out-of-sample predictive accuracy for 1 and 2 days ahead of notified case reports. Models using Google Trends and Twitter typically performed the best 3 and 4 days before case notifications. Spatiotemporal clusters showed spikes in school absenteeism and consumer helpline inquiries that preceded the notified cases in the city primarily affected by the outbreak. CONCLUSIONS Alternative data sources can provide earlier indications of a large gastroenteritis outbreak compared with conventional case notifications. Spatiotemporal analysis can assist in refining the geographical focus of an outbreak and can potentially support public health source attribution efforts. Further work is required to assess the location of such surveillance data sources and methods in routine public health practice.
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Affiliation(s)
- Mehnaz Adnan
- Institute of Environmental Science and Research, Porirua, New Zealand
| | - Xiaoying Gao
- Victoria University of Wellington, Wellington, New Zealand
| | - Xiaohan Bai
- Victoria University of Wellington, Wellington, New Zealand
| | - Elizabeth Newbern
- Institute of Environmental Science and Research, Porirua, New Zealand
| | - Jill Sherwood
- Institute of Environmental Science and Research, Porirua, New Zealand
| | - Nicholas Jones
- Hawke's Bay District Health Board, Hawke's Bay, New Zealand
| | | | - Tim Wood
- Institute of Environmental Science and Research, Porirua, New Zealand
| | - Wei Gao
- Victoria University of Wellington, Wellington, New Zealand
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Pascoe B, Schiaffino F, Murray S, Méric G, Bayliss SC, Hitchings MD, Mourkas E, Calland JK, Burga R, Yori PP, Jolley KA, Cooper KK, Parker CT, Olortegui MP, Kosek MN, Sheppard SK. Genomic epidemiology of Campylobacter jejuni associated with asymptomatic pediatric infection in the Peruvian Amazon. PLoS Negl Trop Dis 2020; 14:e0008533. [PMID: 32776937 PMCID: PMC7440661 DOI: 10.1371/journal.pntd.0008533] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/20/2020] [Accepted: 06/29/2020] [Indexed: 12/20/2022] Open
Abstract
Campylobacter is the leading bacterial cause of gastroenteritis worldwide and its incidence is especially high in low- and middle-income countries (LMIC). Disease epidemiology in LMICs is different compared to high income countries like the USA or in Europe. Children in LMICs commonly have repeated and chronic infections even in the absence of symptoms, which can lead to deficits in early childhood development. In this study, we sequenced and characterized C. jejuni (n = 62) from a longitudinal cohort study of children under the age of 5 with and without diarrheal symptoms, and contextualized them within a global C. jejuni genome collection. Epidemiological differences in disease presentation were reflected in the genomes, specifically by the absence of some of the most common global disease-causing lineages. As in many other countries, poultry-associated strains were likely a major source of human infection but almost half of local disease cases (15 of 31) were attributable to genotypes that are rare outside of Peru. Asymptomatic infection was not limited to a single (or few) human adapted lineages but resulted from phylogenetically divergent strains suggesting an important role for host factors in the cryptic epidemiology of campylobacteriosis in LMICs. Campylobacter is the leading bacterial cause of gastroenteritis worldwide and despite high incidence in low- and middle-income countries (LMICs), where infection can be fatal, culture based isolation is rare and the genotypes responsible for disease have not broadly been identified. The epidemiology of disease is different to that in high income countries, where sporadic infection associated with contaminated food consumption typically leads to acute gastroenteritis. In some LMICs infection is endemic among children and common asymptomatic carriage is associated with malnutrition, attenuated growth in early childhood, and poor cognitive and physical development. Here, we sequenced the genomes of isolates sampled from children in the Peruvian Amazon to investigate genotypes associated with varying disease severity and the source of infection. Among the common globally circulating genotypes and local genotypes rarely seen before, no single lineage was responsible for symptomatic or asymptomatic infection–suggesting an important role for host factors. However, consistent with other countries, poultry-associated strains were a likely major source of infection. This genomic surveillance approach, that integrates microbial ecology with population based studies in humans and animals, has considerable potential for describing cryptic epidemiology in LMICs and will inform work to improve infant health worldwide.
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Affiliation(s)
- Ben Pascoe
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
- Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
- * E-mail: (BP); (MNK)
| | - Francesca Schiaffino
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Susan Murray
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, United Kingdom
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratories, Uppsala University, Uppsala, Sweden
| | - Guillaume Méric
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Sion C. Bayliss
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Matthew D. Hitchings
- Swansea University Medical School, Swansea University, Singleton Park, Swansea, United Kingdom
| | - Evangelos Mourkas
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Jessica K. Calland
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
| | - Rosa Burga
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Iquitos, Peru
| | - Pablo Peñataro Yori
- The Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
- Asociacion Benefica Prisma, Loreto, Peru
| | - Keith A. Jolley
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
| | - Kerry K. Cooper
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, Arizona, United States of America
| | - Craig T. Parker
- Produce Safety and Microbiology Research Unit, Agricultural Research Service, US Department of Agriculture, Albany, California, United States of America
| | | | - Margaret N. Kosek
- The Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, United States of America
- Asociacion Benefica Prisma, Loreto, Peru
- * E-mail: (BP); (MNK)
| | - Samuel K. Sheppard
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, United Kingdom
- Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Zoology, University of Oxford, South Parks Road, Oxford, United Kingdom
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Martora F, Pagliuca C, Della Pepa ME, Della Rocca MT, Curto S, Iovene MR, Vitiello M. Campylobacter jejuni bacteremia in Italian pediatric patients with acute lymphoblastic leukemia: Report of two cases. New Microbiol 2020; 43:96-98. [PMID: 32310303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
Infections caused by Campylobacter jejuni are rarely associated with extraintestinal complications. C. jejuni bacteremia is difficult to detect in patients with hematological malignancies undergoing chemotherapy where the choice of appropriate antibiotic treatment is extremely important. We report two cases of C. jejuni bacteremia in Italian pediatric patients affected by acute lymphoblastic leukemia (ALL). Agreeing with the most recent epidemiological data, both clinical isolates showed a typical phenotypic antimicrobial resistance patterns with combined resistance to ciprofloxacin and tetracycline. To our knowledge, this is the first report of C. jejuni isolation from the blood of ALL pediatric patients in Italy, and it provides important epidemiological information on this rare infection.
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Affiliation(s)
- Francesca Martora
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy
| | - Chiara Pagliuca
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Via S. Pansini 5, 80135 Naples, Italy
| | - Maria Elena Della Pepa
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy
| | - Maria Teresa Della Rocca
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy
| | - Stefano Curto
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy
| | - Maria Rosaria Iovene
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy
| | - Mariateresa Vitiello
- Department of Clinical Pathology, Virology Unit, "San Giovanni di Dio e Ruggi d'Aragona Hospital", Salerno, Italy
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Golz JC, Epping L, Knüver MT, Borowiak M, Hartkopf F, Deneke C, Malorny B, Semmler T, Stingl K. Whole genome sequencing reveals extended natural transformation in Campylobacter impacting diagnostics and the pathogens adaptive potential. Sci Rep 2020; 10:3686. [PMID: 32111893 PMCID: PMC7048796 DOI: 10.1038/s41598-020-60320-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/05/2020] [Indexed: 11/09/2022] Open
Abstract
Campylobacter is the major bacterial agent of human gastroenteritis worldwide and represents a crucial global public health burden. Species differentiation of C. jejuni and C. coli and phylogenetic analysis is challenged by inter-species horizontal gene transfer. Routine real-time PCR on more than 4000 C. jejuni and C. coli field strains identified isolates with ambiguous PCR results for species differentiation, in particular, from the isolation source eggs. K-mer analysis of whole genome sequencing data indicated the presence of C. coli hybrid strains with huge amounts of C. jejuni introgression. Recombination events were distributed over the whole chromosome. MLST typing was impaired, since C. jejuni sequences were also found in six of the seven housekeeping genes. cgMLST suggested that the strains were phylogenetically unrelated. Intriguingly, the strains shared a stress response set of C. jejuni variant genes, with proposed roles in oxidative, osmotic and general stress defence, chromosome maintenance and repair, membrane transport, cell wall and capsular biosynthesis and chemotaxis. The results have practical impact on routine typing and on the understanding of the functional adaption to harsh environments, enabling successful spreading and persistence of Campylobacter.
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Affiliation(s)
- Julia C Golz
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Campylobacter, Berlin, Germany
| | - Lennard Epping
- Robert Koch Institute, Microbial Genomics, Berlin, Germany
| | - Marie-Theres Knüver
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Campylobacter, Berlin, Germany
| | - Maria Borowiak
- German Federal Institute for Risk Assessment, Department of Biological Safety, Study Centre for Genome Sequencing and Analysis, Berlin, Germany
| | - Felix Hartkopf
- Robert Koch Institute, Microbial Genomics, Berlin, Germany
| | - Carlus Deneke
- German Federal Institute for Risk Assessment, Department of Biological Safety, Study Centre for Genome Sequencing and Analysis, Berlin, Germany
| | - Burkhard Malorny
- German Federal Institute for Risk Assessment, Department of Biological Safety, Study Centre for Genome Sequencing and Analysis, Berlin, Germany
| | | | - Kerstin Stingl
- German Federal Institute for Risk Assessment, Department of Biological Safety, National Reference Laboratory for Campylobacter, Berlin, Germany.
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Abstract
Myocarditis is a rare complication of acute diarrhea due to Campylobacter Jejuni infection. We present the case of 25-year-old male who presented with campylobacter jejuni colitis who subsequently had chest pain and elevated cardiac biomarkers. The patient developed acute myocarditis confirmed on cardiac magnetic resonance imaging.
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Affiliation(s)
- Oussama Daboussi
- Department of Gastroenterology, Hospital Center Chartres, France
| | - Salamata Diallo
- Department of Gastroenterology, Hospital Center Chartres, France
- Department of Gastroenterology, Hospital Center Aristide Le Dantec, Senegal
- Corresponding author: Salamata Diallo, Department of Gastroenterology, Hospital Center Chartres, France.
| | - Boundia Djiba
- Department of Gastroenterology, Hospital Center Chartres, France
- Department of internal Medicine, Hospital Center Aristide Le Dantec, Senegal
| | - Mamadou Ngoné Gueye
- Department of Gastroenterology, Hospital Center Chartres, France
- Department of Gastroenterology, Hospital Center Idrissa Pouye, Senegal
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Cody AJ, Maiden MC, Strachan NJ, McCarthy ND. A systematic review of source attribution of human campylobacteriosis using multilocus sequence typing. Euro Surveill 2019; 24:1800696. [PMID: 31662159 PMCID: PMC6820127 DOI: 10.2807/1560-7917.es.2019.24.43.1800696] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/07/2019] [Indexed: 12/31/2022] Open
Abstract
BackgroundCampylobacter is a leading global cause of bacterial gastroenteritis, motivating research to identify sources of human infection. Population genetic studies have been increasingly applied to this end, mainly using multilocus sequence typing (MLST) data.ObjectivesThis review aimed to summarise approaches and findings of these studies and identify best practice lessons for this form of genomic epidemiology.MethodsWe systematically reviewed publications using MLST data to attribute human disease isolates to source. Publications were from January 2001, when this type of approach began. Searched databases included Scopus, Web of Science and PubMed. Information on samples and isolate datasets used, as well as MLST schemes and attribution algorithms employed, was obtained. Main findings were extracted, as well as any results' validation with subsequent correction for identified biases. Meta-analysis is not reported given high levels of heterogeneity.ResultsOf 2,109 studies retrieved worldwide, 25 were included, and poultry, specifically chickens, were identified as principal source of human infection. Ruminants (cattle or sheep) were consistently implicated in a substantial proportion of cases. Data sampling and analytical approaches varied, with five different attribution algorithms used. Validation such as self-attribution of isolates from known sources was reported in five publications. No publication reported adjustment for biases identified by validation.ConclusionsCommon gaps in validation and adjustment highlight opportunities to generate improved estimates in future genomic attribution studies. The consistency of chicken as the main source of human infection, across high income countries, and despite methodological variations, highlights the public health importance of this source.
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Affiliation(s)
- Alison J Cody
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Oxford, Oxford, United Kingdom
| | - Martin Cj Maiden
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Oxford, Oxford, United Kingdom
| | - Norval Jc Strachan
- School of Biological Sciences, University of Aberdeen, St. Machar Drive, Aberdeen, United Kingdom
| | - Noel D McCarthy
- Department of Zoology, University of Oxford, Oxford, United Kingdom
- NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Oxford, Oxford, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Meistere I, Ķibilds J, Eglīte L, Alksne L, Avsejenko J, Cibrovska A, Makarova S, Streikiša M, Grantiņa-Ieviņa L, Bērziņš A. Campylobacter species prevalence, characterisation of antimicrobial resistance and analysis of whole-genome sequence of isolates from livestock and humans, Latvia, 2008 to 2016. Euro Surveill 2019; 24:1800357. [PMID: 31387670 PMCID: PMC6685098 DOI: 10.2807/1560-7917.es.2019.24.31.1800357] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 03/25/2019] [Indexed: 11/20/2022] Open
Abstract
BackgroundCampylobacter is the main cause of bacterial gastroenteritis worldwide. The main transmission route is through consumption of food contaminated with Campylobacter species or contact with infected animals. In Latvia, the prevalence of campylobacteriosis is reported to be low (4.6 cases per 100,000 population in 2016).AimTo determine prevalence, species spectrum and antimicrobial resistance (AMR) of Campylobacter spp. in Latvia, using data from various livestock and human clinical samples.MethodsWe analysed data of Campylobacter microbiological monitoring and AMR (2008 and 2014-16) in Latvia. Data from broilers, poultry, pigs, calves and humans were used to determine prevalence of Campylobacter. Additionally, 45 different origin isolates (22 human) were sequenced on the Illumina MiSeq platform; for each isolate core genome multilocus sequence typing was used and relevant antimicrobial resistance mechanisms were identified.ResultsOverall, Campylobacter prevalence in was 83.3% in pigs, 50.2% in broilers, 16.1% in calves and 5.3% in humans; C. jejuni was the predominant species in all sources except pigs where C. coli was main species. High level of resistance in Campylobacter were observed against fluoroquinolones, tetracycline and streptomycin, in most of sequenced isolates genetic determinants of relevant AMR profiles were identified.ConclusionsIn Latvia, prevalence of Campylobacter in livestock is high, especially in pigs and broilers; prevalence in poultry and humans were lower than in other European countries. AMR analysis reveals increase of streptomycin and tetracycline resistant broiler origin C. jejuni strains. WGS demonstrates a high compliance between resistance phenotype and genotype for quinolones and tetracyclines.
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Affiliation(s)
- Irēna Meistere
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Juris Ķibilds
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Lāsma Eglīte
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Laura Alksne
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Jeļena Avsejenko
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Alla Cibrovska
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Svetlana Makarova
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | - Madara Streikiša
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
| | | | - Aivars Bērziņš
- Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
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Skripkina E, Canivet A, Wautier M, Martiny D, Hallin M, Meex C, Layios N. [Campylobacter jejuni meningitis]. Rev Med Liege 2019; 74:420-423. [PMID: 31373458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cases of Campylobacter jejuni meningitis are extremely rare. In the literature, less than ten cases have been described so far, although Campylobacter spp is one of the most common pathogens causing gastroenteritis in the world. Some common stigmata can be found across these cases such as rupture of the blood-brain barrier, immunosuppression, as well as the tropism of Camplylobacter jejuni for neurological parenchyma. Campylobacter jejuni bacteremia is certainly underestimated because Campylobacter is a thermophilic bacterium and special conditions are required to isolate this organism in blood cultures. PCR is thus an interesting alternative technique for diagnosis. In our case, a patient with a history of resected astrocytoma, had undergone treatment with chemotherapy and radiotherapy because of anaplastic transformation. The patient was admitted with gastroenteritis and Campylobacter jejuni meningitis. The diagnosis was obtained initially on stool cultures and then by PCR of cerebrospinal fluid. The evolution was favorable with meropenem.
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Affiliation(s)
- E Skripkina
- Service d'Anesthésie-Réanimation, CHU Liège, Belgique
| | - A Canivet
- Service de Cardiologie et des Soins Intensifs, CHC Liège, Belgique
| | - M Wautier
- Département de Microbiologie, LHUB-ULB, National Reference Center for Campylobacter, CHU Saint-Pierre, Bruxelles, Belgique
| | - D Martiny
- Département de Microbiologie, LHUB-ULB, National Reference Center for Campylobacter, CHU Saint-Pierre, Bruxelles, Belgique
| | - M Hallin
- Département de Microbiologie, LHUB-ULB, National Reference Center for Campylobacter, CHU Saint-Pierre, Bruxelles, Belgique
| | - C Meex
- ) Service de Microbiologie Clinique, CHU Liège, Belgique
| | - N Layios
- Service de Soins Intensifs généraux, CHU Liège, Belgique
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Agnetti J, Seth-Smith HMB, Ursich S, Reist J, Basler M, Nickel C, Bassetti S, Ritz N, Tschudin-Sutter S, Egli A. Clinical impact of the type VI secretion system on virulence of Campylobacter species during infection. BMC Infect Dis 2019; 19:237. [PMID: 30845966 PMCID: PMC6407262 DOI: 10.1186/s12879-019-3858-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 02/28/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The clinical course of Campylobacter infection varies in symptoms and severity depending on host factors, virulence of the pathogen and initiated therapy. The type VI secretion system (T6SS) has been identified as a novel virulence factor, which mediates contact-dependent injection of enzymes and toxins into competing bacteria or host cells and facilitates the colonisation of a host organism. We aimed to compare the clinical course of Campylobacter infection caused by strains with and without the T6SS and identify possible associations between this putative virulence factor and the clinical manifestations of disease. METHODS From April 2015 to January 2017, patients with detection of Campylobacter spp. were identified at the University Hospital of Basel and the University Children's Hospital of Basel and included in this case-control study. Presence of the T6SS gene cluster was assayed by PCR targeting the hcp gene, confirmed with whole genome sequencing. Pertinent clinical data was collected by medical record review. Differences in disease- and host-characteristics between T6SS-positive (case) and -negative (control) were compared in a uni- and multi-variable analysis. Hospital admission, antibiotic therapy, admission to intensive care unit, development of bacteraemia and in-hospital mortality were considered as clinical endpoints. RESULTS We identified 138 cases of Campylobacter jejuni infections and 18 cases of Campylobacter coli infections from a paediatric and adult population. Analyses were focused on adult patients with C. jejuni (n = 119) of which 16.8% were T6SS-positive. Comparisons between T6SS-positive and -negative C. jejuni isolates did not reveal significant differences regarding clinical manifestations or course of disease. All clinical endpoints showed a similar distribution in both groups. A higher score in the Charlson Comorbidity Index was associated with T6SS-positive C. jejuni isolates (p < 0.001) and patients were more likely to have a solid organ transplant and to be under immunosuppressive therapy. CONCLUSIONS Our study does not provide evidence that T6SS is associated with a more severe clinical course. Interestingly, T6SS-positive isolates are more commonly found in immunocompromised patients: an observation which merits further investigation.
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Affiliation(s)
- Jessica Agnetti
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Helena M. B. Seth-Smith
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- Clinical Microbiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Sebastian Ursich
- Biozentrum, University of Basel, Basel, Switzerland
- Current address: Institute for Molecular Cancer Research IMCR, University of Zürich, Zürich, Switzerland
| | - Josiane Reist
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- Clinical Microbiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Marek Basler
- Biozentrum, University of Basel, Basel, Switzerland
| | - Christian Nickel
- Emergency Department, University Hospital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Nicole Ritz
- Paediatric Infectious Diseases and Vaccinology, University Children Hospital Basel, Basel, Switzerland
- Department of Pediatrics, Royal Children’s Hospital Melbourne, University of Melbourne, Parkville, Australia
| | - Sarah Tschudin-Sutter
- Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Adrian Egli
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
- Current address: Institute for Molecular Cancer Research IMCR, University of Zürich, Zürich, Switzerland
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Ahmad W, Nguyen NH, Boland BS, Dulai PS, Pride DT, Bouland D, Sandborn WJ, Singh S. Comparison of Multiplex Gastrointestinal Pathogen Panel and Conventional Stool Testing for Evaluation of Diarrhea in Patients with Inflammatory Bowel Diseases. Dig Dis Sci 2019; 64:382-390. [PMID: 30361807 PMCID: PMC6358459 DOI: 10.1007/s10620-018-5330-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Gastrointestinal pathogen panels (GPPs) are increasingly being used for evaluation of diarrhea. The impact of these tests on patients with inflammatory bowel diseases (IBD) is unknown. We performed a time-interrupted cohort study comparing GPPs and conventional stool evaluation in patients with IBD with diarrhea. METHODS We included 268 consecutive patients with IBD who underwent GPP (BioFire Diagnostics®) (n = 134) or conventional stool culture and Clostridium difficile polymerase chain reaction testing (n = 134) during suspected IBD flare between 2012 and 2016. Primary outcome was composite of 30-day IBD-related hospitalization, surgery, or emergency department visit; secondary outcome was IBD treatment modification. RESULTS Overall, 41/134 (30.6%) patients tested positive on GPP (18 C. difficile, 17 other bacterial infections, and 6 viral pathogens) versus 14/134 patients (10.4%, all C. difficile) testing positive on conventional testing. Rate of IBD treatment modification in response to stool testing was lower in GPP group as compared conventional stool testing group (35.1 vs. 64.2%, p < 0.01). On multivariate analysis, diagnostic evaluation with GPP was associated with three times higher odds of IBD-related hospitalization/surgery/ED visit (95% CI, 1.27-7.14), as compared to conventional stool testing. This negative impact was partly mediated by differences in ordering provider specialty, with non-gastroenterologists more likely to order GPP as compared to gastroenterologists. CONCLUSIONS In patients with suspected flare of IBD, GPPs have higher pathogen detection rate and lead to lower rate of IBD treatment modification. A diagnostic testing strategy based on GPPs is associated with higher hospital-related healthcare utilization as compared to conventional stool testing, particularly when utilized by non-gastroenterologists.
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Affiliation(s)
- Waseem Ahmad
- Department of Internal Medicine, University of California San Diego, La Jolla, CA, USA
| | - Nghia H Nguyen
- Department of Internal Medicine, University of California San Diego, La Jolla, CA, USA
| | - Brigid S Boland
- Division of Gastroenterology, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W501, La Jolla, CA, 92093, USA
| | - Parambir S Dulai
- Division of Gastroenterology, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W501, La Jolla, CA, 92093, USA
| | - David T Pride
- Department of Pathology and Infectious Diseases, University of California San Diego, La Jolla, CA, USA
| | - Daniel Bouland
- Division of Hospital Medicine, University of California San Diego, La Jolla, CA, USA
| | - William J Sandborn
- Division of Gastroenterology, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W501, La Jolla, CA, 92093, USA
| | - Siddharth Singh
- Division of Gastroenterology, University of California San Diego, 9452 Medical Center Drive, ACTRI 1W501, La Jolla, CA, 92093, USA.
- Division of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA.
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Oka K, Nakano Y, Sazumi Y, Michitani T, Horiguchi S, Ocho K, Iwamuro M, Otsuka F. Clival Osteomyelitis with Cavernous Sinus Thrombosis Due to Fusobacterium nucleatum and Campylobacter rectus Induced by Tooth Extraction. Intern Med 2018; 57:3325-3328. [PMID: 29984751 PMCID: PMC6288000 DOI: 10.2169/internalmedicine.1025-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A 70-year-old woman who had suffered from aseptic meningitis complained of chronic headache after dental treatment including tooth extraction. She developed a fever and respiratory failure. Based on chest computed tomography and head magnetic resonance imaging (MRI), she was diagnosed with osteomyelitis in the clivus accompanying moderate pituitary involvement, cavernous sinus thrombosis and septic pulmonary embolism. Both of the causal bacteria, Fusobacterium nucleatum and Campylobacter rectus, were isolated from her blood. Dual infection leading to clival osteomyelitis and cavernous sinus thrombosis has not been reported. It is important to perform enhanced MRI and blood culture for patients with chronic headache related to dental treatment.
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Affiliation(s)
- Kosuke Oka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Yosuke Sazumi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Tomo Michitani
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Shigeru Horiguchi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | | | - Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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Pedersen SK, Wagenaar JA, Vigre H, Roer L, Mikoleit M, Aidara-Kane A, Cawthorne AL, Aarestrup FM, Hendriksen RS. Proficiency of WHO Global Foodborne Infections Network External Quality Assurance System Participants in Identification and Susceptibility Testing of Thermotolerant Campylobacter spp. from 2003 to 2012. J Clin Microbiol 2018; 56:e01066-18. [PMID: 30209182 PMCID: PMC6204681 DOI: 10.1128/jcm.01066-18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/27/2018] [Indexed: 11/20/2022] Open
Abstract
Campylobacter spp. are foodborne and waterborne pathogens. While rather accurate estimates for these pathogens are available in industrialized countries, a lack of diagnostic capacity in developing countries limits accurate assessments of prevalence in many regions. Proficiency in the identification and susceptibility testing of these organisms is critical for surveillance and control efforts. The aim of the study was to assess performance for identification and susceptibility testing of thermotolerant Campylobacter spp. among laboratories participating in the World Health Organization (WHO) Global Foodborne Infections Network (GFN) External Quality Assurance System (EQAS) over a 9-year period. Participants (primarily national-level laboratories) were encouraged to self-evaluate their performance as part of continuous quality improvement. The ability to correctly identify Campylobacter spp. varied by year and ranged from 61.9% (2008) to 90.7% (2012), and the ability to correctly perform antimicrobial susceptibility testing (AST) for Campylobacter spp. appeared to steadily increase from 91.4% to 93.6% in the test period (2009 to 2012). The poorest performance (60.0% correct identification and 86.8% correct AST results) was observed in African laboratories. Overall, approximately 10% of laboratories reported either an incorrect identification or antibiogram. As most participants were supranational reference laboratories, these data raise significant concerns regarding capacity and proficiency at the local clinical level. Addressing these diagnostic challenges is critical for both patient-level management and broader surveillance and control efforts.
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Affiliation(s)
- Susanne Karlsmose Pedersen
- WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Jaap A Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- WHO Collaborating Center for Campylobacter/OIE Reference Laboratory for Campylobacteriosis, Utrecht, The Netherlands
- Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - Håkan Vigre
- WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Louise Roer
- WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Matthew Mikoleit
- WHO Collaborating Centre for Surveillance, Epidemiology and Control of Salmonella and other Foodborne Diseases, Atlanta, Georgia, USA
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Awa Aidara-Kane
- World Health Organization, Department of Food Safety, Zoonoses and Foodborne Diseases, Geneva, Switzerland
| | - Amy L Cawthorne
- World Health Organization, Department of Food Safety, Zoonoses and Foodborne Diseases, Geneva, Switzerland
| | - Frank M Aarestrup
- WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Rene S Hendriksen
- WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
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Karg M, Frickmann H, Hotzel H, Lugert R, Groß U, Hagen RM, Tomaso H, Poppert S, Zautner AE. Identification of Campylobacter fetus by fluorescence in situ hybridization (FISH). J Microbiol Methods 2018; 151:44-47. [PMID: 29803718 DOI: 10.1016/j.mimet.2018.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 11/19/2022]
Abstract
Two new DNA FISH-probes for Campylobacter fetus were designed, in silico checked for cross-reactions and successfully evaluated in a multi-centric approach with 41 Campylobacter fetus isolates including isolates of all three know subspecies: Campylobacter fetus ssp. fetus, Campylobacter fetus ssp. venerealis, and Campylobacter fetus ssp. testudinum and 40 strains of five non-target Campylobacter species.
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Affiliation(s)
- Matti Karg
- Institut für Medizinische Mikrobiologie, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Hagen Frickmann
- Fachbereich Tropenmedizin am Bernhard-Nocht Institut, Bundeswehrkrankenhaus Hamburg, Hamburg, Germany; Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsmedizin Rostock, Rostock, Germany
| | - Helmut Hotzel
- Institut für bakterielle Infektionen und Zoonosen, Friedrich-Loeffler-Institut Bundesforschungsinstitut für Tiergesundheit, Jena, Germany
| | - Raimond Lugert
- Institut für Medizinische Mikrobiologie, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Uwe Groß
- Institut für Medizinische Mikrobiologie, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Ralf M Hagen
- Abteilung A - Lehre Gesundheitsversorgung, Sanitätsakademie der Bundeswehr, München, Germany
| | - Herbert Tomaso
- Institut für bakterielle Infektionen und Zoonosen, Friedrich-Loeffler-Institut Bundesforschungsinstitut für Tiergesundheit, Jena, Germany
| | - Sven Poppert
- Schweizerisches Tropen- und Public Health-Institut (Swiss TPH), Basel, Switzerland; Switzerland & Medizinische Fakultät, Universität Basel, Basel, Switzerland
| | - Andreas E Zautner
- Institut für Medizinische Mikrobiologie, Universitätsmedizin Göttingen, Göttingen, Germany.
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François R, Yori PP, Rouhani S, Siguas Salas M, Paredes Olortegui M, Rengifo Trigoso D, Pisanic N, Burga R, Meza R, Meza Sanchez G, Gregory MJ, Houpt ER, Platts-Mills JA, Kosek MN. The other Campylobacters: Not innocent bystanders in endemic diarrhea and dysentery in children in low-income settings. PLoS Negl Trop Dis 2018; 12:e0006200. [PMID: 29415075 PMCID: PMC5819825 DOI: 10.1371/journal.pntd.0006200] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/20/2018] [Accepted: 12/31/2017] [Indexed: 12/13/2022] Open
Abstract
Background Campylobacter is one of the main causes of gastroenteritis worldwide. Most of the current knowledge about the epidemiology of this food-borne infection concerns two species, C. coli and C. jejuni. Recent studies conducted in developing countries and using novel diagnostic techniques have generated evidence of the increasing burden and importance of other Campylobacter species, i.e. non-C. coli/jejuni. We performed a nested case-control study to compare the prevalence of C. coli/jejuni and other Campylobacter in children with clinical dysentery and severe diarrhea as well as without diarrhea to better understand the clinical importance of infections with Campylobacter species other than C. coli/jejuni. Methodology/Principal findings Our nested case-control study of 439 stool samples included dysenteric stools, stools collected during severe diarrhea episodes, and asymptomatic stools which were systematically selected to be representative of clinical phenotypes from 9,160 stools collected during a birth cohort study of 201 children followed until two years of age. Other Campylobacter accounted for 76.4% of the 216 Campylobacter detections by qPCR and were more prevalent than C. coli/jejuni across all clinical groups. Other Campylobacter were also more prevalent than C. coli/jejuni across all age groups, with older children bearing a higher burden of other Campylobacter. Biomarkers of intestinal inflammation and injury (methylene blue, fecal occult test, myeloperoxidase or MPO) showed a strong association with dysentery, but mixed results with infection. MPO levels were generally higher among children infected with C. coli/jejuni, but Shigella-infected children suffering from dysentery recorded the highest levels (26,224 ng/mL); the lowest levels (10,625 ng/mL) were among asymptomatic children infected with other Campylobacter. Adjusting for age, sex, and Shigella infection, dysentery was significantly associated with C. coli/jejuni but not with other Campylobacter, whereas severe diarrhea was significantly associated with both C. coli/jejuni and other Campylobacter. Compared to asymptomatic children, children suffering from dysentery had a 14.6 odds of C. coli/jejuni infection (p-value < 0.001, 95% CI 5.5–38.7) but were equally likely to have other Campylobacter infections–odds ratio of 1.3 (0.434, 0.7–2.4). Children suffering from severe diarrhea were more likely than asymptomatic children to test positive for both C. coli/jejuni and other Campylobacter–OR of 2.8 (0.034, 1.1–7.1) and 1.9 (0.018, 1.1–3.1), respectively. Compared to the Campylobacter-free group, the odds of all diarrhea given C. coli/jejuni infection and other Campylobacter infection were 8.8 (<0.001, 3.0–25.7) and 2.4 (0.002, 1.4–4.2), respectively. Eliminating other Campylobacter in this population would eliminate 24.9% of the diarrhea cases, which is almost twice the population attributable fraction of 15.1% due to C. coli/jejuni. Conclusions/Significance Eighty-seven percent of the dysentery and 59.5% of the severe diarrhea samples were positive for Campylobacter, Shigella, or both, emphasizing the importance of targeting these pathogens to limit the impact of dysentery and severe diarrhea in children. Notably, the higher prevalence of other Campylobacter compared to C. coli/jejuni, their increasing burden during early childhood, and their association with severe diarrhea highlight the importance of these non-C. coli/jejuni Campylobacter species and suggest a need to clarify their importance in the etiology of clinical disease across different epidemiological contexts. Campylobacter is a major public health concern in developed and developing countries. C. coli and C. jejuni have long been considered to be the major disease-causing species, and clinical microbiologic approaches target these two species. However, less selective diagnostic approaches have shown the increasing importance of other Campylobacter species (i.e. non-C. coli/jejuni). Our case-control study investigated the association between diarrhea, C. coli/jejuni, and other Campylobacter among 439 stool samples from 201 children in peri-urban communities in Loreto, Peru. Three quarters of the 216 Campylobacter detections were associated with other Campylobacter, whose prevalence increased with age and was greater than that of C. coli/jejuni in all age and clinical groups (dysentery, severe diarrhea, and asymptomatic). Despite their lower prevalence, C. coli/jejuni were more strongly associated with higher levels of myeloperoxidase, clinical dysentery, and the presence of leukocytes and blood in the stool compared to other Campylobacter. Other Campylobacter were equally likely as C. coli/jejuni to be detected in severe diarrhea cases–odds ratio of 1.9 (p-value = 0.018, 95% CI 1.1–3.1) and 2.8 (0.034, 1.1–7.1), respectively. Removing C. coli/jejuni in this population would eliminate 15.1% of diarrhea compared to 24.9% if other Campylobacter were eliminated.
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Affiliation(s)
- Ruthly François
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Pablo Peñataro Yori
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
- Biomedical Research, Asociación Benéfica PRISMA, Iquitos, Peru
| | - Saba Rouhani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | | | | | | | - Nora Pisanic
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Rosa Burga
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Rina Meza
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Graciela Meza Sanchez
- Facultad de Medicina Humana, Universidad Nacional de la Amazonía Peruana, Iquitos, Peru
| | - Michael J. Gregory
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Eric R. Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, United States of America
| | - James A. Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, United States of America
| | - Margaret N. Kosek
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
- Biomedical Research, Asociación Benéfica PRISMA, Iquitos, Peru
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, United States of America
- * E-mail:
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42
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Abstract
We report a case of myocarditis complicating gastroenteritis caused by Campylobacter jejuni The patient had an uncomplicated course and made a full recovery. Cardiac MRI was useful in securing an early diagnosis and establishing baseline heart function. Myocarditis should be considered in younger patients presenting with chest pain and elevations in serum troponin. The occurrence of myocarditis complicating Campylobacter jejuni gastroenteritis is reviewed.
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Affiliation(s)
| | - Jonathan Mailey
- specialty trainee year 3 cardiology, Antrim Hospital, Antrim, UK
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43
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Affiliation(s)
- Roby P Bhattacharyya
- From the Department of Medicine, Division of Infectious Disease (R.P.B.), and the Departments of Radiology (E.J.F.) and Pathology (M.M.A.), Massachusetts General Hospital, and the Departments of Medicine (R.P.B.), Radiology (E.J.F.), and Pathology (M.M.A.), Harvard Medical School - both in Boston
| | - Efren J Flores
- From the Department of Medicine, Division of Infectious Disease (R.P.B.), and the Departments of Radiology (E.J.F.) and Pathology (M.M.A.), Massachusetts General Hospital, and the Departments of Medicine (R.P.B.), Radiology (E.J.F.), and Pathology (M.M.A.), Harvard Medical School - both in Boston
| | - Marwan M Azar
- From the Department of Medicine, Division of Infectious Disease (R.P.B.), and the Departments of Radiology (E.J.F.) and Pathology (M.M.A.), Massachusetts General Hospital, and the Departments of Medicine (R.P.B.), Radiology (E.J.F.), and Pathology (M.M.A.), Harvard Medical School - both in Boston
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44
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May FJ, Stafford RJ, Carroll H, Robson JM, Vohra R, Nimmo GR, Bates J, Kirk MD, Fearnley EJ, Polkinghorne BG. The effects of culture independent diagnostic testing on the diagnosis and reporting of enteric bacterial pathogens in Queensland, 2010 to 2014. Commun Dis Intell (2018) 2017; 41:E223-E230. [PMID: 29720071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Changes in diagnostic laboratory testing procedures can impact on the number of cases notified and the public health surveillance of enteric pathogens. Culture independent diagnostic testing using a multiplex polymerase chain reaction (PCR) test was introduced for the rapid detection of bacterial enteric pathogens in pathology laboratories in Queensland, Australia, from late 2013 onwards. We conducted a retrospective descriptive study using laboratory data to assess the impact of the introduction of PCR testing on four common enteric pathogens, Salmonella, Campylobacter, Shigella and Yersinia, in Queensland between 2010 and 2014. The number of stool specimens tested and the proportion positive for each of the four pathogens increased in 2014 after the introduction of culture independent diagnostic testing. Among the specimens tested by both PCR and culture, 12% of Salmonella positive stools, 36% of Campylobacter positive stools, 74% of Shigella / enteroinvasive Escherichia coli positive stools and 65% of Yersinia positive stools were PCR positive only. Including those where culture was not performed, 19% of Salmonella positive stools, 44% of Campylobacter positive stools, 83% of Shigella positive stools and 79% of Yersinia positive stools had no cultured isolate available for further characterisation. The detection and tracking of foodborne and non-foodborne gastrointestinal outbreaks will become more difficult as culture independent diagnostic testing becomes more widespread. Until new techniques for characterisation of pathogens directly from clinical specimens have been developed, we recommend laboratories continue to culture specimens concurrently or reflexively with culture independent diagnostic tests.
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Affiliation(s)
- Fiona J May
- Master of Philosophy in Applied Epidemiology Scholar, National Centre for Epidemiology and Population Health, Research School of Population Health, College of Medicine, Biology and Environment, Australian National University and Australian Government Department of Health, and Senior Epidemiologist, Health Protection Branch, Prevention Division, Department of Health, Queensland Government
| | - Russell J Stafford
- Epidemiologist Consultant, Communicable Diseases Branch, Prevention Division, Department of Health, Queensland Government
| | - Heidi Carroll
- Medical Director, Communicable Diseases Branch, Prevention Division, Department of Health, Queensland Government
| | - Jennifer Mb Robson
- Pathologist, Sullivan Nicolaides Pathology, 24 Hurworth Street, Bowen Hills, Brisbane Qld 4006
| | - Renu Vohra
- Pathologist, QML Pathology, 11 Riverview Place, Metroplex on Gateway, Murarrie, Qld 4172
| | - Graeme R Nimmo
- Director of Microbiology, Pathology Queensland Central Laboratory, Herston and Professor, Griffith University, School of Medicine
| | - John Bates
- Chief Scientist, Public Health Microbiology, Forensic and Scientific Services
| | - Martyn D Kirk
- Associate Professor, National Centre for Epidemiology and Population Health, Research School of Population Health, College of Medicine, Biology and Environment, Australian National University
| | - Emily J Fearnley
- Research Fellow, National Centre for Epidemiology and Population Health, Research School of Population Health, College of Medicine, Biology and Environment, Australian National University
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45
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Vidic J, Manzano M, Chang CM, Jaffrezic-Renault N. Advanced biosensors for detection of pathogens related to livestock and poultry. Vet Res 2017; 48:11. [PMID: 28222780 PMCID: PMC5320782 DOI: 10.1186/s13567-017-0418-5] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/23/2017] [Indexed: 01/01/2023] Open
Abstract
Infectious animal diseases caused by pathogenic microorganisms such as bacteria and viruses threaten the health and well-being of wildlife, livestock, and human populations, limit productivity and increase significantly economic losses to each sector. The pathogen detection is an important step for the diagnostics, successful treatment of animal infection diseases and control management in farms and field conditions. Current techniques employed to diagnose pathogens in livestock and poultry include classical plate-based methods and conventional biochemical methods as enzyme-linked immunosorbent assays (ELISA). These methods are time-consuming and frequently incapable to distinguish between low and highly pathogenic strains. Molecular techniques such as polymerase chain reaction (PCR) and real time PCR (RT-PCR) have also been proposed to be used to diagnose and identify relevant infectious disease in animals. However these DNA-based methodologies need isolated genetic materials and sophisticated instruments, being not suitable for in field analysis. Consequently, there is strong interest for developing new swift point-of-care biosensing systems for early detection of animal diseases with high sensitivity and specificity. In this review, we provide an overview of the innovative biosensing systems that can be applied for livestock pathogen detection. Different sensing strategies based on DNA receptors, glycan, aptamers and antibodies are presented. Besides devices still at development level some are validated according to standards of the World Organization for Animal Health and are commercially available. Especially, paper-based platforms proposed as an affordable, rapid and easy to perform sensing systems for implementation in field condition are included in this review.
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Affiliation(s)
- Jasmina Vidic
- Virologie et Immunologie Moléculaires, UR892, INRA, Paris Saclay University, 78350 Jouy-en-Josas, France
| | - Marisa Manzano
- Dipartimento di Scienze AgroAlimentari, Ambientali e Animali, Università di Udine, 33100 Udine, Italy
| | - Chung-Ming Chang
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Tao-Yuan, 33302 Taiwan
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46
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Chuma IS, Nonga HE, Mdegela RH, Kazwala RR. Epidemiology and RAPD-PCR typing of thermophilic campylobacters from children under five years and chickens in Morogoro Municipality, Tanzania. BMC Infect Dis 2016; 16:692. [PMID: 27871251 PMCID: PMC5117500 DOI: 10.1186/s12879-016-2031-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Campylobacter species are gram negative and flagellated bacteria under the genus Campylobacter, family Campylobacteriaceae. These pathogens cause zoonotic infections among human and animal populations. This study was undertaken between December 2006 and May 2007 to determine prevalence, risk factors and genetic diversity of thermophilic Campylobacter isolates from children less than 5 years and chickens in Morogoro Municipality, Tanzania. METHODS The Skirrow's protocol was used for isolation and identification of Campylobacter from 268 human stool specimens and 419 chicken cloacal swabs. Patient biodata and risk factors associated with human infection were also collected. Genetic diversity of Campylobacter isolates was determined by a RAPD-PCR technique using OPA 11 primer (5'-CAA TCG CCG T-3'). Phylogenetic analysis and band pattern comparison were done by Bionumerics software and visual inspection. RESULTS Stool samples from 268 children and 419 cloacal swabs from chickens were analyzed. Prevalence of thermophilic Campylobacters in children was 19% with higher isolation frequency (p = 0.046) in males (23.5%) than females (13.8%). Campylobacter jejuni (78.4%) was more isolated (p = 0.000) than C. coli (19.6%) and 2% were unidentified isolates. In chickens, the prevalence was 42.5% with higher isolation rate (p = 0.000) of C. jejuni (87%) than C. coli (13%). Campylobacters were more frequently recovered (p = 0.000) from indigenous/ local chickens (75.0%) followed by cockerels (52.2%), broilers (50.0%) and lowest in layers (22.7%). Keeping chickens without other domestic animals concurrently (p = 0.000), chicken types (p = 0.000) and flock size (p = 0.007) were risk factors for infection in chickens. One hundred and fifty two (152) thermophillic Campylobacter isolates were genotyped by RAPD-PCR of which 114 were C. jejuni (74 from chickens and 40 humans) and 38 C. coli (28 from chickens and 10 humans). Comparison of Campylobacter isolates from children and chickens revealed high diversity with only 6.1% of C. jejuni and 5.3% of C. coli being 100% genetically similar. CONCLUSIONS This study has recorded high prevalence of thermophilic Campylobacter in children less than 5 years and chickens in Morogoro municipality. The observed genetic similarity among few C. jejuni and C. coli isolates from children and chicken suggests existence of cross transmission of these pathogens between children under 5 years and chickens.
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Affiliation(s)
- Idrissa S. Chuma
- Tanzania National Parks (Serengeti), P. O. Box 3134, Arusha, Tanzania
| | - Hezron E. Nonga
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, College of Veterinary and Medical Sciences, P. O. Box 3021, Morogoro, Tanzania
| | - Robinson H. Mdegela
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, College of Veterinary and Medical Sciences, P. O. Box 3021, Morogoro, Tanzania
| | - Rudovick. R. Kazwala
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, College of Veterinary and Medical Sciences, P. O. Box 3021, Morogoro, Tanzania
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47
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Abstract
The disease burden of pathogens as estimated by QMRA (quantitative microbial risk assessment) and EA (epidemiological analysis) often differs considerably. This is an unsatisfactory situation for policymakers and scientists. We explored methods to obtain a unified estimate using campylobacteriosis in the Netherlands as an example, where previous work resulted in estimates of 4.9 million (QMRA) and 90,600 (EA) cases per year. Using the maximum likelihood approach and considering EA the gold standard, the QMRA model could produce the original EA estimate by adjusting mainly the dose-infection relationship. Considering QMRA the gold standard, the EA model could produce the original QMRA estimate by adjusting mainly the probability that a gastroenteritis case is caused by Campylobacter. A joint analysis of QMRA and EA data and models assuming identical outcomes, using a frequentist or Bayesian approach (using vague priors), resulted in estimates of 102,000 or 123,000 campylobacteriosis cases per year, respectively. These were close to the original EA estimate, and this will be related to the dissimilarity in data availability. The Bayesian approach further showed that attenuating the condition of equal outcomes immediately resulted in very different estimates of the number of campylobacteriosis cases per year and that using more informative priors had little effect on the results. In conclusion, EA was dominant in estimating the burden of campylobacteriosis in the Netherlands. However, it must be noted that only statistical uncertainties were taken into account here. Taking all, usually difficult to quantify, uncertainties into account might lead to a different conclusion.
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Affiliation(s)
- Eric G Evers
- Centre for Zoonoses and Environmental Microbiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Martijn Bouwknegt
- Centre for Zoonoses and Environmental Microbiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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48
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Bless PJ, Muela Ribera J, Schmutz C, Zeller A, Mäusezahl D. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners. PLoS One 2016; 11:e0161650. [PMID: 27603141 PMCID: PMC5014335 DOI: 10.1371/journal.pone.0161650] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/09/2016] [Indexed: 02/04/2023] Open
Abstract
Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID). Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics ("test") and antibiotic therapy ("treat") are interrelated and follow four strategies: "Wait & See", "Treat & See", "Treat & Test", and "Test & See". AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely leads to improved case management and higher case numbers in surveillance systems.
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Affiliation(s)
- Philipp J. Bless
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Joan Muela Ribera
- Partners for Applied Social Sciences (PASS) Suisse, Neuchâtel, Switzerland
| | - Claudia Schmutz
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas Zeller
- Centre for Primary Health Care, University of Basel, Basel, Switzerland
| | - Daniel Mäusezahl
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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49
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Yun J, Greiner M, Höller C, Messelhäusser U, Rampp A, Klein G. Association between the ambient temperature and the occurrence of human Salmonella and Campylobacter infections. Sci Rep 2016; 6:28442. [PMID: 27324200 PMCID: PMC4914963 DOI: 10.1038/srep28442] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/03/2016] [Indexed: 12/26/2022] Open
Abstract
Salmonella spp. and thermotolerant Campylobacter spp. are the most important causes of human bacterial diarrheal infections worldwide. These bacterial species are influenced by several factors like behaviour of the host, shedding, environment incl. directly or indirectly through ambient temperature, and the infections show seasonality. Therefore, the aim of our study was to investigate the association between the occurrence of human campylobacteriosis and salmonellosis and the ambient temperature. The number of campylobacteriosis and salmonellosis cases in two German metropolises, Munich and Berlin, and three rural regions was analysed with simultaneous consideration of the ambient temperature over a period of four years (2001 to 2004) using regression, time series, and cross-correlation analysis. The statistical analysis showed that an increase in the ambient temperature correlated positively with an increase in human Salmonella and Campylobacter cases. The correlation occurred with a delay of approximately five weeks. The seasonal rise in ambient temperature correlated with increased incidence of bacterial diarrheal infections.
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Affiliation(s)
- Josef Yun
- Institute of Food Quality and Food Safety, University of Veterinary Medicine of Hannover Foundation, Bischofsholer Damm 15, D-30173 Hannover, Germany
- Government of Lower Bavaria, Regierungsplatz 540, D-84028 Landshut, Germany
| | - Matthias Greiner
- Institute of Food Quality and Food Safety, University of Veterinary Medicine of Hannover Foundation, Bischofsholer Damm 15, D-30173 Hannover, Germany
- Federal Institute for Risk Assessment (BfR) and University of Veterinary Medicine of Hannover Foundation, Max-Dohrn-Str 8-10, D-10589 Berlin, Germany
| | - Christiane Höller
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, D-85764 Oberschleissheim, Germany
| | - Ute Messelhäusser
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, D-85764 Oberschleissheim, Germany
| | - Albert Rampp
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, D-85764 Oberschleissheim, Germany
| | - Günter Klein
- Institute of Food Quality and Food Safety, University of Veterinary Medicine of Hannover Foundation, Bischofsholer Damm 15, D-30173 Hannover, Germany
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50
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Bojanić K, Midwinter AC, Marshall JC, Rogers LE, Biggs PJ, Acke E. Variation in the limit-of-detection of the ProSpecT Campylobacter microplate enzyme immunoassay in stools spiked with emerging Campylobacter species. J Microbiol Methods 2016; 127:236-241. [PMID: 27317896 DOI: 10.1016/j.mimet.2016.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/14/2016] [Accepted: 06/14/2016] [Indexed: 11/20/2022]
Abstract
Campylobacter enteritis in humans is primarily associated with C. jejuni/coli infection. The impact of other Campylobacter spp. is likely to be underestimated due to the bias of culture methods towards Campylobacter jejuni/coli diagnosis. Stool antigen tests are becoming increasingly popular and appear generally less species-specific. A review of independent studies of the ProSpecT® Campylobacter Microplate enzyme immunoassay (EIA) developed for C. jejuni/coli showed comparable diagnostic results to culture methods but the examination of non-jejuni/coli Campylobacter spp. was limited and the limit-of-detection (LOD), where reported, varied between studies. This study investigated LOD of EIA for Campylobacter upsaliensis, Campylobacter hyointestinalis and Campylobacter helveticus spiked in human stools. Multiple stools and Campylobacter isolates were used in three different concentrations (10(4)-10(9)CFU/ml) to reflect sample heterogeneity. All Campylobacter species evaluated were detectable by EIA. Multivariate analysis showed LOD varied between Campylobacter spp. and faecal consistency as fixed effects and individual faecal samples as random effects. EIA showed excellent performance in replicate testing for both within and between batches of reagents, in agreement between visual and spectrophotometric reading of results, and returned no discordance between the bacterial concentrations within independent dilution test runs (positive results with lower but not higher concentrations). This study shows how limitations in experimental procedures lead to an overestimation of consistency and uniformity of LOD for EIA that may not hold under routine use in diagnostic laboratories. Benefits and limitations for clinical practice and the influence on estimates of performance characteristics from detection of multiple Campylobacter spp. by EIA are discussed.
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Affiliation(s)
- Krunoslav Bojanić
- (m)EpiLab, Infectious Disease Research Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - Anne Camilla Midwinter
- (m)EpiLab, Infectious Disease Research Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand.
| | - Jonathan Craig Marshall
- (m)EpiLab, Infectious Disease Research Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - Lynn Elizabeth Rogers
- (m)EpiLab, Infectious Disease Research Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand; MedLab Central Limited, Palmerston North, New Zealand
| | - Patrick Jon Biggs
- (m)EpiLab, Infectious Disease Research Centre, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - Els Acke
- Veterinary Teaching Hospital, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
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