Abstract
Campylobacter jejuni is a leading cause of bacterial diarrhoea worldwide. The objective of this study was to examine the association between C. jejuni capsule types and clinical signs and symptoms of diarrhoeal disease in a well-defined birth cohort in Peru. Children were enrolled in the study at birth and followed until 2 years of age as part of the Malnutrition and Enteric Infections birth cohort. Associations between capsule type and clinical outcomes were assessed using the Pearson's χ2 and the Kruskal-Wallis test statistics. A total of 318 C. jejuni samples (30% from symptomatic cases) were included in this analysis. There were 22 different C. jejuni capsule types identified with five accounting for 49.1% of all isolates. The most common capsule types among the total number of isolates were HS4 complex (n = 52, 14.8%), HS5/31 complex (n = 42, 11.9%), HS15 (n = 29, 8.2%), HS2 (n = 26, 7.4%) and HS10 (n = 24, 6.8%). These five capsule types accounted for the majority of C. jejuni infections; however, there was no significant difference in prevalence between symptomatic and asymptomatic infection (all p > 0.05). The majority of isolates (n = 291, 82.7%) were predicted to express a heptose-containing capsule. The predicted presence of methyl phosphoramidate, heptose or deoxyheptose on the capsule was common.
Highlights
Diarrhoeal disease is the leading infectious disease cause of morbidity and the second leading infectious cause of death globally in children under 5 years of age [1]
70% of all infections were asymptomatic with no significant differences in the proportion of diarrhoeal cases between the first and subsequent infections (29.2% vs. 32.0%, respectively; p = 0.6)
The top five most common serotypes among all infections included the HS4 complex (14.8%), the HS5/31 complex (11.9%), HS15 (8.2%), HS2 (7.4%) and HS10 (6.8%) with no significant differences in the frequency of isolation by the presence or absence of clinical illness (Figs 1 and 2)
Summary
Diarrhoeal disease is the leading infectious disease cause of morbidity and the second leading infectious cause of death globally in children under 5 years of age [1]. Morbidity resulting from enteric infection can have significant consequences, including acquired malnutrition and linear growth deficits from repeated enteric infections before the age of two [2, 3]. Malnutrition in early childhood may predispose children to more severe and prolonged infections, and can result in impaired cognitive development that yield negative societal outcomes and long-term health effects including cardiovascular and metabolic diseases [3,4,5]. Clinical disease from C. jejuni in developing countries primarily affects the paediatric population and typically results in acute watery diarrhoea with concomitant signs and symptoms such as fever, abdominal pain and vomiting [6, 7]. Recent studies have found an association of Campylobacter infection with malnutrition and growth stunting in paediatric populations in the developing world [7]
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