Comparative genotyping of Campylobacter jejuni strains from patients with Guillain-Barré syndrome in Bangladesh.

Zhahirul Islam,Helen Tabor,Bart C Jacobs,Hubert P Endtz,Kaisar A Talukder,Alison J Cody,Alex Van Belkum,Albert G De Boer,Jaap A Wagenaar

doi:10.1371/journal.pone.0007257

Abstract

Background Campylobacter jejuni is a common cause of acute gastroenteritis and is associated with post-infectious neuropathies such as the Guillain-Barré syndrome (GBS) and the Miller Fisher syndrome (MFS). We here present comparative genotyping of 49 C. jejuni strains from Bangladesh that were recovered from patients with enteritis or GBS. All strains were serotyped and analyzed by lipo-oligosaccharide (LOS) genotyping, amplified fragment length polymorphism (AFLP) analysis, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE).Methodology/Principal Findings C. jejuni HS:23 was a predominant serotype among GBS patients (50%), and no specific serotype was significantly associated with GBS compared to enteritis. PCR screening showed that 38/49 (78%) of strains could be assigned to LOS classes A, B, C, or E. The class A locus (4/7 vs 3/39; p<0.01) was significantly associated in the GBS-related strains as compared to enteritis strains. All GBS/oculomotor related strains contained the class B locus; which was also detected in 46% of control strains. Overlapping clonal groups were defined by MLST, AFLP and PFGE for strains from patients with gastroenteritis and GBS. MLST defined 22 sequence types (STs) and 7 clonal complexes including 7 STs not previously identified (ST-3742, ST-3741, ST-3743, ST-3748, ST-3968, ST-3969 and ST-3970). C. jejuni HS:23 strains from patients with GBS or enteritis were clonal and all strains belonged to ST-403 complex. Concordance between LOS class B and ST-403 complex was revealed. AFLP defined 25 different types at 90% similarity. The predominant AFLP type AF-20 coincided with the C. jejuni HS:23 and ST-403 complex.Conclusion/SignificanceLOS genotyping, MLST, AFLP and PFGE helped to identify the HS:23 strains from GBS or enteritis patients as clonal. Overall, genotypes exclusive for enteritis or for GBS-related strains were not obtained although LOS class A was significantly associated with GBS strains. Particularly, the presence of a clonal and putative neuropathogenic C. jejuni HS:23 serotype may contribute to the high prevalence of C. jejuni related GBS in Bangladesh.

Highlights

Campylobacter jejuni is the most significant bacterial cause of human gastroenteritis [1,2,3,4]
We performed comparative genomics of a set of 49 C. jejuni strains isolated from Guillain-Barré syndrome (GBS) and enteritis patients in Bangladesh by multilocus sequence typing (MLST), amplified fragment length polymorphism (AFLP), LOS typing and pulsed-field gel electrophoresis (PFGE) fingerprinting
This is the first report on molecular characterization of GBS and enteritis related C. jejuni strains from Bangladesh

Summary

Introduction

Campylobacter jejuni is the most significant bacterial cause of human gastroenteritis [1,2,3,4]. Clinical syndromes vary from mild to severe and from gastroenteritis to extraintestinal diseases. This latter category includes acute autoimmune neuromuscular complications such as the Guillain-Barré syndrome (GBS) and Miller-Fisher syndrome [5]. Extensive effort has been put into the identification of novel determinants of C. jejuni associated with the development of GBS [16,17]. Campylobacter jejuni is a common cause of acute gastroenteritis and is associated with post-infectious neuropathies such as the Guillain-Barré syndrome (GBS) and the Miller Fisher syndrome (MFS). All strains were serotyped and analyzed by lipo-oligosaccharide (LOS) genotyping, amplified fragment length polymorphism (AFLP) analysis, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE)

Objectives

Methods

Conclusion