Abstract
There has been little research on the determinants of Campylobacter coli infection, despite its contributing up to 10% of human Campylobacter infections. A case-control and two case-case study methods explored the aetiology of C. coli over a one year period across Scotland. The case-control multivariate model found an increased risk of C. coli infection in people older than 19 years (O.R. = 3.352), and during the summer months (O.R. = 2.596), while residing in an urban area decreased the risk (O.R. = 0.546). The first case-case study compared C. coli and C. jejuni cases and also showed a higher risk of C. coli during the summer (O.R. = 1.313) and in people older than 19 years (O.R. = 0.791). Living in an urban area was associated with a reduced risk of infection (O.R. = 0.769). Multi-locus sequence typing (MLST) indicated that sheep and chicken C. coli sequence types (STs) were most frequently found in humans whilst those from cattle and pigs were rarer. MLST diversity was high in isolates from pigs and chicken, intermediate in human isolates, and low in ruminant isolates. The second case-case study used MLST data to ascribe putative sources of infection to the cases. The putative source for 40% of cases was chicken, with 60% acquired from other sources (ruminants 54% and pigs 6%). The case-case analysis also showed that female gender was a risk factor (O.R. = 1.940), which may be explained by females being more likely to prepare poultry in the home. These findings indicate differences between the aetiology of C. coli and C. jejuni infections: this should be taken into account by public health professionals when developing strategies to reduce the burden of human campylobacteriosis.
Highlights
Human campylobacteriosis is the most commonly reported bacterial gastrointestinal infectious disease in the world [1,2] with an estimated 572,000 community cases in the UK during 2009 [3] and 845,000 cases in the USA annually [4]
In England and Wales the symptoms caused by C. jejuni and C. coli appear to be clinically indistinguishable, [6] in the Netherlands diarrhoea is reported in fewer cases of C. coli than C. jejuni [11]
The aim of this paper is investigate the aetiology of human C. coli infections using genotyped isolates by conducting and analysing (1) a simulated case-control study where Scottish C. coli cases are compared to randomly generated controls from the human population, (2) a case-case study that compares C. coli cases to C. jejuni cases, (3) comparing Multi-locus sequence typing (MLST) genotypes from humans and animals to determine their genealogy, source attribution and diversity and (4) a case-case study that compares human C. coli cases attributed to chicken with those assigned to other animal reservoirs
Summary
Human campylobacteriosis is the most commonly reported bacterial gastrointestinal infectious disease in the world [1,2] with an estimated 572,000 community cases in the UK during 2009 [3] and 845,000 cases in the USA annually [4]. Campylobacter jejuni and Campylobacter coli are the commonest species to cause human infections, with approximately 9% of human infections being caused by C. coli in the USA [5] and approximately 7% in England and Wales [6]. The symptoms of human campylobacteriosis include diarrhoea (which can be bloody), abdominal pain and fever [8]. About 10% of reported cases are hospitalised [9] and, rare, severe sequelae include Guillain-Barresyndrome, arthritis, or gastrointestinal perforation and occasionally death [8,10]. In England and Wales the symptoms caused by C. jejuni and C. coli appear to be clinically indistinguishable, [6] in the Netherlands diarrhoea is reported in fewer cases of C. coli than C. jejuni [11]
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