Abstract
Campylobacteriosis is the most common bacterial foodborne illness in the United States and is frequently associated with foods of animal origin. The goals of this study were to compare clinical and non-clinical Campylobacter populations from Tennessee (TN) and Pennsylvania (PA), use phylogenetic relatedness to assess source attribution patterns, and identify potential outbreak clusters. Campylobacter isolates studied (n = 3080) included TN clinical isolates collected and sequenced for routine surveillance, PA clinical isolates collected from patients at the University of Pennsylvania Health System facilities, and non-clinical isolates from both states for which sequencing reads were available on NCBI. Phylogenetic analyses were conducted to categorize isolates into species groups and determine the population structure of each species. Most isolates were C. jejuni (n = 2132, 69.2%) and C. coli (n = 921, 29.9%), while the remaining were C. lari (0.4%), C. upsaliensis (0.3%), and C. fetus (0.1%). The C. jejuni group consisted of three clades; most non-clinical isolates were of poultry (62.7%) or cattle (35.8%) origin, and 59.7 and 16.5% of clinical isolates were in subclades associated with poultry or cattle, respectively. The C. coli isolates grouped into two clades; most non-clinical isolates were from poultry (61.2%) or swine (29.0%) sources, and 74.5, 9.2, and 6.1% of clinical isolates were in subclades associated with poultry, cattle, or swine, respectively. Based on genomic similarity, we identified 42 C. jejuni and one C. coli potential outbreak clusters. The C. jejuni clusters contained 188 clinical isolates, 19.6% of the total C. jejuni clinical isolates, suggesting that a larger proportion of campylobacteriosis may be associated with outbreaks than previously determined.
Highlights
The clinical isolates from TN were collected as part of routine state-wide surveillance, whereas the isolates from PA were collected from patients from facilities within a single health system in the Philadelphia and surrounding areas (PA does not currently collect and sequence Campylobacter for surveillance)
Most of the isolates were determined to be C. jejuni (69.2%) and C. coli (29.9%), with the remaining isolates belonging to C. lari (0.4%), C. upsaliensis (0.3%), and C. fetus (0.1%) (Table 1)
We identified livestock source attribution trends for individual C. jejuni and C. coli clades based on phylogenetic clustering
Summary
Campylobacteriosis, caused by Campylobacter spp., is the most common bacterial foodborne illness in the United States, with an annual incidence rate of 19.5 cases per 100,000 in 2019 [1]. The USDA Economic Research Service estimated that up to 1.6 million cases occurred in 2018 in the United States, resulting in a total cost of illness up to $5.2 billion [2]. Campylobacteriosis is common in low- and middle-income countries. Though most people affected fully recover, campylobacteriosis is linked to chronic sequalae including irritable bowel syndrome, reactive arthritis, and Guillain–Barré syndrome (GBS) [3,4]
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