Infectious Diseases 2019

Infectious Diseases 2019

A systematic review of source attribution of human campylobacteriosis - MLST

ECDC: Volume 24, Issue 43, 24/Oct/2019 2 November, 2019

Campylobacter gastroenteritis is a leading cause of acute bacterial gastroenteritis in high, low, and middle income countries. The number of confirmed cases has continued to increase across countries of the European Union (214,000 in 2013 to 246,000 in 2016 and 2017), and over 800,000 cases are estimated to occur annually in the United States. In low income countries Campylobacter is increasingly implicated in growth faltering among children under 2 years of age. Chicken products have been identified as an important risk factor for human infection by a variety of techniques including natural experiments, case–control studies, and increasingly by the application of genotypic methods. Other infection sources identified by observational epidemiological studies include cattle, sheep, pigs, wild birds and the environment.
Alongside epidemiological studies there has been an increasing use of population genetic analyses to attribute human cases to likely sources. In these analyses, the genetic diversity of isolates from humans is compared with that of collections of Campylobacter isolates obtained from possible sources of infection, allowing quantitative attribution to these sources.
Multilocus sequence type (MLST) data have become the standard data used in such population genetic analyses, the results of which are generally consistent with the findings from epidemiological analyses.
The following systematic review brings together compelling evidence for poultry as the major source of human campylobacteriosis.