The presence of Campylobacter species and enteric RNA viruses in stools from diarrheic (n ‫؍‬ 442) and healthy (n ‫؍‬ 58) humans living in southwestern Alberta was examined (May to October 2005). A large number of diarrheic individuals who were culture negative for C. jejuni (n ‫؍‬ 54) or C. coli (n ‫؍‬ 19) were PCR positive for these taxa. Overall detection rates for C. jejuni and C. coli in diarrheic stools were 29% and 5%, respectively. In contrast, 3% and 0% of stools from healthy humans were positive for these taxa, respectively. Infection with C. jejuni was endemic over the study period. However, there was no difference in infection rates between individuals living in urban or rural locations. Stools from a large number of diarrheic (74%) and healthy (88%) individuals were positive for Campylobacter DNA. The prevalence rates of C. concisus, C. curvus, C. fetus, C. gracilis, C. helveticus, C. hominis, C. hyointestinalis, C. mucosalis, C. showae, C. sputorum, and C. upsaliensis DNA were either not significantly different or were significantly lower in stools from diarrheic than from healthy individuals. No C. lanienae or C. lari DNA was detected. Stools from 4% and 0% of diarrheic and healthy humans, respectively, were positive for rotavirus, sapovirus, or norovirus (GI/GII). Our results showed a high prevalence of diarrheic individuals living in southwestern Alberta who were infected by C. jejuni and, to a lesser extent, by C. coli. However, other Campylobacter species, norovirus, rotavirus, sapovirus, and bovine enteric calicivirus were either inconsequential pathogens during the study period or are not pathogens at all.

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dArcobacter butzleri has been linked to enteric disease in humans, but its pathogenicity and epidemiology remain poorly understood. The lack of suitable detection methods is a major limitation. Using comparative genome analysis, we developed PCR primers for direct detection and quantification of A. butzleri DNA in microbiologically complex matrices. These primers, along with existing molecular and culture-based methods, were used to detect A. butzleri and enteric pathogens in stools of diarrheic and nondiarrheic people (n ‫؍‬ 1,596) living in southwestern Alberta, Canada, from May to November 2008. In addition, quantitative PCR was used to compare A. butzleri densities in diarrheic and nondiarrheic stools. Arcobacter butzleri was detected more often by PCR (59.6%) than by isolation methods (0.8%). Comparison by PCR-based detection found no difference in the prevalence of A. butzleri between diarrheic (56.7%) and nondiarrheic (45.5%) individuals. Rates of detection in diarrheic stools peaked in June (71.1%) and October (68.7%), but there was no statistically significant correlation between the presence of A. butzleri and patient age, sex, or place of habitation. Densities of A. butzleri DNA in diarrheic stools (1.6 ؎ 0.59 log 10 copies mg ؊1 ) were higher (P ‫؍‬ 0.007) than in nondiarrheic stools (1.3 ؎ 0.63 log 10 copies mg ؊1 ). Of the 892 diarrheic samples that were positive for A. butzleri, 74.1% were not positive for other bacterial and/or viral pathogens. The current study supports previous work suggesting that A. butzleri pathogenicity is strain specific and/or dependent on other factors, such as the level of host resistance. N early 1.7 billion cases of diarrheal disease are reported globally each year (1), although this is an underestimation of true rates of enteritis, as many afflicted individuals do not have access to or choose not to pursue medical assistance (2). For those seeking diagnosis, the majority of cases of acute enteritis are not linked to an identified etiological agent (3, 4). Ascertaining the etiology of enteric disease is essential for the development of effective therapeutics and preventative mitigation strategies. Direct contact with animals and ingestion of untreated water and/or undercooked animal products are recognized risk factors for acute enteritis (3), which suggests that a significant number of cases of enteritis are caused by unidentified biotic pathogens of human or zoonotic origin. Critical components of the epidemiology of arcobacteriosis and the population structure of Arcobacter butzleri have yet to be resolved, in large part because effective culture and/or molecular-based detection methods for this bacterium have yet to be developed.Arcobacter butzleri is ubiquitous in the environment (e.g., river water contaminated with human and/or nonhuman animal feces) (5-7). That the bacterium is detected in such a variety of sources suggests that pathways for transmission among animals and environmental sources exist, but accurate source tracking of A. butzleri is hampered by a ...

c Two immunoassays (Shiga Toxin Chek and Shiga Toxin Quik Chek) and real-time PCR were used to detect Shiga toxin-producing Escherichia coli. For enriched culture, the sensitivity and specificity of the three methods ranged from 80.0% to 98.2% and 98.0% to 100.0%, respectively. STEC isolates were identified in 2.6% of the 784 samples.

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Antimicrobial resistance was evaluated in Campylobacter jejuni isolated from 1,291 diarrheic people over a 15 year period (2004-2018) in Southwestern Alberta, a model location in Canada with a high rate of campylobacteriosis. The prevalence of resistance to chloramphenicol, clindamycin, erythromycin, and gentamicin was low during the examination period (≤4.8%). Resistance to tetracycline remained consistently high (41.6-65.1%), and resistance was primarily conferred by plasmid-borne tetO (96.2%). Resistance rates to ciprofloxacin and nalidixic acid increased substantially over the examination period, with a maximal fluoroquinolone resistance (FQR) prevalence of 28.9% in 2016. The majority of C. jejuni isolates resistant to ciprofloxacin (93.9%) contained a C257T mutation within the gyrA chromosomal gene. Follow up with infected people indicated that the observed increase in FQR was primarily due to domestically acquired infections. Moreover, the majority of FQR C. jejuni subtypes (82.6%) were endemic in Canada, primarily linked to cattle and chicken reservoirs; 18.4% of FQR isolates were assigned to three subtypes, predominantly associated with cattle. Study findings indicate the need to prioritize FQR monitoring in C. jejuni infections in Canada, and to elucidate the dynamics of the emergence and transmission of resistant C. jejuni strains within and from cattle and chicken reservoirs.