Comparative Genotyping of Campylobacter jejuni Strains from Patients with Guillain-Barré Syndrome in Bangladesh

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.

Multilocus Sequence Typing Confirms Wild Birds as the Source of a Campylobacter Outbreak Associated with the Consumption of Raw Peas

“…This observation indicates that the development of GBS after Campylobacter infection could vary depending on host factors, even when individuals are infected with seemingly genetically identical strains. Therefore, a correlation between MLST genotypes and the onset of GBS could be difficult to determine, though several studies have found significant associations (38,39). Nonetheless, our result has added further support to the described association between infection with HS:41 and the development of GBS, even from a wild bird source.…”

Galleria mellonella as an infection model for Campylobacter jejuni virulence

“…jejuni strains can be classified by MLST complexes. A number of studies have sought to establish whether there is a link between MLST type and the development of postinfectious complications (Dingle et al, 2001;Nielsen et al, 2010;Islam et al, 2009). It was noted that the ST22 complex is over-represented in isolates from patients who have contracted Guillain-Barré syndrome; no GuillainBarré-related isolates have been shown to carry ST45, despite it being a common sequence type (Dingle et al, 2001;Nielsen et al, 2010).…”

“…It was noted that the ST22 complex is over-represented in isolates from patients who have contracted Guillain-Barré syndrome; no GuillainBarré-related isolates have been shown to carry ST45, despite it being a common sequence type (Dingle et al, 2001;Nielsen et al, 2010). No sequence types have been found to be exclusive for clinical outcomes (Islam et al, 2009). This supports the findings of Manning et al (2003), who studied a large number of C. jejuni isolates and found that in terms of MLST types, the populations of veterinary and human isolates overlapped; it was suggested that most veterinary sources should be considered reservoirs of pathogenic campylobacters.…”

Finnish Campylobacter jejuni Strains of Multilocus Sequence Type ST-22 Complex Have Two Lineages with Different Characteristics

“…Limited data is available on the association of the LOS classes with ST complexes; however, studies on GBS associated strains have identified ST-22 strains to have LOS class A [8]. In the study of Mortensen et al [24], sialylated LOS class A strains were significantly associated with reactive arthritis as well.…”