Investigation of an Outbreak of Campylobacter upsaliensis in Day Care Centers in Brussels: Analysis of Relationships among Isolates by Phenotypic and Genotypic Typing Methods

Goossens, Herman; Giesendorf, B. A. J.; Vandamme, Peter; Vlaes, L; Borre, C Van den; Koeken, Ankie; Quint, Wim; Blomme, Walter; Hanicq, Pol; Koster, D.S.; Hofstra, H.; Butzler, Jean‐Paul; Plas, J. van der

doi:10.1093/infdis/172.5.1298

Cited by 60 publications

(29 citation statements)

References 22 publications

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“…There have also been rare/controversial reports of hemolytic-uremic syndrome and Guillain-Barré syndrome associated with C. upsaliensis (4,9,14). In both pediatric and immunocompromised hosts, C. upsaliensis is recognized as a clinically important emerging diarrheal pathogen (10,17,19). However, human cases of C. upsaliensis gastroenteritis with severe persistent bloody diarrhea similar to that observed in this patient have not been described.…”

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confidence: 67%

“…An alternative hypothesis is that the sister-in-law (who had molecular evidence of recent infection with a Campylobacter species and was treated empirically) may have acquired Campylobacter by drinking unfiltered spring water while recently hiking and subsequently transmitted the infection to the patient while visiting his home during her illness. Acquisition of C. jejuni from drinking contaminated groundwater has been previously described for hikers (27), and human-to-human transmission of both C. upsaliensis and C. jejuni have been described (10,18). It is also possible that the patient acquired the infection from a source unrelated to the canines' or sister-in-law's illnesses.…”

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Association of Campylobacter upsaliensis with Persistent Bloody Diarrhea

2012

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Campylobacter upsaliensis is a zoonotic, emerging pathogen that is not readily recovered in traditional stool culture. This case represents the first report of persistent bloody diarrhea with C. upsaliensis that was confirmed by filtration culture, PCR, and sequencing. CASE REPORTA n 83-year-old male presented to the emergency department (ED) with an acute history of severe bloody diarrhea. His symptoms began with nausea, vomiting, and abdominal cramping, which he mistook for constipation. The patient took a single dose of laxative and shortly thereafter experienced numerous episodes of profuse bloody diarrhea that continued for several hours. He did not have fevers, chills, or sweats. The patient was found by his wife at home, collapsed in a chair, and was brought to the ED for evaluation. The patient's past medical history was significant for irritable bowel syndrome but no history of bloody diarrhea or rectal bleeding. His social history revealed contact with his sisterin-law and two canine pets, all with bloody diarrhea. On arrival in the ED, the patient's physical examination was unremarkable; however, out of concern for a lower gastrointestinal bleed, the patient was admitted for observation and further testing. Stool studies were negative for all gastrointestinal pathogens, including Salmonella, Shigella, Campylobacter, Aeromonas, Plesiomonas, and Vibrio by stool culture, Cryptosporidium, Giardia, and Shiga-toxigenic Escherichia coli (STEC) by enzyme immunoassay (EIA), and Clostridium difficile by PCR. In addition, ovum and parasite exams of the stool were performed and were remarkable only for numerous erythrocytes and leukocytes. These findings were consistent with the grossly bloody stool and a positive fecal lactoferrin EIA. The patient's symptoms gradually improved but did not resolve over the course of 48 h. He remained afebrile and hemodynamically stable and was discharged on hospital day 2 with no known etiologic cause of diarrhea. Five days later, he was treated with ciprofloxacin for continuing diarrhea out of concern for possible person-to-person spread of a still-unidentified gastrointestinal pathogen but only after STEC was ruled out by Shiga toxin EIA.The clinical microbiology laboratory was consulted for additional testing for enteroinvasive or enteroaggregative E. coli, given the widely publicized enteroaggregative/Shiga-toxigenic E. coli O104:H4 outbreak that had recently concluded in Germany. No testing was available for these organisms; however, the stool was filtered through a 0.6-m filter (Pall Life Sciences, Ann Arbor, MI) onto a brucella blood agar plate (Hardy Diagnostics, Santa Maria, CA) and cultured in an increased-hydrogen atmosphere of approximately 6.5 to 12.5% (7) (BioBag Type Cfj; BD, Franklin Lakes, NJ) at 37°C to enhance the detection of hydrogen-requiring Campylobacter spp. (21). For direct stool PCR, the specimen was treated with AL stool lysis buffer (Qiagen, Valencia, CA) and heated at 95°C for 10 min. The DNA was extracted with the Maxwell Cell LEV DNA purification k...

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Association of Campylobacter upsaliensis with Persistent Bloody Diarrhea

2012

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“…In general, ribotyping seems to be most useful for determining the species of Campylobacter isolates that are difficult to analyze phenotypically (43). Nevertheless, the technique has been used successfully for subtyping, at least to some degree, C. jejuni, C. coli, C. upsaliensis (31,83), C. lari (70), C. helveticus, and aerotolerant Campylobacter spp. (43).…”

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confidence: 99%

Genotyping of Campylobacter spp

Wassenaar

Newell²

2000

Appl Environ Microbiol

367

307

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“…Although the majority of Campylobacter infections are caused by C. jejuni, other Campylobacter species, e.g., C. coli, C. lari, and C. upsaliensis, have been associated with either sporadic (10,28,37,39,52,55,65) or outbreak (8,26,40,57) cases of gastroenteritis in humans. C. jejuni and C. coli are often isolated from the same hosts (48).…”

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Extended Multilocus Sequence Typing System for Campylobacter coli , C. lari , C. upsaliensis , and C. helveticus

On²,

et al. 2005

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A multilocus sequence typing (MLST) system has been reported previously for Campylobacter jejuni to both differentiate strains and identify clonal lineages. However, sequence variation at the MLST loci prevents its use for closely related Campylobacter species. We describe herein an expanded MLST method to include three clinically relevant Campylobacter species, C. coli, C. lari, and C. upsaliensis, and a fourth Campylobacter species, C. helveticus. The C. coli and C. helveticus methods use the same seven C. jejuni loci (aspA, atpA, glnA, gltA, glyA, pgm, and tkt); however, adk and pgi were substituted for aspA and gltA in C. lari and for gltA and pgm in C. upsaliensis. Multiple C. coli (n ‫؍‬ 57), C. lari (n ‫؍‬ 20), C. upsaliensis (n ‫؍‬ 78), and C. helveticus (n ‫؍‬ 9) isolates, representing both clinical and environmental sources, were typed. All four species were genetically diverse: the majority (>80%) of the isolates had unique sequence types (STs). Using this method, mixed C. lari, C. upsaliensis, and C. helveticus isolates were identified; upon separation, each isolate was shown to contain two strains of the same species with distinct STs. Additionally, the expanded MLST method was able to detect potential lateral transfer events between C. jejuni and either C. coli or C. lari and between C. upsaliensis and C. helveticus. Thus, the expanded MLST method will prove useful in differentiating strains of five Campylobacter species, identifying mixed Campylobacter cultures, and detecting genetic exchange within the genus.

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Investigation of an Outbreak of Campylobacter upsaliensis in Day Care Centers in Brussels: Analysis of Relationships among Isolates by Phenotypic and Genotypic Typing Methods

Cited by 60 publications

References 22 publications

Association of Campylobacter upsaliensis with Persistent Bloody Diarrhea

Association of Campylobacter upsaliensis with Persistent Bloody Diarrhea

Genotyping of Campylobacter spp

Extended Multilocus Sequence Typing System for Campylobacter coli , C. lari , C. upsaliensis , and C. helveticus

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