Prevalence, risk factors and molecular epidemiology of Brachyspira pilosicoli in humans on the island of Bali, Indonesia

Abstract

The purpose of this study was to investigate the prevalence and epidemiology of the anaerobic intestinal spirochaete Brachyspira pilosicoli amongst Indonesians living in rural and urban settings on the island of Bali. Faecal samples (n ¼ 992) were collected on two occasions, 4 months apart, from people living in four traditional farming villages, one peri-urban location and one urban area. Samples were cultured anaerobically on selective agar and intestinal spirochaete isolates were confirmed to be B. pilosicoli by using a species-specific PCR. Forty-eight of the 121 isolates obtained were typed by using PFGE. A questionnaire was administered to participants and analysed in order to identify potential risk factors for colonization. Overall prevalence of carriage on the two visits was 11 . 8 and 12 . 6 %, respectively. Prevalence at different locations varied from 3 . 3 to 23 . 4 %, with the highest prevalence occurring in the peri-urban location. Considerable strain diversity was found, with the 48 isolates being divided into 44 PFGE types. There was no significant association between colonization and ownership of animals, contact with animals, farming, age or gender. On the first visit, colonization was significantly more common in people who used well water compared to those who used tap water. On the second visit, colonization was significantly more common in people with wet faeces than in those with normal faeces.

Comparison of prevalence and risk factors for faecal carriage of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in four Australian populations

“…Again, colonization was restricted to the Aboriginal and migrant groups, but with the apparent prevalence of faecal shedding increased to levels more consistent with that previously described in Aboriginal children in a remote rural community in WA (33 %) [12], and to those of villagers in Papua New Guinea (23 %) [9], India (25 %) [11], and Bali, Indonesia (12 %) [10]. Apart from the presence of B. aalborgi, which was significantly associated with the presence of B. pilosicoli in both population groups, and in the previous study from India [11], the new analysis did not strengthen the identification of significant risk factors.…”

“…Apart from the presence of B. aalborgi, which was significantly associated with the presence of B. pilosicoli in both population groups, and in the previous study from India [11], the new analysis did not strengthen the identification of significant risk factors. It was unfortunate that data were not available on water supply or water quality, as in previous studies in both India and Bali the use of untreated well water was associated with increased B. pilosicoli carriage [10,11]. Differences in water quality might have helped explain the different prevalence observed amongst population groups in this study.…”

“…It is usually detected by polymerase chain reaction (PCR) or gene probe assays, and has only occasionally been isolated [5][6][7]. B. pilosicoli is easier to isolate, and has been cultured from faeces in several developing countries [8][9][10][11], from Australian Aborigines [12,13], migrants to Australia from developing countries [13] and homosexual males [14]. Prevalence rates for B. pilosicoli in the faeces of these populations vary from y10 to 50%.…”

Exposure to norepinephrine enhances Brachyspira pilosicoli growth, attraction to mucin and attachment to Caco-2 cells

“…Infections with B. pilosicoli are common amongst intensively farmed pigs and chickens, where they cause diarrhoea and reduced production (Hampson & Duhamel, 2006;Hampson & Swayne, 2008). Colonization also is common in people living in crowded and unhygienic conditions in developing countries (Trott et al, 1997;Margawani et al, 2004;Nelson et al, 2009), as well as in homosexual males and HIV-positive individuals in developed countries (Law et al, 1994;Trivett-Moore et al, 1998). In some studies, colonization in humans has been found to be significantly associated with chronic diarrhoea, failure to thrive and being underweight (Brooke et al, 2006).…”

Isolation of the anaerobic intestinal spirochaete Brachyspira pilosicoli from long-term residents and Indonesian visitors to Perth, Western Australia

“…Colonization with B. pilosicoli is common (10-50 % prevalence) in people living in developing countries, including Gulf Arabs in Oman (Barrett, 1990), villagers in Papua New Guinea (PNG) (Trott et al, 1997a), villagers and peri-urban residents in Bali, Indonesia (Margawani et al, 2004) and villagers in tea plantations in India (Munshi et al, 2004). In developed countries, including the UK and Australia, the spirochaete is rarely isolated from individuals in the general population (Tompkins et al, 1986;Brooke et al, 2006), although prevalence rates reach the high levels seen in developing countries in Australian Aborigines living in remote communities (Lee & Hampson, 1992;Brooke et al, 2001Brooke et al, , 2006, homosexual males and HIV patients (Käsbohrer et al, 1990;Trivett-Moore et al, 1998) and immigrants on arrival from developing countries (Brooke et al, 2001(Brooke et al, , 2006).…”