Campylobacter genotyping to determine the source of human infection.

BACKGROUND: Campylobacter species cause a high proportion of bacterial gastroenteritis cases and are a significant burden on health care systems and economies worldwide; however, the relative contributions of the various possible sources of infection in humans are unclear. METHODS: National-scale genotyping of Campylobacter species was used to quantify the relative importance of various possible sources of human infection. Multilocus sequence types were determined for 5674 isolates obtained from cases of human campylobacteriosis in Scotland from July 2005 through September 2006 and from 999 Campylobacter species isolates from 3417 contemporaneous samples from potential human infection sources. These data were supplemented with 2420 sequence types from other studies, representing isolates from a variety of sources. The clinical isolates were attributed to possible sources on the basis of their sequence types with use of 2 population genetic models, STRUCTURE and an asymmetric island model. RESULTS: The STRUCTURE and the asymmetric island models attributed most clinical isolates to chicken meat (58% and 78% of Campylobacter jejuni and 40% and 56% of Campylobacter coli isolates, respectively), identifying it as the principal source of Campylobacter infection in humans. Both models attributed the majority of the remaining isolates to ruminant sources, with relatively few isolates attributed to wild bird, environment, swine, and turkey sources. CONCLUSIONS: National-scale genotyping was a practical and efficient methodology for the quantification of the contributions of different sources to human Campylobacter infection. Combined with the knowledge that retail chicken is routinely contaminated with Campylobacter, these results are consistent with the view that the largest reductions in human campylobacteriosis in industrialized countries will come from interventions that focus on the poultry industry.

Quantitative risk assessment of human infection from Escherichia coli O157 associated with recreational use of animal pasture.

A quantitative microbial risk assessment incorporating Monte Carlo simulations is described which estimates the probability of Escherichia coli O157 infection of humans by visiting pasture previously grazed by cattle. The risk assessment is performed for a number of scenarios including a variation in the grazing period prior to the human visit, the duration of visit (8-h day or 24-h camp) and the level of E. coli O157 shed by the cattle. Assuming the cattle have been on the field for 28 days, followed directly by a human visit, and the proportion of animals shedding the organism are as described in previous surveys 5 +/- 1% (Synge, B.A., Gunn, G.J., Ternent, H.E., Hopkins, G.F., Thomson-Carter, F., Foster, G., Chase-Topping, M., McKendrick, I., 2001). Prevalence and factors affecting the shedding of verocytotoxin producing Escherichia coli O157 in beef cattle in Scotland. In: Concerted Action CT98-3935 Veroctotoxigenic E. coli in Europe, 5. Epidemiology of Verocytotoxigenic E. coli, Dublin, pp. 98-103.), a probability of infection of 0.1% is attained for 8- and 24-h periods when the cattle are shedding approximately 10(3) and 10(4) CFU g(-1), respectively. Monte Carlo simulations demonstrated that risk mitigation strategies of removing cattle from the pasture 4 weeks prior to the human visit in addition to physical removal of faeces showed significant reductions in potential infection rates.