Enhancement of Campylobacter hepaticus culturing to facilitate downstream applications.

Campylobacter hepaticus causes Spotty Liver Disease (SLD) in chickens. C. hepaticus is fastidious and slow-growing, presenting difficulties when growing this bacterium for the preparation of bacterin vaccines and experimental disease challenge trials. This study applied genomic analysis and in vitro experiments to develop an enhanced C. hepaticus liquid culture method. In silico analysis of the anabolic pathways encoded by C. hepaticus revealed that the bacterium is unable to biosynthesise L-cysteine, L-lysine and L-arginine. It was found that L-cysteine added to Brucella broth, significantly enhanced the growth of C. hepaticus, but L-lysine or L-arginine addition did not enhance growth. Brucella broth supplemented with L-cysteine (0.4 mM), L-glutamine (4 mM), and sodium pyruvate (10 mM) gave high-density growth of C. hepaticus and resulted in an almost tenfold increase in culture density compared to the growth in Brucella broth alone (log10 = 9.3 vs 8.4 CFU/mL). The type of culture flask used also significantly affected C. hepaticus culture density. An SLD challenge trial demonstrated that C. hepaticus grown in the enhanced culture conditions retained full virulence. The enhanced liquid culture method developed in this study enables the efficient production of bacterial biomass and therefore facilitates further studies of SLD biology and vaccine development.

Possible reservoirs of thermotolerant Campylobacter at the farm between rearing periods and after the use of enrofloxacin as a therapeutic treatment.

Campylobacteriosis is a zoonosis and the most frequent cause of food-borne bacterial enteritis in humans. C. jejuni and C. coli are the most common species implicated in campylobacteriosis. Broilers and their products are considered the most important food sources of human infections. The aim of the present study was to evaluate the presence of thermotolerant Campylobacter in different reservoirs at the farm, and the permanence of this pathogen during four consecutive rearing periods. The samples were taken from the same house farm in the downtime period and during the last week of broiler rearing, prior to their slaughter during four consecutive cycles. Different reservoirs as potential sources of Campylobacter were analysed. The prevalence of Campylobacter in vectors was 23% in A. diaperinus larvae, 20% in wild birds, 13% in A. diaperinus adults, and 9% in flies; as regards fomites, the prevalence was 50% in workers' boots, 27% in litter, and 21% in feed, while in broilers it was 80%. Campylobacter jejuni was the most detected species (51%) in the samples analysed. In addition, some Campylobacter genotypes persisted in the house farm throughout consecutive rearing periods, indicating that those strains remain during downtime periods. However, our study could not identify the Campylobacter sources in the downtime periods because all the samples were negative for Campylobacter isolation. In addition, a remarkable finding was the effect of the use of enrofloxacin (as a necessary clinical intervention for flock health) in cycle 3 on the Campylobacter population. No Campylobacter could be isolated after that clinic treatment. Afterwards, we found a greater proportion of C. coli isolates, and the genotypes of those isolates were different from the genotypes found in the previous rearing periods. In conclusion, the effect of the use of enrofloxacin during the rearing period changed the Campylobacter species proportion, and this finding is particularly interesting for further evaluation. Furthermore, more studies should be conducted with the aim of detecting the Campylobacter sources between rearing periods.

Campylobacter: A Review of New Promising Remedies with Medicinal Plants and Natural Antioxidants.

Campylobacter (curved bacteria) is considered one of the most important and common zoonotic bacteria and the three leading bacterial causes of gastroenteritis and diarrhea. Antibacterial resistance is growing and expanding. The aim of this review article is to report anti-Campylobacter medicinal plants. For this purpose, the search terms consisting of Campylobacter, medicinal plants, essential oil, extract, and traditional medicine were used to retrieve the relevant articles published in the journals indexed in Information Sciences Institute, Web of Science, PubMed, Scopus, Google Scholar, and Scientific Information Databases. Then, the findings of eligible articles were analyzed. According to the analysis, 71 medicinal plants were found to exert anti-Campylobacter effect. The active compounds of these plants are possibly nature-based antibiotic agents that are effective on Campylobacter. If these compounds are isolated, purified, and studied in pharmaceutical investigations, they can be used to produce nature-based, anti-Campylobacter antibiotics.

Evaluation of potassium clavulanate supplementation of Bolton broth for enrichment and detection of Campylobacter from chicken.

Culture-based detection of Campylobacter can be affected by competing flora, temperature, incubation time, and presence of blood. The presence of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli in poultry has become one of the most common factors interfering with the detection of Campylobacter. In the present study, we evaluated potassium clavulanate (ESBL inhibitor) as a supplement in Bolton broth (C-Bolton broth) for enrichment and detection of Campylobacter. First, we determined growth kinetics of Campylobacter in the presence of different concentrations of ESBL E. coli in C-Bolton broth during enrichment. The effects of other factors such as incubation time, incubation temperature, and presence of blood on Campylobacter detection in C-Bolton broth were also investigated. The growth of Campylobacter co-cultured at a low concentration (2 and 4 log10 CFU/mL) of ESBL E. coli was similar to that of Campylobacter alone in C-Bolton broth, and Campylobacter co-cultured at a high concentration (6 and 8 log10 CFU/mL) of ESBL E. coli showed slower growth than the pure Campylobacter culture. The Campylobacter detection limit was 1 log10 CFU/mL when mixed with 2, 4, or 6 log10 CFU/mL of E. coli and 3 log10 CFU/mL when mixed with 8 log10 CFU/mL of E. coli after 48 h enrichment in the broth. Campylobacter detection from chicken feces and litter samples was not affected by incubation time, or presence of blood in the broth. A modified procedure of enrichment in C-Bolton broth at 37°C for 24 h without blood showed a significantly (P ≤ 0.05) higher detection rate and a lower false-negative rate than the ISO 10272-1:2006 method for Campylobacter detection from chicken feces and litter samples. In summary, the present study demonstrates the efficacy of Bolton broth supplemented with potassium clavulanate in the detection of Campylobacter mixed with ESBL E. coli, and an improved procedure to detect Campylobacter from chicken feces and litter samples.

Dietary supplementation with ferric tyrosine improves zootechnical performance and reduces caecal Campylobacter spp. load in broilers.

1. The objective of this study was to evaluate the effect of ferric tyrosine on the reduction of Campylobacter spp. and zootechnical performance in broilers exposed to Campylobacter spp. using a natural challenge model to simulate commercial conditions. Additionally, the minimum inhibitory concentrations (MICs) of ferric tyrosine against common enteropathogens were evaluated. 2. At the start of the trial, 840 healthy male 1-d-old birds (Ross 308) were randomly allocated to 6 replicate pens of 35 birds each and fed diets containing different concentrations of ferric tyrosine (0, 0.02, 0.05 and 0.2 g/kg) in mash form for 42 d. 3. Broilers fed diets containing ferric tyrosine showed significantly higher body weight at d 42 and weight gain compared to the control group. However, birds fed ferric tyrosine ate significantly more than the control birds so significant improvements in feed conversion rate were not observed. 4. Microbiological analyses of caecal samples collected on d 42 of the study showed, per gram of sample, 2-3 log10 reduction in Campylobacter spp. and 1 log10 reduction in Escherichia coli in the groups fed diets containing ferric tyrosine compared to the control. 5. The MICs of ferric tyrosine was >400 mg/l for C. jejuni and >200 mg/l for E. coli and Salmonella enterica, indicating that ferric tyrosine did not exert antimicrobial activity. 6. The results showed that birds fed ferric tyrosine grew faster and consumed more feed compared to the control group, indicating potential benefits of faster time to reach slaughter weight with no significant reduction on feed efficiency. Moreover, ferric tyrosine significantly reduced caecal Campylobacter spp. and E. coli indicating potential as a non-antibiotic feed additive to lower the risk of infections transmitted through the food chain.

Antimicrobial Resistance in Campylobacter Species: Mechanisms and Genomic Epidemiology.

The Campylobacter genus is a large and diverse group of Gram-negative bacteria that are known to colonize humans and other mammals, birds, reptiles, and shellfish. While it is now recognized that several emerging Campylobacter species can be associated with human disease, two species, C. jejuni and C. coli, are responsible for the vast majority of bacterial gastroenteritis in humans worldwide. Infection with C. jejuni, in particular, has also been associated with a number of extragastrointestinal manifestations and autoimmune conditions, most notably Guillain-Barré syndrome. The antimicrobial drugs of choice for the treatment of severe Campylobacter infection include macrolides, such as erythromycin, clarithromycin, or azithromycin. Fluoroquinolones, such as ciprofloxacin, are also commonly used for empirical treatment of undiagnosed diarrheal disease. However, resistance to these and other classes of antimicrobial drugs is increasing and is a major public health problem. The US Centers for Disease Control and Prevention estimates that over 300,000 infections per year are caused by drug-resistant Campylobacter. In this chapter, we discuss the taxonomy of the Campylobacter genus, the clinical and global epidemiological aspects of Campylobacter infection, with an emphasis on C. jejuni and C. coli, and issues related to the treatment of infection and antimicrobial resistance mechanisms. We further discuss the use of next-generation sequencing for the detection and surveillance of antimicrobial resistance genes.

Campylobacter Prevalence and Quinolone Susceptibility in Feces of Preharvest Feedlot Cattle Exposed to Enrofloxacin for the Treatment of Bovine Respiratory Disease.

Campylobacter spp. can be pathogenic to humans and often harbor antimicrobial resistance genes. Data on resistance in relation to fluoroquinolone use in beef cattle are scarce. This cross-sectional study of preharvest cattle evaluated Campylobacter prevalence and susceptibility to nalidixic acid and ciprofloxacin in feedlots that previously administered a fluoroquinolone as primary treatment for bovine respiratory disease. Twenty fresh fecal samples were collected from each of 10 pens, in each of five feedlots, 1-2 weeks before harvest. Feces were cultured for Campylobacter using selective enrichment and isolation methods. Genus and species were confirmed via PCR. Minimum inhibitory concentrations (MICs) of ciprofloxacin and nalidixic acid were determined using a micro-broth dilution method and human breakpoints. Antimicrobial use within each pen was recorded. Data were analyzed using generalized linear mixed-models (prevalence) and survival analysis (MICs). Overall, sample-level prevalence of Campylobacter was 27.2% (272/1000) and differed significantly among feedlots (p < 0.01). Campylobacter coli was the most common species (55.1%; 150/272), followed by Campylobacter hyointestinalis (42.6%; 116/272). Within-pen prevalence was not significantly associated with the number of fluoroquinolone treatments, sex, body weight, or metaphylaxis use, but was associated with the number of days cattle were in the feedlot (p = 0.03). The MICs for the majority of Campylobacter isolates were above the breakpoints for nalidixic acid (68.4%; 175/256) and for ciprofloxacin (65.6%; 168/256). Distributions of MICs for nalidixic acid (p ≤ 0.01) and ciprofloxacin (p ≤ 0.05) were significantly different among feedlots, and by Campylobacter species. However, fluoroquinolone treatments, sex, body weight, days on feed, and metaphylaxis were not significantly associated with MIC distributions within pens. We found no evidence that the number of fluoroquinolone treatments within feedlot pens significantly affected the within-pen fecal prevalence or quinolone susceptibilies of Campylobacter in feedlots that used a fluoroquinolone as primary treatment for bovine respiratory disease.

Comparative Genomic Analysis Identifies a Campylobacter Clade Deficient in Selenium Metabolism.

The nonthermotolerant Campylobacter species C. fetus, C. hyointestinalis, C. iguaniorum, and C. lanienae form a distinct phylogenetic cluster within the genus. These species are primarily isolated from foraging (swine) or grazing (e.g., cattle, sheep) animals and cause sporadic and infrequent human illness. Previous typing studies identified three putative novel C. lanienae-related taxa, based on either MLST or atpA sequence data. To further characterize these putative novel taxa and the C. fetus group as a whole, 76 genomes were sequenced, either to completion or to draft level. These genomes represent 26 C. lanienae strains and 50 strains of the three novel taxa. C. fetus, C. hyointestinalis and C. iguaniorum genomes were previously sequenced to completion; therefore, a comparative genomic analysis across the entire C. fetus group was conducted (including average nucleotide identity analysis) that supports the initial identification of these three novel Campylobacter species. Furthermore, C. lanienae and the three putative novel species form a discrete clade within the C. fetus group, which we have termed the C. lanienae clade. This clade is distinguished from other members of the C. fetus group by a reduced genome size and distinct CRISPR/Cas systems. Moreover, there are two signature characteristics of the C. lanienae clade. C. lanienae clade genomes carry four to ten unlinked and similar, but nonidentical, flagellin genes. Additionally, all 76 C. lanienae clade genomes sequenced demonstrate a complete absence of genes related to selenium metabolism, including genes encoding the selenocysteine insertion machinery, selenoproteins, and the selenocysteinyl tRNA.

Identification and antimicrobial resistance patterns of bacterial enteropathogens from children aged 0-59 months at the University Teaching Hospital, Lusaka, Zambia: a prospective cross sectional study.

BACKGROUND: Bacterial diarrhoeal disease is among the most common causes of mortality and morbidity in children 0-59 months at the University Teaching Hospital in Lusaka, Zambia. However, most cases are treated empirically without the knowledge of aetiological agents or antimicrobial susceptibility patterns. The aim of this study was, therefore, to identify bacterial causes of diarrhoea and determine their antimicrobial susceptibility patterns in stool specimens obtained from the children at the hospital. METHODS: This hospital-based cross-sectional study involved children aged 0-59 months presenting with diarrhoea at paediatrics wards at the University Teaching Hospital in Lusaka, Zambia, from January to May 2016. Stool samples were cultured on standard media for enteropathogenic bacteria, and identified further by biochemical tests. Multiplex polymerase chain reaction was used for characterization of diarrhoeagenic Escherichia coli strains. Antimicrobial susceptibility testing was performed on antibiotics that are commonly prescribed at the hospital using the Kirby-Bauer disc diffusion method, which was performed using the Clinical Laboratory Standards International guidelines. RESULTS: Of the 271 stool samples analysed Vibrio cholerae 01 subtype and Ogawa serotype was the most commonly detected pathogen (40.8%), followed by Salmonella species (25.5%), diarrhoeagenic Escherichia coli (18%), Shigella species (14.4%) and Campylobacter species (3.5%). The majority of the bacterial pathogens were resistant to two or more drugs tested, with ampicillin and co-trimoxazole being the most ineffective drugs. All diarrhoeagenic Escherichia coli isolates were extended spectrum ß-lactamase producers. CONCLUSION: Five different groups of bacterial pathogens were isolated from the stool specimens, and the majority of these organisms were multidrug resistant. These data calls for urgent revision of the current empiric treatment of diarrhoea in children using ampicillin and co-trimoxazole, and emphasizes the need for continuous antimicrobial surveillance as well as the implementation of prevention programmes for childhood diarrhoea.

Comparative performance of isolation methods using Preston broth, Bolton broth and their modifications for the detection of Campylobacter spp. from naturally contaminated fresh and frozen raw poultry meat.

The performance of different isolation methods was evaluated for the detection of Campylobacter from naturally contaminated raw poultry meat. Therefore, fresh and frozen poultry meat samples were analysed using the standard procedure (ISO 10272-1:2006), enrichment in Preston broth, and enrichment in modified Bolton broth (supplemented with (i) potassium clavulanate (C-BB), (ii) triclosan (T-BB), (iii) polymyxin B (P-BB)). The enrichment cultures were streaked onto both modified charcoal cefoperazone deoxycholate agar (mCCDA) and RAPID'Campylobacter agar (RCA). Moreover, direct plating on mCCDA and RCA was performed to quantify Campylobacter. In total, 33 out of 59 fresh retail meat samples (55.9%) were Campylobacter positive. For both fresh and frozen poultry meat samples, enrichment in Bolton broth (ISO 10272-1:2006) resulted in a higher number of positive samples than enrichment in Preston broth. Supplementation of Bolton broth with potassium clavulanate (C-BB) and triclosan (T-BB) enhanced the Campylobacter recovery from fresh poultry meat compared to non-supplemented Bolton broth, although the use of C-BB was less applicable than T-BB for Campylobacter recovery from frozen samples. Additionally, the use of RCA resulted in a higher isolation rate compared to mCCDA. The present study demonstrates the impact of culture medium on the recovery of Campylobacter from fresh and frozen naturally contaminated poultry meat samples and can support laboratories in choosing the most appropriate culturing method to detect Campylobacter.

Evaluation of Tazobactam-Supplemented, Modified Charcoal-Cefoperazone-Deoxycholate Agar for Qualitative Detection of Campylobacter from Chicken Carcass Rinse.

Overgrowth of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli on modified charcoal-cefoperazone-deoxycholate agar (mCCDA) is the most common confounding factor for the isolation of Campylobacter from poultry samples. mCCDA modified by supplementation with tazobactam, an ESBL inhibitor, was evaluated for Campylobacter isolation from chicken carcass rinse with regard to isolation rate and selectivity. In total, 120 whole chicken carcasses purchased from retail stores were rinsed with buffered peptone water enriched with 2× blood-free Bolton broth at 42°C for 48 h and then inoculated onto mCCDA with and without tazobactam supplementation (mCCDA or T-mCCDA) at 42°C for 48 h under microaerobic conditions. Suspect colonies were subcultured and confirmed by colony PCR. Plates with tazobactam exhibited a higher Campylobacter isolation rate (56.7% vs. 30.8%, p < 0.05) and selectivity (0.8 vs. 83.3% plates contaminated with non-Campylobacter, p < 0.05) than mCCDA. Thus, tazobactam-supplemented mCCDA would be a useful option for qualitative detection of Campylobacter in chicken carcass rinse.

Diarrheagenic pathogens in adults attending a hospital in Singapore.

BACKGROUND: Singapore's diarrhoeal notification system is based on specific pathogens. Official data may thus be skewed towards notifiable diseases. Limited information is available on the profiles of aetiological agents responsible for acute gastroenteritis (AGE) cases, especially among the adult population. To understand the frequency and distribution of potential causative agents of diarrheal disease in Singapore, we screened adults' stool samples collected from a large public hospital. METHODS: The stool samples were screened for 18 diarrheagenic pathogens using a combination of commercial multiplex polymerase chain reaction (PCR), in-house singleplex PCR and immunochromatographic assays. One hundred adult faecal samples that were collected from October 2013 to January 2014 for routine diagnostic purposes and submitted for culture at Tan Tock Seng Hospital, Singapore were used. RESULTS: Pathogens were detected in 32% of the samples. The predominant organisms encountered were norovirus genogroup II (11%), Aeromonas spp. (9%) and Campylobacter spp. (5%). One sample was positive for both verocytotoxigenic E. coli (VTEC) and E. coli O157:H7. Two other samples were positive for VTEC only, and one other sample was positive for E. coli O157:H7 only. Astrovirus, C. perfringens, Shigella spp. and toxigenic C. difficile were each detected in 2% of the samples. Cryptosporidium parvum, Giardia lamblia, group A rotavirus, Salmonella spp. and Vibrio spp. were each detected in 1% of the samples. No L. monocytogenes, Y. enterocolitica, enteric adenovirus, or norovirus genogroup I were detected. CONCLUSION: Our preliminary findings suggest that pathogens causing non-notifiable diseases might have contributed considerably to the adult hospitalised AGE cases. However, as the samples were from an adult hospital, the data obtained may not be representative of the whole community. Thus, a larger study to collect clinical samples and risk exposure data from primary healthcare clinics and children hospital is planned for, to gain a more holistic perspective on the epidemiology of AGE in Singapore. A larger study may also offer valuable insights for improving the approach of microbiological surveillance of food, as well as strategizing inspection efforts along the food supply chain by public health authorities.

Modification of Karmali agar by supplementation with potassium clavulanate for the isolation of Campylobacter from chicken carcass rinses.

The detection ability and selectivity of Karmali agar was improved by supplementation of an extended-spectrum ß-lactamase inhibitor, potassium clavulanate. The optimum concentration of potassium clavulanate (0.5 µg/ml) in Karmali agar was determined by inoculation of 50 Campylobacter and 30 extended-spectrum ß-lactamase-producing E. coli strains onto normal and modified Karmali agar containing various concentrations of the agent. Eighty retail carcasses were rinsed with 400 ml of buffered peptone water. The rinse samples were enriched in 2 × blood-free Bolton enrichment broth at 42°C for 48 h and then were streaked onto normal and modified Karmali agar containing 0.5 µg/ml potassium clavulanate. The suspicious colonies were subcultured on Columbia blood agar and confirmed by colony PCR. In chicken carcass samples, the modified Karmali agar showed a significantly greater isolation rate than normal Karmali agar (42.5 versus 21.3%; P < 0.05). Furthermore, the selectivity of the modified Karmali agar was also significantly higher (P < 0.05) than that of the normal Karmali agar, as seen by comparison of the number of contaminated agar plates (83.8 versus 97.5%) and the growth index (1.67 versus 2.91) of the non-Campylobacter colonies.

Evaluation of potassium-clavulanate-supplemented modified charcoal-cefoperazone-deoxycholate agar for enumeration of Campylobacter in chicken carcass rinse.

Potassium-clavulanate-supplemented modified charcoal-cefoperazone-deoxycholate agar (C-mCCDA) that was described in our previous study was compared with original mCCDA for the enumeration of Campylobacter in pure culture and chicken carcass rinse. The quantitative detection of viable Campylobacter cells from a pure culture, plated on C-mCCDA, is statistically similar (P > 0.05) to mCCDA. In total, 120 chickens were rinsed using 400 mL buffered peptone water. The rinses were inoculated onto C-mCCDA and mCCDA followed by incubation at 42 °C for 48 h. There was no statistical difference between C-mCCDA (45 of 120 plates; mean count, 145.5 CFU/mL) and normal mCCDA (46 of 120 plates; mean count, 160.8 CFU/mL) in the isolation rate and recovery of Campylobacter (P > 0.05) from chicken carcass rinse. The Pearson correlation coefficient value for the number of Campylobacter cells recovered in the 2 media was 0.942. However, the selectivity was much better on C-mCCDA than on mCCDA plates (P < 0.05). Significantly fewer C-mCCDA plates (33 out of 120 plates; mean count, 1.9 CFU/mL) were contaminated with non-Campylobacter cells than the normal mCCDA plates (67 out of 120 plates; mean count, 27.1 CFU/mL). The C-mCCDA may provide improved results for enumeration of Campylobacter in chicken meat alternative to mCCDA with its increased selectivity the modified agar possess.

Using participatory epidemiology to assess factors contributing to common enteric pathogens in Ontario: results from a workshop held at the Ontario Veterinary College, University of Guelph, Ontario.

BACKGROUND: Common enteric pathogens that cause gastrointestinal illness are transmitted to humans through food, water or direct contact. This poses a significant concern to public health as enteric pathogens can cause disease in a large number of people, and cost a substantial amount to treat and prevent. In order to gain a better understanding of the occurrence of enteric disease in Ontario, this study explored public health professionals' perceptions of major contributing factors for common enteric pathogens. METHODS: A case study was conducted as part of a two week training workshop in Participatory Epidemiology held at the Ontario Veterinary College, University of Guelph, in May 2013. Eight semi-structured interviews and four focus groups were conducted with representatives from the Public Health Agency of Canada, the University of Guelph, and three health regions in Southern Ontario. Written notes and pictures captured the qualitative information provided. Results were then analyzed using the mixed methods techniques of triangulation, convergence, and paradox. RESULTS: A total of fifty factors that contribute to enteric disease were identified across all interviews and focus groups. These contributing factors were grouped into key themes (travel, food handling, industry (farm-to-fork), water, geography, demographics, and behaviours) and were categorized as either a risk factor or susceptibility factor. Informants emphasized the complex relationships between the identified factors, and highlighted why these complexities make it difficult to determine where and how a person most likely acquired an enteric pathogen. Workshop participants observed differences in the type and quality of information collected during interviews and focus groups; we hypothesize that this may be attributed to the dynamics between group members (i.e. focus group discussions) as opposed to one-on-one interviews. CONCLUSIONS: The information gathered will serve as a starting point to further explore contributing factors for common enteric pathogens. The identified complexities would be best explored by conducting additional surveillance, as well as interviews and focus groups with a more diverse group of stakeholders. This type of qualitative study can enhance knowledge of enteric pathogen surveillance and contribute to the development of resources and initiatives to holistically address the occurrence of gastrointestinal illness.

Burden of laboratory-confirmed Campylobacter infections in Guatemala 2008-2012: results from a facility-based surveillance system.

INTRODUCTION: Campylobacteriosis is one of the leading causes of gastroenteritis worldwide. This study describes the epidemiology of laboratory-confirmed Campylobacter diarrheal infections in two facility-based surveillance sites in Guatemala. METHODS: Clinical, epidemiologic, and laboratory data were collected on patients presenting with acute diarrhea from select healthcare facilities in the departments of Santa Rosa and Quetzaltenango, Guatemala, from January 2008 through August 2012. Stool specimens were cultured for Campylobacter and antimicrobial susceptibility testing was performed on a subset of isolates. Multidrug resistance (MDR) was defined as resistance to ≥3 antimicrobial classes. RESULTS: Campylobacter was isolated from 306 (6.0%) of 5137 stool specimens collected. For children <5 years of age, annual incidence was as high as 1288.8 per 100,000 children in Santa Rosa and 185.5 per 100,000 children in Quetzaltenango. Among 224 ambulatory care patients with Campylobacter, 169 (75.5%) received metronidazole or trimethoprim-sulfamethoxazole, and 152 (66.7%) received or were prescribed oral rehydration therapy. Antimicrobial susceptibilities were tested in 96 isolates; 57 (59.4%) were resistant to ciprofloxacin and 12 (12.5%) were MDR. CONCLUSION: Campylobacter was a major cause of diarrhea in children in two departments in Guatemala; antimicrobial resistance was high, and treatment regimens in the ambulatory setting which included metronidazole and trimethoprim-sulfamethoxazole and lacked oral rehydration were sub-optimal.

No evidence of triclosan-resistant bacteria following long-term use of triclosan-containing toothpaste.

BACKGROUND AND OBJECTIVE: There is a paucity of data in relation to the possible emergence of triclosan (TCS)-resistant bacteria following long-term exposure to TCS toothpaste. Therefore, this study investigated whether long-term continuous exposure to TCS in toothpaste selects for TCS-resistant bacteria within the oral biofilm. MATERIAL AND METHODS: Dental plaque samples were collected from 40 individuals during year 5 of a randomised controlled trial. Participants had been randomly assigned to use TCS (3000 µg/mL TCS) (n = 18) or placebo toothpaste (n = 22). Diluted plaque samples were plated on to Wilkins-Chalgren agar plates containing 5% (v/v) laked sheep red blood cells and TCS (concentrations ranging from 25 to 150 µg/mL) and incubated at 37 °C under microaerophilic and anaerobic conditions for 2-10 d. Selected bacterial isolates were identified by partial 16S rDNA sequencing and TCS minimum inhibitory concentration (MIC) determined for each isolate. RESULTS: At 3000 µg/mL TCS no growth was observed under microaerophilic or anaerobic conditions in either group. The MICs of TCS for all isolates ranged from 125 to 1000 µg/mL in both groups. Species common to both groups had similar MICs. Veillonella parvula and Campylobacter gracilis were the most frequent isolates from both groups, with similar MICs in both groups. CONCLUSION: The use of TCS-containing toothpaste did not appear to lead to an increase in MIC of TCS of oral bacterial isolates.

Abundance of pathogens in the gut and litter of broiler chickens as affected by bacitracin and litter management.

Clostridium perfringens, Salmonella spp. and Campylobacter spp. are food-borne enteric pathogens that are commonly associated with poultry. The objective of this study was to investigate the effects of supplemental bacitracin and litter management (fresh vs. reused) on the abundance of these pathogens in commercial broiler chickens. Specific quantitative PCR (qPCR) assays were used to quantify C. perfringens, virulent C. perfringens that carried the genes encoding α-toxin (cpa) and NetB-toxin (netB), Salmonella, and Campylobacter in samples of ileal mucosa, cecal content, and litter. Campylobacter was not detected in any of the samples collected. The abundance of Salmonella was not affected by either bacitracin or litter condition. Generic C. perfringens was detected in the ileal mucosa at very low level at 10 days of age but was much higher at 35 days. Chickens reared on reused litter tended to have a lower abundance of generic C. perfringens compared with those reared on fresh litter. In the ileal mucosa, no cpa or netB was detected at day 10 but was detected at day 35 in the chickens that were not fed supplemental bacitracin. Chicks fed supplemental bacitracin had reduced abundance of generic C. perfringens as well as the cpa and netB genes in the ileal mucosa, cecal content, and litters. A strong positive correlation was found between the abundance of all three measurements of C. perfringens. The abundance of Salmonella spp. and C. perfringens was also shown to be correlated. This is the first study that has examined the effect of dietary bacitracin and litter conditions on the prevalence of these three common enteric pathogens. Unless contaminated from previous flocks, reused litter may not necessarily contain significantly greater abundances of C. perfringens or Salmonella.

Improvement of modified charcoal-cefoperazone-deoxycholate agar by addition of potassium clavulanate for detecting Campylobacter spp. in chicken carcass rinse.

The presence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) in raw poultry is one of the most common factors that interfere with the isolation of Campylobacter by cefoperazone-based selective agar. The performance of modified charcoal-cefoperazone-deoxycholate agar (mCCDA) was improved by addition of an ESBL inhibitor, potassium clavulanate (0.5 mg/L). The ability of the supplemented medium (C-mCCDA) to detect Campylobacter species from chicken carcass rinse was compared with that of normal mCCDA. The isolation rate using C-mCCDA was significantly (p<0.05) higher compared with that using mCCDA (C-mCCDA, 67 out of 120; mCCDA, 38 out of 120). Furthermore, the selectivity of the C-mCCDA as assessed by comparing the number of contaminated plates (C-mCCDA, 44 out of 120; mCCDA, 110 out of 120) and growth index (C-mCCDA, 1.76; mCCDA, 2.79) of competing flora was also better (p<0.05) than that of mCCDA.

[Identification of Campylobacter spp. isolates with phenotypic methods and multiplex polymerase chain reaction and their antibiotic susceptibilities]. / Campylobacter türlerinin fenotipik yöntemler ve multipleks polimeraz zincir reaksiyonu ile tanimlanmasi ve antibiyotik duyarliliklari

The aims of this study were to detect the frequency of isolation of thermophilic Campylobacter spp. from acute gastroenteritis cases by phenotypic and molecular methods and to evaluate the antibiotic susceptibilities of the isolates. A total of 3287 stool samples obtained from diarrheal patients who were admitted to Kayseri Training and Research Hospital, Kayseri, Turkey, between March 2010 - March 2011 and sent to the microbiology laboratory, were included in the study. Cefoperazone, amphotericin B and teicoplanin (CAT) supplemented Campylobacter Blood-free Selective Medium (modified CCDA-Preston, Oxoid CM739, UK) was used for the isolation of Campylobacter spp. The media inoculated with stool samples were incubated at 42°C microaerobically for 72 to 96 hours. The genus and species level identifications of the thermophilic Campylobacter spp. isolates defined by phenotypic tests were carried out with multiplex polymerase chain reaction (mPCR). Antibiotic susceptibilities of the isolates were detected by disc diffusion method and the results were evaluated according to the CLSI guidelines. The thermophilic Campylobacter spp. were isolated from 5.4% (179/3287) of the patients' stool samples. Of Campylobacter positive cases 71% (127/179) were children and 58% (104/179) were male. The prevalence rate was estimated as 7.5% (127/1683) for children and 3.2% (52/1604) for adults. Of the isolates, 146 (82%) were identified as C.jejuni, 24 (13%) were C.coli, 6 (3%) were C.lari and 3 (2%) were C.upsaliensis with phenotypic tests. By using mPCR, 152 (85%) and 27 (15%) of 179 isolates were identified as C.jejuni and C.coli, respectively. Three of the six isolates identified as C.lari by the phenotypic methods were identified as C.jejuni and the remaining three as C.coli by mPCR. Phenotypically identified three C.upsaliensis isolates were shown to be C.jejuni (n= 2) and C.coli (n= 1). On the other hand one C.coli isolate was found to be C.jejuni by mPCR. The rates of resistance of the isolates were 92.6% for trimethoprim-sulfamethoxazole, 79.5% for nalidixic acid, 75.6% for levofloxacin, 73.9% for ciprofloxacin, 40.3% for ampicillin, 35% for cefotaxime, 33.4% for piperacillin-tazobactam, 24% for tetracycline, 14.6% for clindamycin, 11.2% for amikacin and 6.3% for erythromycin. During the 13 months study period, the highest isolation rates were detected between March-June (mean rate 66%). Our data concerning the prevalence and antibiotic resistance rates revealed the significance of campylobacters in gastroenteritis cases. Therefore, specific microbiological isolation and identification methods should be applied in routine microbiology laboratories to investigate the presence of campylobacters in gastroenteritis etiology. Besides, determination of the antibiotic susceptibilities of the isolates on routine basis should be encouraged to help to guide the antimicrobial treatment approaches in case of gastroenteritis. The results of this study also indicated that phenotypic tests were adequate for the identification of campylobacters at the genus-level, however, for accurate identification at the species level and for reliable epidemiological data molecular analysis might be added to the detailed identification procedures.