Michaud Sophie, Ménard Suzanne, Arbeit Robert D
Department of Microbiology and Infectious Diseases, Faculté de Médecine de l'Université de Sherbrooke, 3001 12th Avenue North, Sherbrooke, Québec J1H 5N4, Canada.
J Clin Microbiol. 2005 Mar;43(3):1105-11. doi: 10.1128/JCM.43.3.1105-1111.2005.
The goal of the present study was to assess the contribution of real-time molecular typing, used alone or with clinical surveillance, to the prompt identification of clusters of Campylobacter enteritis. Potential poultry sources were sought by comparing the pulsed-field gel electrophoresis genotypes of human and fresh whole retail chicken isolates collected during the same study period. Among 183 human isolates, 82 (45%) had unique genotypes, 72 (39%) represented 26 clusters of 2 to 7 isolates each, and 29 (16%) represented three clusters of 8 to 11 isolates each. Molecular typing was useful for the confirmation of outbreaks suspected on the basis of epidemiological surveillance, but for most small clusters, no epidemiological link could be established. Thus, the added value of real-time molecular typing is questionable, since the numerous small clusters identified were of unclear public health significance. Among 177 chickens, 41 (23%) yielded campylobacter isolates; of these, 19 (46%) had genotypes similar to those of 41 (22%) human isolates. However, a temporal association was demonstrated in only a minority of cases, and most genotypes were present only in a single species, suggesting that sources other than chickens are important in human campylobacteriosis. Further investigation with samples from water and other possible environmental sources is needed to define the most efficient strategy for the application of molecular typing and identification of the source(s) of sporadic cases of campylobacteriosis.
本研究的目的是评估单独使用实时分子分型或结合临床监测对及时识别空肠弯曲菌肠炎聚集性病例的作用。通过比较在同一研究期间收集的人类和新鲜整只零售鸡肉分离株的脉冲场凝胶电泳基因型,寻找潜在的家禽来源。在183株人类分离株中,82株(45%)具有独特的基因型,72株(39%)代表26个聚集性病例,每个聚集性病例包含2至7株分离株,29株(16%)代表3个聚集性病例,每个聚集性病例包含8至11株分离株。分子分型有助于确认基于流行病学监测怀疑的暴发,但对于大多数小的聚集性病例,无法建立流行病学联系。因此,实时分子分型的附加价值值得怀疑,因为所识别的众多小聚集性病例的公共卫生意义尚不清楚。在177只鸡中,41只(23%)分离出弯曲菌;其中,19只(46%)的基因型与41名(22%)人类分离株的基因型相似。然而,仅在少数病例中证明存在时间关联,并且大多数基因型仅存在于单一物种中,这表明除鸡以外的其他来源在人类弯曲菌病中也很重要。需要对水和其他可能的环境来源的样本进行进一步调查,以确定应用分子分型和识别弯曲菌病散发病例来源的最有效策略。