Molecular Epidemiology and Veterinary Public Health Laboratory, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand.
Epidemiol Infect. 2010 Oct;138(10):1372-83. doi: 10.1017/S0950268809991579. Epub 2010 Feb 9.
The epidemiology of human campylobacteriosis is complex but in recent years understanding of this disease has advanced considerably. Despite being a major public health concern in many countries, the presence of multiple hosts, genotypes and transmission pathways has made it difficult to identify and quantify the determinants of human infection and disease. This has delayed the development of successful intervention programmes for this disease in many countries including New Zealand, a country with a comparatively high, yet until recently poorly understood, rate of notified disease. This study investigated the epidemiology of Campylobacter jejuni at the genotype-level over a 3-year period between 2005 and 2008 using multilocus sequence typing. By combining epidemiological surveillance and population genetics, a dominant, internationally rare strain of C. jejuni (ST474) was identified, and most human cases (65.7%) were found to be caused by only seven different genotypes. Source association of genotypes was used to identify risk factors at the genotype-level through multivariable logistic regression and a spatial model. Poultry-associated cases were more likely to be found in urban areas compared to rural areas. In particular young children in rural areas had a higher risk of infection with ruminant strains than their urban counterparts. These findings provide important information for the implementation of pathway-specific control strategies.
人类弯曲菌病的流行病学较为复杂，但近年来对该病的认识已取得重大进展。尽管弯曲菌病是许多国家的主要公共卫生问题，但由于存在多种宿主、基因型和传播途径，因此难以确定和量化人类感染和疾病的决定因素。这使得包括新西兰在内的许多国家难以制定成功的干预计划，新西兰是一个弯曲菌病发病率相对较高、但直到最近才得到充分了解的国家。本研究在 2005 年至 2008 年期间使用多位点序列分型技术，对 3 年内弯曲杆菌属空肠亚种的基因型流行病学进行了研究。通过将流行病学监测和群体遗传学相结合，鉴定出一种优势的、国际罕见的弯曲杆菌属空肠亚种（ST474）菌株，且发现大多数人类病例（65.7%）由仅 7 种不同基因型引起。通过多变量逻辑回归和空间模型，利用基因型的来源关联来确定基因型水平的危险因素。与农村地区相比，与家禽相关的病例更可能发生在城市地区。特别是，农村地区的幼儿感染反刍动物株的风险高于城市幼儿。这些发现为实施特定途径的控制策略提供了重要信息。
