National Food Institute, Technical University of Denmark, Søborg, Denmark.
Epidemiol Infect. 2012 Jun;140(6):970-81. doi: 10.1017/S0950268811002676. Epub 2012 Jan 3.
Campylobacter spp. is a widespread and important cause of human illness worldwide. Disease is frequently associated with foodborne transmission, but other routes of exposure, such as direct contact with live animals and person-to-person transmission, are also recognized. Identifying the most important sources of human disease is essential for prioritizing food safety interventions and setting public health goals. Numerous case-control studies of sporadic infections of campylobacteriosis have been published. These studies investigated a variety of potential risk factors for disease, often using different methodologies and settings. Systematic reviews (SRs) consist of a formal process for literature review focused on a specific research question, and include the identification of relevant literature, quality assessment of relevant studies, summarization or statistical analysis of data, and conclusions. With the objective of identifying the most important risk factors for human sporadic campylobacteriosis, we performed a SR of case-control studies of human sporadic cases and a meta-analysis of the obtained results. A combined SR focusing on Salmonella and Campylobacter studies was performed and the results analysed separately. From 1295 identified references, 131 passed the relevance screening, 73 passed the quality assessment stage, and data was extracted from 72 studies. Of these, 38 focused on campylobacteriosis. Information on exposures of cases and controls, and estimated odds ratios for investigated risk factors were collected and analysed. In the meta-analysis, heterogeneity between the studies and possible sources of bias were investigated, and pooled odds ratios for identified risk factors were estimated. Results suggest that travelling abroad, eating undercooked chicken, environmental sources, and direct contact with farm animals were significant risk factors for campylobacteriosis. Sub-analyses by geographical region, age group, and study period were performed, and differences were discussed.
弯曲菌属是一种广泛存在且重要的人类病原体，在全球范围内引起了许多人类疾病。疾病通常与食源传播有关，但其他暴露途径，如直接接触活动物和人与人之间的传播，也已被认识到。确定人类疾病的最重要来源对于优先考虑食品安全干预措施和制定公共卫生目标至关重要。已经发表了许多关于弯曲菌病散发病例的病例对照研究。这些研究调查了各种潜在的疾病危险因素，通常使用不同的方法和设置。系统评价（SRs）是一种针对特定研究问题的文献综述的正式过程，包括确定相关文献、评估相关研究的质量、总结或对数据进行统计分析以及得出结论。为了确定人类散发性弯曲菌病最重要的危险因素，我们对人类散发性病例的病例对照研究进行了 SR，并对获得的结果进行了荟萃分析。还对沙门氏菌和弯曲菌的研究进行了综合 SR，并分别分析了结果。从 1295 篇鉴定的参考文献中，有 131 篇通过了相关性筛选，73 篇通过了质量评估阶段，有 72 项研究提取了数据。其中 38 项专注于弯曲菌病。收集并分析了病例和对照者的暴露信息，以及对所研究危险因素的估计比值比。荟萃分析中，研究之间的异质性和可能的偏倚来源进行了调查，并对已确定危险因素的汇总比值比进行了估计。结果表明，出国旅行、食用未煮熟的鸡肉、环境来源以及直接接触农场动物是弯曲菌病的重要危险因素。按地理位置、年龄组和研究期间进行了亚分析，并讨论了差异。
