Ravel André, Pintar Katarina, Nesbitt Andrea, Pollari Frank
Département de pathologie et microbiologie and Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, QC, Canada.
Center for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, ON, Canada.
BMC Public Health. 2016 Sep 27;16(1):1016. doi: 10.1186/s12889-016-3679-4.
Campylobacteriosis is a prominent bacterial gastrointestinal infection worldwide with several transmission pathways. Its non-foodborne routes have been less documented and quantified. The study aimed to quantitatively explore the role of potential risk factors not directly associated with food for sporadic cases of C. jejuni infection in Canada.
This retrospective matched case-control study was built on an enhanced campylobacteriosis surveillance system and on a survey of healthy people and their behaviour with regards to potential risk factors for gastrointestinal infections that occurred in the same area in Canada. Eighty-five cases were individually matched by age and season to 170 controls.
Through conditional logistic regression, risk factors were found only among water-related factors (drinking untreated water, using tap filter, drinking water from well and swimming in natural water), whereas drinking bottled water was protective. Among the 32 non-water related factors explored, 12 were surprisingly 'protective' factors without relevant explanation for that effect (for example gardening, attending a barbecue, eating food from a fast-food restaurant), suggesting that human infection by Campylobacter may be more frequently acquired at home than outside the home.
This study confirms and quantifies the importance of the waterborne transmission of campylobacteriosis. People are encouraged to drink only treated water and to avoid the ingestion of natural water as much as possible while swimming or playing in water. Globally, general hygiene and proper food handling and cooking practices at home should continue to be encouraged.
弯曲杆菌病是一种在全球范围内较为突出的细菌性胃肠道感染疾病，有多种传播途径。其非食源性传播途径的记录和量化较少。本研究旨在定量探讨与食物无直接关联的潜在风险因素在加拿大空肠弯曲菌散发病例中的作用。
这项回顾性配对病例对照研究基于一个强化的弯曲杆菌病监测系统以及一项针对加拿大同一地区健康人群及其胃肠道感染潜在风险因素相关行为的调查。85例病例按年龄和季节与170名对照进行个体配对。
通过条件逻辑回归分析，仅在与水相关的因素（饮用未处理的水、使用水龙头过滤器、饮用井水以及在天然水中游泳）中发现了风险因素，而饮用瓶装水具有保护作用。在探索的32个非水相关因素中，有12个令人惊讶地是“保护”因素，但对此效应没有相关解释（例如园艺活动、参加烧烤、食用快餐店的食物），这表明弯曲杆菌感染在家庭中可能比在家庭外更频繁地发生。
本研究证实并量化了弯曲杆菌病水传播的重要性。鼓励人们只饮用经过处理的水，并在游泳或玩水时尽可能避免摄入天然水。在全球范围内，应继续鼓励在家中保持良好的个人卫生以及正确的食物处理和烹饪习惯。
