Center for Global Safe WASH, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands.
Epidemics. 2018 Sep;24:1-20. doi: 10.1016/j.epidem.2018.02.001. Epub 2018 Feb 8.
Data from a set of different studies on the infectivity and pathogenicity of Campylobacter jejuni were analyzed with a multilevel model, allowing for effects of host species (nonhuman primates and humans) and different strains of the pathogen. All challenge studies involved high doses of the pathogen, resulting in all exposed subjects to become infected. In only one study a dose response effect (increasing trend with dose) for infection was observed. High susceptibility to infection with C. jejuni was found in a joint analysis of outbreaks and challenge studies. For that reason four outbreaks, associated with raw milk consumption, were also included in the present study. The high doses used for inoculation did not cause all infected subjects to develop acute enteric symptoms. The observed outcomes are consistent with a dose response effect for acute symptoms among infected subjects: a conditional illness dose response relation. Nonhuman primates and human volunteers did not appear to have different susceptibilities for developing enteric symptoms, but exposure in outbreaks (raw milk) did lead to a higher probability of symptomatic campylobacteriosis.
使用多水平模型分析了一组关于空肠弯曲菌感染性和致病性的不同研究的数据，允许考虑宿主物种（非人类灵长类动物和人类）和病原体的不同菌株的影响。所有的挑战研究都涉及高剂量的病原体，导致所有暴露的受试者都被感染。只有一项研究观察到感染的剂量反应效应（剂量增加趋势）。在暴发和挑战研究的联合分析中发现，空肠弯曲菌感染的易感性很高。出于这个原因，与生奶消费相关的四起暴发也被纳入本研究。用于接种的高剂量并未导致所有感染的受试者出现急性肠道症状。观察到的结果与感染受试者急性症状的剂量反应效应一致：条件疾病剂量反应关系。非人类灵长类动物和人类志愿者似乎没有对发生肠道症状的不同敏感性，但在暴发（生奶）中的暴露确实导致了更有可能出现症状性弯曲杆菌病。
