Campylobacter spp. in chicken meat from traditional markets in Peru and its impact measured through a quantitative microbiological risk assessment.

Campylobacter is a major cause of foodborne gastroenteritis worldwide, with the mishandling of contaminated chicken meat among the main pathways for human infection. Granted the disease burden due to this pathogen, systematic assessments of its potential impact are necessary. The aims of this study were to evaluate both presence and load of Campylobacter in chicken meat sold in traditional markets, assess risk factors related with the infrastructure and hygienic conditions of market stalls, and evaluate control strategies for campylobacteriosis in Peru through a quantitative microbiological risk assessment (QMRA), a data-driven, systematic approach to quantitatively assess risks by integrating empirical contamination levels, microbial behavior, and consumer exposure. Between February and December 2022, a total of 90 chicken meat samples from traditional markets were sampled and evaluated by both culture and quantitative real-time polymerase chain reaction (qPCR). Campylobacter spp. were detected in 28 % and 76 % of samples with a mean quantification of 3.3 log CFU/g and 4.9 log GC/g through culture and qPCR, respectively. Market stalls with tap water showed higher prevalence and loads, while those without refrigeration had higher quantifications. The QMRA analysis, using the most conservative parameters and bacterial load, indicated that the entire modeled population develops campylobacteriosis at least once annually. These results highlight the public health impact of Campylobacter, potentially linked to the alarming number of Guillain-Barré syndrome cases observed in Peru. Our study suggests that consumer-level interventions, such as reducing kitchen cross-contamination and improving chicken meat storage, could substantially reduce campylobacteriosis cases in this population.