Sur les traces du Campylobacter au Luxembourg
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1 Environmental sources of Campylobacter infections in Luxembourg Priorité Nationale C09/BM/09 Sur les traces du Campylobacter au Luxembourg Catherine Ragimbeau
2 What sort of germ is Campylobacter? A fragile bacteria A pathogenic bacteria spiral-shaped bacteria microaerophilic limited tolerance to oxygen fastidious organisms sensitive to oxygen, drying, freezing, salting, and acid conditions very heat-sensitive destroyed T > 60 C not able to grow and multiply in foods. thermotolerant group C. jejuni C. coli : T op = 42 C body temperature of birds = well adapted to birds C. jejuni = the leading cause of bacterial gastroenteritis in the world The infective dose is small: 500 cells can be enough zoonose animals Human transmission direct = contact with infected animals or contaminated carcasses indirect = consumption of contaminated foods or water Campylobacteriosis symptoms: 2 to 5 days after infection duration of symptoms: 7-10 days
3 *5 countries were not included in the calculation => surveillance not covering the whole population Report , rate = 126/ Overall rate Europe 2012 = 68,35* highest rates 2012 C. coli 2013 C. jejuni
4 and with a closer look? By analysing DNA to create a genetic fingerprint DNA extraction MLST + Sequencing of 9 genes Allele No sequence International database I D C A R D Campylobacter jejuni Isolation: 2012/04/05 Origin: poultry Resistance Quinolone 2 gyra 1 pora 90 unk 8 pgm 7 tkt 56 gly 4 glt 3 gln 12 asp Genotype Simplified name
5 EPIFOOD Project Minimum spanning tree of MLST data for the 208 isolates of C. jejuni. Human N = 124 Bovine N = 48 Poultry, N = 36 Ragimbeau et al Reservoir 40%? CE Environmental route
6 HypoCamp project: Samples and data collected Questionnaires Risk factor survey Case control study veterinary lab. Reference labs ANSES ISP 22 isolates isolates Molecular typing 2140 isolates alleles Sequencing of 9 genes hospitals,clinical lab. year 1 => 687 isolates Year 2 => 610 isolates 1297 isolates 53 sites 920 isolates collected Water cycle
7 Human cases distribution over the time/ Genotypes endemic ~ 47% of cases epidemic micro-épidémie ~ 3 % of cases sporadic ~ 50% of cases 2 years scale
8 EPIFOOD Campylobacter jejuni Genotype Human Gyrase Human cases distribution Top 20 genotypes Poultry Mostly imported Dosmestic mammals Surface Waters Distri E = Endémique C = Cluster Comment T86I S22G E Milking cow and stream E+C C C E Cow and donkey E C Mini-outbreak E+C C Milking cow and stream E E E+C E+C C Sewage C Miini outbreak - turkey E = vs sensible to Quinolone E Sewage E C 1 dog 1 cat-1 bovin in C Mini outbreak E Turkey Huge diversity: 677 genotypes for 1300 human strains Top 20 genotypes account for 30 % of cases!! Half of the genotypes previously identified in 2006 => persistent genotypes 75 % of these reoccuring genotypes => poultry related (direct or indirect link with poultry) 12/20 reoccuring genotypes ( = 64 % of human cases) Genetic profile Quinolone
9 Reoccuring genotypes of C. jejuni the suggested scenario 33 of genotypes linked to 20% of the total clinical isolates Waste Water Treatment Plant Recipients and disseminators of Campy Risk? No geographical hotspots? Bathing waters all negative 57% effluents + Surface waters 70% of all the sites Campylobacter + Reservoir 5% Campylobacter +
10 In 2014, what s going on? 2014 rate > 155 cases/ Characterization by Whole Genome Sequencing Identification of a new genotype
11 , chicken Great Britain Great Britain Great Britain Great Britain Great Britain Great Britain ? Luxembourg Luxembourg Great Britain Great Britain Great Britain Great Britain Luxembourg ? Luxembourg ? Luxembourg ? Great Britain unknown Great Britain Great Britain Luxembourg Luxembourg Luxembourg Luxembourg Luxembourg Luxembourg 1028 genes compared 0.02
12 Questionnaire Témoin => partie hygiène alimentaire 911 personnes interrogées sur 1 an ( ) X 53% X 75% X 73% X 65 %
13 Restons mobilisés! Merci à tous les détectives qui ont participé à ce travail. Christian Penny Henry-Michel Cauchie Cécile Walczak Delphine Collard Blandine Fauvel Melissa Galloux Jean-Claude Schmit Stéphanie Colin Groupe de travail Campy Joël Mossong Anthony Devaux Laurence Gadisseux Christophe Olinger Frédéric Decruyenaere Fatu Djabi Nathalie Welschbillig Camille Strottner François Zimmer (SECUALIM) Serge Losch Joseph Schon Linda Weiland
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