Using sequence data to identify alternative routes and risk of infection: a case-study of campylobacter in Scotland
Using sequence data to identify alternative routes and risk of infection: a case-study of campylobacter in Scotland
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DOI：
10.1186/1471-2334-12-80
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发表时间：
2012-04-01
影响因子：
3.7
通讯作者：
Matthews, Louise
中科院分区：
文献类型：
--
作者：
Bessell, Paul R.;Rotariu, Ovidiu;Matthews, Louise
背景：基因分型数据是确定感染如何获得的潜在强大资源。本文中，MLST 分型用于区分来自家禽和反刍动物来源的空肠弯曲菌人类感染的途径和风险方法：使用 MLST 对来自动物和环境来源以及 2005 年 6 月至 2006 年 9 月期间确诊的报告人类病例的空肠弯曲菌样本进行分型。 STRUCTURE 软件用于将散发性人类病例的特定序列类型分配给特定来源。然后，我们使用混合病例Logistic回归分析来比较不同来源感染空肠弯曲菌的危险因素。结果：共有1,599例（46.3%）病例分配给家禽，1,070例（31.0%）分配给反刍动物，67例（1.9%）分配给野生鸟类；其余 715 个 (20.7%) 没有可以以大于 0.95 的概率分配的来源。与反刍动物来源相比，在人口密度大于 500 人/km(2) 的地区，家禽来源的病例通常发生在成年人中（比值比 (OR) = 1.497，95% 置信区间 (CIs) = 1.211, 1.852），而不是男性中（OR = 0.834，95% CI = 0.712, 0.977）（OR = 1.213，95% CI = 1.030，1.431），在冬季报告（OR = 1.272，95% CI = 1.067，1.517），并且最近进行过海外旅行（OR = 1.618，95% CI = 1.056，2.481）。家禽指定菌株与未指定菌株具有相似的流行病学特征，但未指定菌株报告海外旅行的可能性明显更高。结论：我们的分析表明，不同来源的空肠弯曲菌感染个体具有不同的相关风险因素，而不是估计感染的相对风险。通过增强我们识别高危人群以及这些人群可能面临风险的时间的能力，这项工作可以更有效地瞄准公共卫生信息。对病原体进行基因分型的能力迅速增强，使得这种追踪流行病学分析变得更加容易，并有可能大大加强流行病学危险因素研究。
Background: Genetic typing data are a potentially powerful resource for determining how infection is acquired. In this paper MLST typing was used to distinguish the routes and risks of infection of humans with Campylobacter jejuni from poultry and ruminant sourcesMethods: C. jejuni samples from animal and environmental sources and from reported human cases confirmed between June 2005 and September 2006 were typed using MLST. The STRUCTURE software was used to assign the specific sequence types of the sporadic human cases to a particular source. We then used mixed case-case logistic regression analysis to compare the risk factors for being infected with C. jejuni from different sources.Results: A total of 1,599 (46.3%) cases were assigned to poultry, 1,070 (31.0%) to ruminant and 67 (1.9%) to wild bird sources; the remaining 715 (20.7%) did not have a source that could be assigned with a probability of greater than 0.95. Compared to ruminant sources, cases attributed to poultry sources were typically among adults (odds ratio (OR) = 1.497, 95% confidence intervals (CIs) = 1.211, 1.852), not among males (OR = 0.834, 95% CIs = 0.712, 0.977), in areas with population density of greater than 500 people/km(2) (OR = 1.213, 95% CIs = 1.030, 1.431), reported in the winter (OR = 1.272, 95% CIs = 1.067, 1.517) and had undertaken recent overseas travel (OR = 1.618, 95% CIs = 1.056, 2.481). The poultry assigned strains had a similar epidemiology to the unassigned strains, with the exception of a significantly higher likelihood of reporting overseas travel in unassigned strains.Conclusions: Rather than estimate relative risks for acquiring infection, our analyses show that individuals acquire C. jejuni infection from different sources have different associated risk factors. By enhancing our ability to identify at-risk groups and the times at which these groups are likely to be at risk, this work allows public health messages to be targeted more effectively. The rapidly increasing capacity to conduct genetic typing of pathogens makes such traced epidemiological analysis more accessible and has the potential to substantially enhance epidemiological risk factor studies.