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Epidemiology of Campylobacter Infections among Children in Egypt

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  • 1 Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland;
  • | 2 United States Naval Medical Research Unit-3, Cairo, Egypt;
  • | 3 Enteric Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
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Campylobacter is a frequently isolated bacterial pathogen among children with diarrhea. Data are lacking on the distribution and spectrum of disease associated with Campylobacter species and Campylobacter jejuni capsular polysaccharide (CPS) types. This information is essential because current vaccine research seeks to target specific CPS types. An effective CPS-conjugate vaccine will need to cover CPS types that are both common and associated with severe disease. The US Naval Medical Research Unit-3 conducted several prospective cohort studies researching diarrheal disease in Egypt from 1995 to 2003. In total, 1,057 children were enrolled and followed to a maximum age of 36 months. We analyzed Campylobacter-positive stool samples that were collected while subjects were symptomatic, along with corresponding clinical data. Of 441 Campylobacter isolates, 322 represented primary infections (189 C. jejuni, 127 Campylobacter coli, six unspeciated). There were 19 C. jejuni CPS types identified; eight accounted for 63.5% of primary C. jejuni infections. We also screened for the presence of the type-6 secretion system (T6SS), a putative virulence determinant. The T6SS was found in 18.0% of C. coli isolates and 57.6% of C. jejuni isolates (P < 0.001), and was not uniformly distributed among CPS types (P < 0.001). Strains with the T6SS were not associated with more severe disease. Clinical presentations across species and CPS types appeared similar. This study adds to the growing epidemiological data and also provides some analysis of the clinical spectrum associated with infection by specific Campylobacter species, C. jejuni capsule types, and possible virulence determinants.

Author Notes

Address correspondence to Rebecca Sainato, 5700 Mayfair Manor Drive, Rockville, MD 20852. E-mail: rebecca.j.sainato.mil@mail.mil

Financial support: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Authors’ addresses: Rebecca Sainato, Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD, E-mail: rebecca.j.sainato.mil@mail.mil. Atef ElGendy, Naval Medical Research Unit 3, Cairo, Egypt, E-mail: atef.elgendy@gmail.com. Frédéric Poly, Janelle Kuroiwa, Patricia Guerry, Mark S. Riddle, and Chad K. Porter, Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, E-mails: frederic.m.poly.civ@mail.mil, janelle.m.kuroiwa.civ@mail.mil, patricia.guerry-kopecko.civ@mail.mil, mark.s.riddle10.mil@mail.mil, and chad.k.porter2.civ@mail.mil.

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