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Journal of Clinical Microbiology, August 2005, p. 4221-4224, Vol. 43, No. 8
0095-1137/05/$08.00+0 doi:10.1128/JCM.43.8.4221-4224.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Genetic Diversity of Campylobacter sp. Isolates from Retail Chicken Products and Humans with Gastroenteritis in Central Michigan
Brooke R. Fitch,1
Kacey L. Sachen,1
Stacey R. Wilder,1
Matthew A. Burg,1
David W. Lacher,4
Walid T. Khalife,2,5
Thomas S. Whittam,1,4 and
Vincent B. Young1,3,4*
Department of Microbiology and Molecular Genetics,1
Medical Technology Program,2
Infectious Diseases Unit, Department of Internal Medicine,3
National Food Safety and Toxicology Center, Michigan State University, East Lansing, Michigan 48824,4
Microbiology Laboratory, Sparrow Hospital, Lansing, Michigan 489125
Received 28 February 2005/
Returned for modification 17 April 2005/
Accepted 24 April 2005

ABSTRACT
Multilocus sequencing was used to compare
Campylobacter sp.
strains isolated from retail chicken products and humans with
gastroenteritis in central Michigan. Sequence comparisons demonstrated
overlapping diversity between chicken and human isolates.
Campylobacter jejuni isolates from clinical sources had a greater diversity
of flagellin alleles and a higher rate of quinolone resistance
than isolates from retail chicken products.

TEXT
Campylobacter species are a frequent cause of foodborne illnesses
in the United States (
1). Because
Campylobacter jejuni and
Campylobacter coli isolates occur in high numbers in the gastrointestinal
tracts of chickens (
18) and can be readily recovered from retail
chicken products (
7,
8), sporadic human infection is thought
to arise most commonly via contaminated poultry products (
15).
To examine this link, we cultured for
Campylobacter isolates
from retail chicken products from 12 supermarkets in the Lansing,
Michigan, area by using selective plates and filter enrichment
techniques. Twenty-three
Campylobacter isolates were recovered
from 113 chicken samples over an 11-week period (Fig.
1). At
the same time, 19
Campylobacter isolates from patients with
gastroenteritis were obtained from the clinical laboratory of
a private hospital in Lansing.
DNA was extracted from all
Campylobacter isolates.
C. jejuni and
C. coli were identified by amplification of the
flaA gene
(
16) and discriminated by PCR assays targeting the hippuricase
(
N-acyl-
L-amino-acid amidohydrolase) gene (
hipO) of
C. jejuni and a
C. coli-specific chromosomal sequence (
10). Thirteen chicken
isolates were
C. jejuni isolates (56.5%) and 10 were
C. coli isolates (43.5%), whereas 17 human isolates were
C. jejuni isolates
(89.5%) and 2 were
C. coli isolates (10.5%). Compared to the
isolation of these two species from retail chicken products,
C. jejuni was significantly more likely to be isolated from
human clinical specimens than
C. coli (
P = 0.015;
2 test).
To determine the clonal relatedness of strains, we used multilocus sequence typing (MLST) devised for C. jejuni (4, 13, 19) as a tool for epidemiologic investigation (3). Sequence analysis of seven housekeeping genes (4) identified, on average, 15 polymorphic nucleotide sites per locus for the 30 C. jejuni strains from both clinical and retail chicken product samples (Table 1). There was substantial overlap between the alleles found in strains recovered from chickens and those from patients. No alleles were specific to either source; shared alleles were found for all seven genes (Table 1). In terms of the multilocus genotypes, there were 21 sequence types (STs) resolved, 4 (19%) of which were identified in both human and chicken isolates.
The average pairwise sequence divergence of the MLST loci among
the human isolates (

1%) was the same as among chicken isolates.
The net genetic distance between chicken and human isolates
combined was virtually zero, providing no evidence for genetic
differentiation between poultry and human clinical isolates.
Seventeen of the 30 (57%)
C. jejuni strains belonged to previously
recognized STs (Table
2). The remaining 13 isolates represent
nine new sequence types. ST-21, ST-475, ST-918, and ST-937 were
represented by both human and chicken isolates. Thirteen (43%)
isolates belonged to novel STs, suggesting that unique STs circulate
in local geographic regions (
5).
Sixteen
C. jejuni strains isolated here grouped into the clonal
complexes ST-21, ST-48, and ST-353. Along with 1 strain each
in the complexes ST-52 and ST-49, these 18 strains (60% of the
C. jejuni isolates) fell into 1 of 17 clonal complexes that
encompassed 92% of 814
C. jejuni strains, forming a diverse
collection mainly from the United Kingdom and The Netherlands
(
3).
To further quantify the genetic diversity of C. jejuni, we examined sequence variation in two common traits used for Campylobacter subtyping. First, we examined allelic variation in hippuricase by designing primers (hipO-F156, 5'-AAT AGG AAA AAC AGG CGT TG-3'; hipO-R721, 5'-GTC CTG CAT TAA AAG CTC CT-3') to amplify a 566-base-pair region in hipO. Sequencing of a 377-base-pair internal region of this amplicon revealed 17 polymorphic sites and 14 distinct hipO alleles among the 30 C. jejuni isolates with nucleotide variation comparable to that of the seven MLST loci (Table 1). A dendrogram constructed by combining the seven MLST and hipO sequences (the MLST sequences were submitted to the PubMLST Campylobacter database [http://campylobacter.mlst.net]) demonstrates overlapping relatedness and diversity of chicken and human strains (Fig. 2).
Second, we examined sequence variation in the
flaA short variable
region (SVR) of the
C. jejuni isolates (
14) which identified
82 variable sites, 21 sequence variants (Table
1), and 10 FlaA
amino acid sequence variants (Fig.
2). Assigning these sequences
to STs, human strains fell into all 10 FlaA STs, while chicken
isolates fell into 5 STs, with 8 of 13 in ST-3. The average
divergence ± standard error of FlaA among the human isolates
(7.6% ± 0.9%) was greater than that of FlaA among chicken
isolates (2.2% ± 0.5%). Furthermore, the nonsynonymous
base substitution-to-synonymous base substitution ratio for
the
flaA SVR of the human isolates was 0.177, compared to 0.072
for chicken isolates. The nonsynonymous base substitution-to-synonymous
base substitution ratio for all seven MLST loci and
hipO was
0.071. Given the overlapping diversity between human and chicken
isolates as measured by MLST, increased flagellar diversity
may reflect either reduced functional constraints on the protein
or increased selection pressure within the human host.
All Campylobacter isolates were tested for sensitivity to ciprofloxacin by Etest (11). Two human C. coli isolates and one chicken isolate were ciprofloxacin resistant. Seven C. jejuni isolates (all from humans) representing 41.2% of human isolates, were ciprofloxacin resistant (Fig. 2). The difference between the rate of ciprofloxacin resistance encountered in chicken and human isolates was statistically significant (P = 0.002;
2 test).
A portion of the gyrA gene was sequenced for each isolate (17). Nine of 10 ciprofloxacin-resistant Campylobacter strains had a C-to-T transition that codes for the substitution of isoleucine for threonine at position 86 (T86I), the most common mutation found in highly fluoroquinolone-resistant Campylobacter strains (21).
Geographically linked C. jejuni isolates from poultry and humans can have corresponding high rates of quinolone resistance (9, 12). Among our C. jejuni isolates in this study, unexpectedly, none of the chicken isolates was ciprofloxacin resistant, while 7 of the 17 clinical isolates of C. jejuni were ciprofloxacin resistant, in all cases associated with the T86I gyrA amino acid substitution. The treatment of patients with quinolones could select for resistant isolates and drive them to high frequency. Quinolone resistance (via the T86I mutation) can arise rapidly in C. jejuni and C. coli in the gastrointestinal tracts of animals and humans treated with quinolones (2, 6, 20).
In summary, a polyphasic scheme was used to compare the diversity of Campylobacter species isolated from retail poultry and humans with gastroenteritis. MLST analysis of housekeeping genes of C. jejuni strains provides support for the hypothesis that retail chicken products can serve as food reservoirs for C. jejuni that leads to human gastroenteritis. Analysis of potentially variable traits (flagellar typing and antibiotic resistance profiling) suggests that additional selection occurs at some point during the transition from the environmental reservoir and sampling of the human host, perhaps within the gastrointestinal tract of the host itself.
Nucleotide sequence accession numbers.
flaA SVR sequences were submitted to GenBank under the accession numbers AY927807 to AY927484, and the partial hipO sequences were submitted under the accession numbers AY944146 to AY944175.

ACKNOWLEDGMENTS
Parts of this study were funded with support from the Michigan
State University Center for Emerging Infectious Diseases.
We thank Jennifer Ellis-Cortez for expert technical assistance.

FOOTNOTES
* Corresponding author. Mailing address: Room B42, Food Safety and Toxicology Building, Michigan State University, East Lansing, MI 48824. Phone: (517) 432-3100. Fax: (517) 432-2310. E-mail:
youngvi{at}msu.edu.


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Journal of Clinical Microbiology, August 2005, p. 4221-4224, Vol. 43, No. 8
0095-1137/05/$08.00+0 doi:10.1128/JCM.43.8.4221-4224.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
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