Campylobacter abundance in breastfed infants and identification of a new species in the global enterics multicenter study

Authors: BIAN, XIAOMING - University Of Georgia; GARBER, JOLENE - University Of Georgia; COOPER, KERRY - University Of Arizona; Huynh, Steven; JONES, JENNIFER - University Of Maryland; MILLS, MICHAEL - University Of Georgia; RAFALA, DANIEL - University Of Georgia; NASARIN, DILRUBA - University Of Maryland; KOTLOFF, KAREN - University Of Maryland; Parker, Craig; TENNANT, SHARON - University Of Maryland; Miller, William - Bill; SZYMANSKI, CHRISTINE - University Of Alberta

Submitted to: mSphere
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/9/2019
Publication Date: 1/15/2020
Citation: Bian, X., Garber, J.M., Cooper, K.K., Huynh, S., Jones, J., Mills, M., Rafala, D., Nasarin, D., Kotloff, K.L., Parker, C., Tennant, S.M., Miller, W.G., Szymanski, C.M. 2020. Campylobacter abundance in breastfed infants and identification of a new species in the global enterics multicenter study. mSphere. 5(1):e00735-19. https://doi.org/10.1128/mSphere.00735-19.
DOI: https://doi.org/10.1128/mSphere.00735-19

Interpretive Summary: Campylobacter is the leading cause of bacterial foodborne illness worldwide. Typically, most campylobacterioses are associated with Campybacter jejuni and Campylobacter coli, although other Campylobacter species have been implicated in serious illness. In addition to severe diarrheal disease, pediatric infection with Campylobacter can also lead to higher infant mortality and growth stunting. Breastfeeding has been proposed to reduce these effects, presumably through the passage of beneficial antibodies and carbohydrates that reduce infection and/or lower the severity of illness. In this study, campylobacters were recovered from infant fecal samples obtained in Africa and south Asia, as part of the GEMS collaboration. Although previous studies have shown a correlation between breastfeeding and the reduction of severe illness, this study found the opposite; however, a positive correlation was observed between breastfeeding and reduction of growth stunting in infants. A novel Campylobacter, labeled C. GEMS, was identified in this study. This organism is related to Campylobacter fetus and Campylobacter hyointestinalis, which have also been recovered from human clinical samples. A detection method for C. GEMS was developed here and can specifically identify this novel species without extraneous identification of the related Campylobacter species.

Technical Abstract: Campylobacter jejuni is a leading cause of bacterial diarrheal disease worldwide and associated with a high rate of childhood mortality and growth stunting in children inhabiting low to middle resource countries. To better understand the influence of breastfeeding on Campylobacter infection in children under one year of age in sub-Saharan Africa and south Asia, we examined growth data, fecal microbial compositions, Campylobacter isolates and their carbohydrate metabolic pathways from Campylobacter-positive infants in the Global Enterics Multicenter Study (GEMS). Unexpectedly, we found a significantly higher Campylobacter burden in breastfed children with diarrhea and this was negatively correlated with the ability of the isolates to metabolize fucose. Among the diarrheal cases, a significantly lower proportion of breastfed children were growth stunted compared to non-breastfed children at enrollment and at the 60-day follow-up. Although C. jejuni and C. coli are still the most prevalent species in these children, other Campylobacter species were identified including C. hyointestinalis, C. upsaliensis, C. lari and a new species we refer to as C. GEMS. Asymptomatic Campylobacter carriers have significantly different proportions of specific gut microbes, including Blautia, compared to diarrheal cases. These findings provide insight into the Campylobacter epidemiology in children in sub-Saharan Africa and south Asia, and help inform strategies aimed at eliminating campylobacteriosis in children in these areas.