Campylobacter at HPA Colindale. Dr Andy Lawson Centre for Infections Health Protection Agency London
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1 Campylobacter at HPA Colindale Dr Andy Lawson Centre for Infections Health Protection Agency London
2 Health Protection Agency Establised in 2003, functions as a non-departmental public body. The HPA has a large network of approximately 3000 staff based at three major centres (Colindale, Porton and Chilton) & regionally & locally throughout England with a small central office in London. The Centre for Infections Based at Colindale is the base for communicable disease surveillance & specialist microbiology. The Centre for Radiation, Chemical & Environmental Hazards Based at Chilton. The Centre for Emergency Preparedness & Response Based at Porton.
3 Laboratory Reports Annual UK laboratory reports selected GI pathogens Campylobacter Salmonella Shigella Rotavirus Cryptosporidium * Year Data from CDSC Colindale (*provisional figures)
4 The human impact of selected GI pathogens in the UK Pathogen Estimated cases Presentations to GPs Hospital admissions Hospital bed days Deaths Campylobacter Salmonella (non- typhiodal) E. coli O Novovirus Rotavirus Cryptosporidium Estimates for 2000 Adak et al. Gut 2002; 51: 832
5 History of Campylobacter microbiology at Colindale 1980 s to1990 s: National Collection of Type Cultures Early species descriptions & typing methods 1993 to 1997: Campylobacter Special Projects Unit Identification & typing for IID study 1997 to 2004: Campylobacter Reference Unit Sentinel Surveillance Study (& other work) 2004 to 2007: Campylobacter & Helicobacter Reference Unit Core reference work & studies 2007 onwards: Diagnostic & Specialist Identification Unit Broader remit incorporates functions of CHRU
6 Tools for Campylobacter work Identification TaqMan assay for C. jejuni & C. coli (Best et al. FEMS Micro Let 229: 237.) Phenotypical & genotypic assays for other species Antimicrobial susceptibility testing Breakpoint method MIC determination if required Typing Pulsed Field Gel Electrophoresis Sequencing typing (MLST & fla SVR) Archiving -80ºC Freezer archive of >30,000 isolates from various studies Departmental support Part of the Department for Gastrointestinal, Emerging & Zoonotic Infections - with full support from specialist Epidemiology & Food Microbiology Units.
7 Campylobacter microbiology at Colindale (DSIU) Referrals Blood culture & systemic site isolates Identification of atypical isolates Resistant isolates Outbreak investigation Two or three outbreaks per year often difficult to obtain cultures Surveillance No official surveillance for human Campylobacter isolates in the UK Monitor antimicrobial susceptibility trends Studies Numerous studies funded by various bodies
8 Percentage resistant Ciprofloxacin resistance in isolates from humans C. coli C. jejuni Year
9 Percentage resistant Erythromycin resistance in isolates from humans C. coli C. jejuni Year
10 Past & prospective UK Campylobacter studies Infective Intestinal Diseases Study (DoH) Sentinel Surveillance Study (PHLS/HPA) 2001 Retail poultry survey (FSA) Prevalence of Campylobacter in raw red meats (HPA/LACORS) Case Control Study in England of human C. jejuni (FSA) Effect of Antibiotic therapy on Campylobacter in poultry flocks (Defra) Wales & Northern Ireland retail poultry survey (FSA) CLASSP - retail poultry England and Scotland (FSA) MLST analysis of isolates from selected FSA surveys (FSA) Campylobacter in the River Thames (HPA/LPHA) 2006 Campylobacter in poultry other than chicken - review (FSA) Red meat survey (FSA) Retail poultry survey (FSA) Infective Intestinal Diseases Study II (FSA) Retail poultry survey in Eire (Safefood Ireland)
11 Prevalence of Campylobacter species in raw red meats: UK survey Meat type Meat product Number sampled Samples with Campylobacter (%) Beef Cuts (5) Offal 49 6 (12) Lamb Cuts (7) Offal (37) Pork Cuts (5) Offal (18) Game & other meats Cuts 47 5 (11) Offal/other 4 0
12 Prevalence of antibiotic resistant Campylobacter species in raw red meats Meat type Species Number of isolates (%) Ciprofloxacin resistance Erythromycin resistance Beef C. jejuni 43 (88) 12% 0 C. coli 6 (12) 17% 17% Lamb C. jejuni 64 (71) 11% 0 C. coli 26 (29) 23% 23% Pork C. jejuni 36 (53) 19% 8 % C. coli 32 (47) 28% 41% Game and other meats C. jejuni C. coli Total C. jejuni 146 (69) 11% 2% C. coli 65 (31) 27% 20%
13 Campylobacter work presented at CHRO 2007 Rotterdam A new Campylobacter species isolated from humans? Polyphasic taxonomic analysis of human C. fetus strains with markers of reptile origin. Characterization of C. fetus strains originating in reptiles & closely related human strains by MLST. MLST analysis of C. fetus isolates from humans in the UK. Developing an epidemiologically robust typing approach to identify, describe & trace outbreaks of C. jejuni infection. Risk factors for reported Campylobacter enteritis in England: A case-control study. A three-year population based investigation of human C. jejuni epidemiology using sequence typing & patient survey data. Campylobacter species isolated from the river Thames. Campylobacter from retail poultry: MLST analysis and the origin of human infection. Towards a combined microbiological & epidemiological approach for investigating hostmicrobe interactions of C. jejuni CAMPYNET III (WP 30). No association found between pvir & bloody diarrhoea in UK isolates of C. jejuni.
14 Yearly referred isolates of C. fetus subspecies fetus from humans in England & Wales by MLST sequence type C. fetus isolates referred ST2 ST3 ST6 ST11 Other STs Not examined UK F&M disease National Outbreak Year
RISK ASSESSMENT CAMPYLOBACTER INFECTION TRANSMISSION FROM PIGS TO MAN USING ERYTHROMYCIN RESISTANCE AS A MARKER
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