Long-term Colonization by Campylobacter jejuni Within a Human Host: Evolution, Antimicrobial Resistance, and Adaptation. (1st November 2017)

• Record Type: Journal Article
• Authors: Bloomfield, Samuel J; Midwinter, Anne C; Biggs, Patrick J; French, Nigel P; Marshall, Jonathan C; Hayman, David T S; Carter, Philip E; Thornley, Craig; Yap, Rudyard; Benschop, Jackie
• Is Part Of: Journal of infectious diseases. Volume 217:Number 1(2018)
• Page Start: 103
• Page End: 111
• Publication Date: 2017-11-01
• Subjects: Campylobacter -- evolution -- antibiotic resistance -- genomics -- chronic infection; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jix561
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract : A patient was identified who had been continuously colonized with Campylobacter organisms for over a decade. Whole-genome sequencing and antimicrobial susceptibility testing suggested that the Campylobacter population had adapted to the host by altering motility and becoming resistant to prescribed antibiotics. Abstract: Background: Campylobacteriosis is inflammation of the gastrointestinal tract as a result of Campylobacter infection. Most campylobacteriosis cases are acute and self-limiting, with Campylobacter excretion ceasing a few weeks after symptoms cease. We identified a patient with fecal specimens positive for Campylobacter jejuni (ST45) intermittently during a 10-year period. Methods: Sixteen Campylobacter isolates were collected from the patient during 2006–2016. The isolates' genomes were sequenced to determine their relatedness, and their antimicrobial susceptibility patterns and motility were measured to determine the effects of antibiotic therapy and long-term excretion on the Campylobacter population. Results: Phylogenetic analyses estimated that the isolates shared a date of common ancestor between 1998 and 2006, coinciding with the onset of symptoms for the patient. Genomic analysis identified selection for changes in motility, and antimicrobial susceptibility testing suggested that the Campylobacter population developed resistance to several antibiotics coinciding with periods of antibiotic therapy. Conclusions: The patient was consistently colonized with organisms from a Campylobacter population that adapted to the internal environment of the patient. Genomic and phylogenetic analyses can give insight into a patient's infection history and the effect of antimicrobial treatment on Campylobacter populations in this unusual situation of long-term colonization of an individual.