Abstract:
The
transmission of Campylobacter infections from meat to man is considered one of
the major routes of spread, along with water contamination, of this
increasingly common form of infectious intestinal disease. To make a risk
assessment of the likely transmission from pigs to man, a database was
established from a variety of references, as there was much variation in the
data and few were sufficiently complete to allow for a quantitative assessment
to be made. It was noted that erythromycin resistance was very high in pigs for
both C. jejuni and C. coli in comparison with man and chicken,
thought to be one of the major sources of infection and that this would act as
a possible marker to determine the transmission rate of campylobacter spp. from
pigs to man. There was no evidence of transmission of C. jejuni from
pigs to man, as the organism was rarely isolated in pigs (4%) in comparison
with chicken (90%) and man (92%) and resistance rates were very low at 2% in
man, chicken 4% and 35% in pigs. With regard to C. coli, isolation in
pigs is very high (96%) but low in chicken (10%) and man (8%) and erythromycin
resistance in man (15%) is similar to chickens (15%) but much lower than in
pigs (57%). This confirms that pig meat and environmental contamination by
slurry / waste from pigs via water can be considered either a no risk or very low
risk in the transmission of campylobacter infections to man and therefore also
a no risk or very low risk in the transmission of antimicrobially resistant
strains to man.
Introduction:
Campylobacter spp have become the most
frequently reported cause of gastrointestinal infections in man, even more than
Salmonella spp. (House of Lords, 1998). In 1999, 61713 reports were recorded in
the UK and it was estimated from earlier studies that only 50% of cases went to
the doctor, about one eighth of cases were reported and that the best estimate
of cases of Campylobacter infections in the country was 870/100,000 population
(0.87%). In Denmark it was estimated to be only 82 cases /100,000 population (Danmap,
2001) but in the United
States an estimated
2.4 million persons were affected each year (0.84%) by the Center for Disease
Control and Prevention (2001). An estimated 124 cases were fatal each year
(0.00004%) and life-threatening sepsis could occur in immuno-compromised
patients. The condition is thought to be primarily transmitted by contact with
contaminated food, particularly raw or undercooked poultry meat and possibly
unpasteurised milk. Water also has a role and the incidence increases 3-4 times
in the summer months, possibly associated with swimming and environmental
contamination may be a factor. Campylobacter jejuni is the main cause of
disease in man but C. coli is also found. It was the purpose of this
work to review the current literature, to determine the incidence of the
different Campylobacter spp. in each animal species, examine their
antimicrobial resistance patterns and to assess the risk of transmission from
pigs to man.
Campylobacter spp. incidence -
determination for each animal species:
Papers, which
had a comparative isolation data of C. jejuni and C. coli from
different animal species, were used to obtain comparative isolation percentages
for each species.
Table 1. Campylobacter spp.
determination for each animal species