The first study of Campylobacter spp. in hospitalized children with acute inflammatory diarrhea and in poultry samples in Georgia

Abstract

Background. By the World Health Organization Campylobacter is the leading food-borne
pathogen, causing bacterial gastroenteritis globally. The main source of the infection is attributed
to poultry and poultry meat. Campylobacteriosis is self-limited gastrointestinal illness,
characterized by diarrhea, fever, and abdominal cramps. Mostly, it is treated by maintaining
hydration and electrolyte balance, however there are cases when antibiotic treatment is
necessary. Post infection long-term autoimmune sequelae makes the burden of the disease
greater.
Aim of the study was to deliver the first systematic data of campylobacteriosis among hospitalized
children with bacterial gastroenteritis, and to reveal the recent epidemiologic trends in

comparison to Salmonella and Shigella, also to assess poultry flocks Campylobacter spp.
colonization status.
Methods. Totally, 481 human stool samples were collected from June 2020 to September 2021 at
Tbilisi Children Infection Clinical Hospital, and through the NCDC Disease Surveillance System. The
samples were tested for presence of other enteric bacteria at the clinics laboratories and sent to
the NCDC-Lugar center for Campylobacter spp. identification.
Additionally, 97 chicken caeca samples were collected at Digomi live animal market in Tbilisi and
50 samples from medium-sized poultry farm, located at eastern Georgia.
Culture-based bacteriological methods, described at ISO 10272-1:2017 part C on modified
charcoal, cefoperazone, deoxycholate agar and Campylobacter Chromogenic agar, as an additional
selective medium were applied for Campylobacter spp. isolation. Phenotypic Biomeriux ApiCampy
biochemical tests served for bacterial identification, confirmation and species discrimination.
Results. Totally, out of 440 samples, where enteric pathogen was not detected by the clinics,
14.3% (95% CI: 11.2 - 17.9% (n=63)) were positive for Campylobacter spp. In particular, share of
campylobacteriosis in Tbilisi was 14.3 % (95% CI: 10.9 – 18.3 %), in Batumi and Kutaisi, respectively
16.3% (95% CI: 7.3 – 29.7%) and 12% (95% CI: 2.5 – 31.2 %).
Besides, Shigella sonnei was the most frequently isolated bacteria (20.5 % (95% CI: 16.7 – 24.8%)),
followed by Campylobacter spp. (12.8 % (95% CI: 9.7 – 16.5%)) and Salmonella spp. (4.9% (95% CI:
3.0 – 7.5%)) among hospitalized children with acute diarrheal illnesses and gastroenteritis in
Tbilisi.
In addition, the studied poultry flocks were totally colonized by Campylobacter spp.

Conclusions. The study revealed that campylobacteriosis among children population might be the
second and in preschoolers the first cause of acute inflammatory diarrhea and gastroenteritis in
the country. Also, the colonization rate of poultry flocks by Campylobacter spp. is a matter of
concern.