Laboratory Study on the Gastroenteritis Outbreak Caused by a Multidrug-Resistant Campylobacter coli in China

Three severe acute gastroenteritis patients were identified within a 5-h period in a sentinel hospital enrolled in the foodborne pathogen surveillance project in Beijing. All patients had high fever (over 38.5°C), diarrhea, abdominal pain, vomiting, and headache. Ten grams of fresh patient stool sample and 25 g of six suspected foods were collected for real-time PCR screening for 10 major pathogens. Bacterial isolation was performed. Pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and antibiotic susceptibility tests were conducted for all the isolates. Whole-genome sequences of the three Campylobacter coli isolates were compared using whole-genome MLST. All stool samples were positive for C. coli, as revealed by PCR. Eleven of the C. coli isolates had the same PFGE and ST type. All isolates were resistant to nalidixic acid, ciprofloxacin, streptomycin, and tetracycline, consistent with the findings of the in silico antibiotic resistance gene profiling. Most coding sequences (99%, 1736/1739) were identical among the three sequenced isolates, except for three frameshift-mutated genes caused by the simple sequence repeats (poly-Gs). This was likely a single-source outbreak caused by a group of highly clonal C. coli. This was the first outbreak of severe gastroenteritis caused by C. coli in China.