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Published on: March 10, 2020
Campylobacter concisus is prevalent in the gastrointestinal tract of patients with microscopic colitis
Marta Emilie Yde Aagaard1,2, Karina Frahm Kirk1, Hans Linde Nielsen2,3
1Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
Objectives:
Microscopic colitis (MC) is potentially induced by an inflammatory reaction to a luminal gut factor. The emerging pathogen Campylobacter concisus is associated with prolonged diarrhoea and subsequently increased risk of MC. We aimed to examine the prevalence of C. concisus in clinical samples from MC patients, analyse the subtypes collagenous colitis (CC) and lymphocytic colitis (LC), and characterise C. concisus isolates from MC patients by genomic sequencing.
Methods:
Mucosal biopsies were collected by sigmoidoscopy in 55 MC patients (CC n = 34, LC n = 21). Saliva and faecal samples were also collected. A two-step cultivation method and PCR established C. concisus prevalence. Biopsy and faecal isolates were sequenced for genomic analysis.
Results:
Cultivation revealed C. concisus in saliva 55/55, faeces 14/55 and biopsies 69/436, which was confirmed by PCR in faeces 28/55 and biopsies 215/430. Interestingly, biopsy prevalence was higher in CC patients than in LC patients both by cultivation (50/270 vs.19/166, p = .058) and by PCR (175/270 vs. 40/160, p < .0001). Long disease duration also affected biopsy prevalence both by cultivation 30/244 (<2 years) vs. 39/192 (>2 years) (p = .025) and by PCR 103/239 (<2 years) vs. 112/191 (>2 years) (p = .002). Genomic analysis on sixty biopsy and twenty faecal isolates revealed division into two clusters/genomospecies and a high presence of various, putative virulence genes (zot, exotoxin 9 and hcp).
Conclusions:
Campylobacter concisus was prevalent in MC patients. Interestingly, the biopsy prevalence differed in biopsies from CC and LC patients and with regard to disease duration. Further studies are needed to elucidate this possible association.
Insights
Campylobacter concisus bacteria were frequently found in microscopic colitis (MC) patients. Higher prevalence in collagenous colitis (CC) biopsies and with longer disease duration suggests a potential link requiring further investigation.
Area of Science:
- Gastroenterology
- Microbiology
- Genomics
Background:
- Microscopic colitis (MC) may result from an inflammatory response to gut factors.
- Campylobacter concisus, an emerging pathogen, is linked to prolonged diarrhea and increased MC risk.
Purpose of the Study:
- To determine the prevalence of Campylobacter concisus in clinical samples from MC patients.
- To analyze C. concisus prevalence in collagenous colitis (CC) and lymphocytic colitis (LC) subtypes.
- To characterize C. concisus isolates from MC patients using genomic sequencing.
Main Methods:
- Collection of mucosal biopsies, saliva, and fecal samples from 55 MC patients (34 CC, 21 LC).
- Two-step cultivation and PCR methods to establish C. concisus prevalence.
- Genomic sequencing of biopsy and fecal isolates for analysis.
Main Results:
- C. concisus was detected in saliva (100%), feces (25.5%), and biopsies (16%).
- Biopsy prevalence was significantly higher in CC patients (18.5%) vs. LC patients (12%) (p < 0.0001) and increased with disease duration (>2 years).
- Genomic analysis revealed two main clusters/genomospecies and the presence of virulence genes (zot, exotoxin 9, hcp).
Conclusions:
- Campylobacter concisus is prevalent in microscopic colitis patients.
- Biopsy prevalence of C. concisus differs between CC and LC subtypes and correlates with disease duration.
- Further research is necessary to clarify the association between C. concisus and microscopic colitis.
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