Global Distribution of Campylobacter jejuni Penner Serotypes: A Systematic Review

Brian L Pike, Patricia Guerry, Frédéric Poly, Brian L Pike, Patricia Guerry, Frédéric Poly

Abstract

Penner serotyping has been the principal method for differentiating Campylobacter isolates since its inception. Campylobacter capsule polysaccharide (CPS), the principal serodeterminant on which Penner serotyping is based, is presently of interest as a vaccine component. To determine the required valency of an effective CPS-based vaccine, a comprehensive understanding of CPS distribution is needed. Because of the association between Penner serotype and CPS, we conducted a systematic review to estimate the frequency and distribution of Penner serotypes associated with cases of Campylobacteriosis. In total, more than 21,000 sporadic cases of C. jejuni cases were identified for inclusion. While regional variation exists, distribution estimates indicate that eight serotypes accounted for more than half of all sporadic diarrheal cases globally and three serotypes (HS4 complex, HS2, and HS1/44) were dominant inter-regionally as well as globally. Furthermore, a total of 17 different serotypes reached a representation of 2% or greater in at least one of the five regions sampled. While this review is an important first step in defining CPS distribution, these results make it clear that significant gaps remain in our knowledge. Eliminating these gaps will be critical to future vaccine development efforts.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Proportional representation of the three…
Figure 1. Proportional representation of the three most dominant HS serotypes (HS4c, HS2, and HS1/44) by region.
Lightly shaded areas represent the 33 (of 35) HS serotypes not indicated in color on the graph. Darkly shaded areas indicating those isolates not accounted for in the 35 HS serotypes examined were empirically derived by subtracting the sum of the percentages of the 35 serotypes from 100%. The darkly shaded area also includes non-typable isolates.

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