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Carriage of CdtB Encoding Campylobacter spp., Salmonella enterica, and Yersinia entercolitica in Patients with Gastroenteritis and Irritable Bowel Syndrome

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Abstract

Introduction

Cytolethal distending toxin (Cdt) is one of the bacterial toxins that present in a variety of gram-negative human pathogens, such as E. coli, Salmonella spp., and Campylobacter spp. CDT is composed of three subunits encoded by three adjacent genes, including cdtA, cdtB, and cdtC. cdtB has been shown to have toxic activity and cause DNA damage in host cells. Despite its presence in different bacterial species, the role of CdtB in acute and chronic infections, such as gastroenteritis and irritable bowel syndrome (IBS), is unclear. To analyze this correlation, we studied the prevalence of cdtB among different enteropathogenic bacteria in patients with gastroenteritis and IBS compared with healthy people.

Materials and Methods

In this cross-sectional descriptive study, 230 stool samples were collected from patients with gastroenteritis, IBS, and healthy people. The presence of CdtB encoding bacteria, including Escherichia coli, Campylobacter spp., Yersinia entercolitica, Providencia alkalifacience, and Salmonella enterica, was examined by polymerase chain reaction using genus-specific primers.

Results

Out of 230 stool samples, CdtB encoding Campylobacter spp. were found in 34.6% (52/150), 6.25% (5/80), and 4% (2/50) of the patients with gastroenteritis, IBS, and the control group, respectively. Carriage of CdtB encoding Salmonella enterica was characterized among 5.3% (8/150) of the patients with gastroenteritis and 17.5% (14/80) of the IBS patients. Although none of the patients carried CdtB encoding E. coli and Providencia spp., cdtB of Y. enterocolitica was detected in one of the patients with gastroenteritis (0.6%). Statistical analysis showed significant correlation between infection with CdtB encoding Campylobacter spp. and IBS-D subtype. No significant correlation was found between infection with CdtB encoding bacteria and other clinical and demographic data.

Conclusion

Our results confirmed a relatively higher frequency of CdtB encoding bacteria in the intestine of patients with gastroenteritis and those with IBS compared with healthy individuals. Regarding the frequency of CdtB encoding Salmonella and Campylobacter bacteria, it was proposed that infection with these enteropathogens could be considered a risk factor for the development or progression of IBS among Iranian patients. Further studies are needed to establish this involvement.

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Acknowledgments

This study was part of a PhD thesis that was approved by the ethics committee of the Department of Pathobiology, Tehran University of Medical Sciences, Tehran, Iran (TUMS. ethics.code 92-02-27-22726). The authors thank all staff of Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, which helped us in this study. Indeed, many thanks go to Prof. Saeid Bouzari (Pasteure Institute of Iran, E. coli Reference Laboratory, Iran) for providing DNA of CdtB encoding E. coli.

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Authors and Affiliations

  1. Health Reference Laboratory Research Center, Reference Health Laboratory, Ministry of Health and Medical Education, Tehran, Iran

    Leila Ganji & Mohammad Rahbar

  2. Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Leila Ganji & Masoud Alebouyeh

  3. Department of Pathobiology, School of Public Health, University of Medical Sciences, Tehran, Iran

    Mohammad Hassan Shirazi

  4. Department of Gastroenterology and Hepatology, Tehran University of Medical Sciences, Tehran, Iran

    Nasser Ebrahimi-Daryani

  5. Department of Microbiology, Central Laboratory, Milad Hospital, Tehran, Iran

    Parisa Eslami

  6. Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Reza Zali

  7. Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Masoud Alebouyeh

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  1. Leila Ganji
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Correspondence to Masoud Alebouyeh.

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Ganji, L., Shirazi, M.H., Ebrahimi-Daryani, N. et al. Carriage of CdtB Encoding Campylobacter spp., Salmonella enterica, and Yersinia entercolitica in Patients with Gastroenteritis and Irritable Bowel Syndrome. Dig Dis Sci 67, 5522–5528 (2022). https://doi.org/10.1007/s10620-022-07468-x

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