Comprehensive analysis of lipo-oligosaccharides in Campylobacter jejuni isolated from Guillain–Barré syndrome and enteritis patients, and healthy controls

Background: Campylobacter jejuni is one of the most frequent causes of acute gastroenteritis and is associated with post-infectious sequelae such as Guillain–Barré Syndrome (GBS). The lipooligosaccharide (LOS) of C. jejuni has been reported as an important determinant to develop GBS.

Objective: This study aimed to investigate the association of C. jejuni LOS classes with GBS and enteritis patients and healthy controls in Bangladesh.

Method: We studied 30 C. jejuni strains from GBS patients, 152 from enteritis patients and 215 from healthy control in Bangladesh. All strains were analyzed by PCR for 14 LOS classes (A-S).

Results: A total of 314/397 (79%) C. jejuni strains assigned to different LOS classes. LOS class A was significantly associated with GBS-associated strains compared to enteritis patients (47% vs 3%, p <0.01) and healthy controls (47% vs 7%, p <0.01). LOS Class B was frequent in GBS (50%), enteritis patients (40%) and healthy controls (53%). LOS class E was identified more frequently in enteritis patients compared to healthy controls (16% and 8% respectively). A total of 28 (7%) C. jejuni either from enteritis or healthy controls belonged to one of the following classes D, I, Q, K, N, F, J, or S. Two strains from enteritis patients had LOS class N and two from healthy control had LOS class S, J or F.

Conclusion: Our study identified LOS class A being responsible for the induction of GBS; however, further effort is warranted for proper classification of the strains which could not be typed by the existing LOS classification scheme.