Quantitative microbial risk assessment of hyperaerotolerant and multidrug-resistant Campylobacter jejuni and C. coli related to contaminated chicken meat consumption.

Hyperaerotolerant and multidrug-resistant (HATMDR) Campylobacter spp. are emerging. Contaminations of C. jejuni and C. coli from chicken meat are contributors to campylobacteriosis. This study determined the cross-contamination and recontamination transfer rates of HATMDR C. jejuni and C. coli via cutting board, glove, and knife on chicken meat. Transfer rates in cross-contaminations were the highest on the cutting board in both C. jejuni (40.58 ± 21.07%) and C. coli (37.79 ± 26.49%). The recontamination transfer rates of C. jejuni and C. coli from contaminated glove to cooked chicken were the highest, with 4.57 ± 1.43% and 23.19 ± 14.89%, respectively. The transfer rates were then input into retail-to-fork scenario-specific quantitative microbial risk assessment (QMRA), utilizing two-dimensional Monte Carlo (2D-MC) simulations to estimate campylobacteriosis risks from chicken consumption in Malaysia. Five phenotypes of C. jejuni and C. coli with different aerotolerance and MDR status were incorporated in this QMRA. C. jejuni and C. coli were estimated with 566 (404 to 741, 95% C.I.) and 398 (281 to 536, 95% C.I.) cases per 100,000 population per year, respectively. Moreover, HATMDR C. jejuni and C. coli contributed the highest annual number of disability-adjusted life years per 100,000 (DALYs100,000) with 3.46 and 3.33, respectively. Sensitivity analysis revealed that the probability of illness (Pill) was the most sensitive factor in the uncertainty dimension in both C. jejuni and C. coli, with strong and moderate positive correlations of ρ = 0.74 and ρ = 0.69, respectively. In comparison, the probability of using contaminated cutting board (Pboard) was the most sensitive factor in variability dimensions in both C. jejuni and C. coli, with moderate positive correlation of ρ = 0.51, respectively. Overall uncertainty ratio analysis showed that dose-response relationship (Pinf1) has the highest overall uncertainty ratios of 50.88 in both C. jejuni and C. coli, indicating the biological variation of Pinf1 in human susceptibility is large. In the intervention scenario, the combination of three mitigation measures, including improvement in retail hygiene, retail washing, and preparation hygiene, demonstrated the greatest risk reduction, with reductions of 51.94% and 51.26% in C. jejuni and C. coli, respectively. This study highlights the burden of C. jejuni and C. coli, especially the HATMDR strains, and the importance of hygienic practices in curbing campylobacteriosis.