ORIGINAL ARTICLE Campylobacter jejuni virulence genes and immune-inflammatory biomarkers association with growth impairment in children from Northeastern Brazil Herlice do Nascimento Veras 1 & Pedro H. Q. S. Medeiros 1 & Samilly A. Ribeiro 1 & Thiago M. Freitas 1 & Ana K. S. Santos 1 & Marília S. M. G. Amaral 1 & Mariana D. Bona 1 & Alexandre Havt 1 & Ila F. N. Lima 1 & Noélia L. Lima 1 & Alessandra Di Moura 3 & Álvaro M. Leite 3 & Alberto M. Soares 1 & José Q. Filho 1 & Richard L. Guerrant 1,2,3 & Aldo A. M. Lima 1 Received: 6 June 2018 /Accepted: 18 July 2018 # Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Campylobacter spp. have been associated with anthropometric Z-score decrements, but the role of specific virulence genes associated with these outcomes has not been explored. This study aimed to investigate whether specific Campylobacter jejuni virulence-related gene and immune-inflammatory biomarkers are associated with malnutrition in children from Northeastern Brazil. A case-control study was performed in Fortaleza, Brazil. Children aging 6–24 months were charac- terized as malnourished (cases) if weight-for-age Z-score (WAZ) = 2 and as nourished (controls) if WAZ ≥ 1. DNA samples were extracted from stools and screened for C. jejuni/coli by real-time PCR. A subsequent C. jejuni-specific PCR was employed and positive samples were evaluated for 18 C. jejuni virulence genes by using four multiplex PCRs. C. jejuni was detected in 9.71% (33/340) of the children’ s samples, being 63.63% (21/33) from nourished and 37.37% (12/33) from malnourished children. The cadF , iamA, cheW, and sodB genes were the most frequent genes (100%, 90.9%, 87.9%, and 75.8%, respectively), while some others (ceuE, jlpA, pldA, and pVir) showed low rates (all below 6%). Malnourished children were significantly associated with infection with C. jejuni strains lacking cdtB gene (active subunit of cytolethal distending toxin) and harboring flgE gene (flagellar hook protein). These strains were also associated with children presenting increased serum SAA and sCD-14, but decreased IgG anti-LPS. These data reinforce the impact of Campylobacter jejuni infection on children without diarrhea and highlight the contribution of a specific virulence gene profile, cdtB(-)flgE(+) and increased systemic response in malnutrition children. Keywords Campylobacter . Malnutrition . Virulence traits . Immune-inflammatory biomarkers Introduction Campylobacter spp. infections are the most common cause of bacterial gastroenteritis caused by food contamination worldwide [1]. An overall increase in the incidence of campylobacteriosis in developing countries has been ob- served in the last decade [2]. Infections in humans are commonly caused by Campylobacter jejuni, followed by C. coli and C. lari, but there are about 15 more species related to human infections [3]. The main risk factors for transmission are contaminated drinking water consump- tion, unpasteurized milk, and poorly processed foods, es- pecially broiler [4, 5]. Campylobacter species, such as C. jejuni, colonize the human lower gastrointestinal tract and can cause mild and self-limited gastroenteritis that are characterized by acute diarrhea with potential blood in stools, fever, and abdom- inal pain. Serious complications such as the Guillain-Barre syndrome may occur in a small number of patients [6, 7]. Children under 5 years old are one of the groups at higher * Herlice do Nascimento Veras herlicenv@hotmail.com 1 Institute of Biomedicine for Brazilian Semiarid, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315, Rodolfo Teófilo, Fortaleza, Ceará 60430270, Brazil 2 Center for Global Health & Division of Infectious Diseases and International Health and Department of Pediatrics, University of Virginia, 1400 W Main Street, Charlottesville, VA 22908-1379, USA 3 Institute for the Promotion of Nutrition and Human Development, 15 Professor Carlos Lobo, Fortaleza, Ceará 60281-740, Brazil European Journal of Clinical Microbiology & Infectious Diseases https://doi.org/10.1007/s10096-018-3337-0