Detection and assessment of fecal carriage of gastrointestinal pathogens in healthy community adults: a year-long study

The prevalence of enteric pathogens in hospital settings within the surrounding environment has been extensively studied and documented. However, there is a lack of knowledge regarding the presence of these pathogens in the general healthy community. Asymptomatic carriers may unknowingly harbor these pathogens and later develop infections or transmit them to vulnerable individuals. Therefore, our objective is to identify gastrointestinal pathogens associated with fecal carriage among healthy adults in different industries. This cross-sectional study was conducted over one year to investigate the carriage of gastrointestinal pathogens among healthy adult staff at local restaurants and community hospitals. Stool samples were analyzed using a multiplex PCR panel to determine the pathogen detection rate and the incidence of co-carriage, with a focus on seasonal variations and differences between the two industry types. A total of 204 fecal samples were collected from a healthy population, with 147 from cater-related industries and 57 from non-cater-related industries, across all four seasons. Of these, 137 (67.2%) tested positive for pathogens. The most common pathogen was EAEC at 35.8%, followed by EPEC at 23.0%, P. shigelloides at 9.8%, C. difficile at 5.4%, ETEC at 4.4%, and both V. parahaemolyticus and Salmonella at 2.0% each. Co-carriages with two pathogens were found in 26 samples, and with three pathogens in 5 samples, with EPEC and ETEC being the most frequent combination. EAEC, EPEC, and single pathogen carriage were most prevalent in the elderly, while P. shigelloides and multiple pathogen carriages were highest in middle-aged individuals. The pathogens most commonly identified, such as EAEC, EPEC, ETEC, single and dual pathogen carriages were all found to be present in a positive state over a period of four months. C. difficile was detected exclusively in samples from catering-related industries. EAEC, EPEC, P. shigelloides and C. difficile were most common enteric pathogens in single carriage while former three of which predominated in co-carriages. The exclusive colonization of C. difficile in cater-related industries may enhance its transmission. Middle-aged individuals exhibited a higher susceptibility to co-pathogen carriage, although positive samples were distributed evenly across all age groups. The incidence of pathogen carriage was associated with seasonal variations and temperature fluctuations.