Clostridium difficile infection: the next big thing!
Michele M. Squire A and Thomas V. Riley AMicrobiology & Immunology
School of Pathology & Laboratory Medicine
The University of Western Australia
Queen Elizabeth II Medical Centre
Nedlands 6009
Western Australia
Tel: 61-8-9346-3690
Fax: 61-8-9346-2912
E-mail: thomas.riley@uwa.edu.au
Microbiology Australia 33(4) 163-164 https://doi.org/10.1071/MA12163
Published: 1 November 2012
Abstract
Clostridium difficile causes infectious diarrhoea in humans and animals. It has been found in pigs, horses, and cattle, suggesting a potential reservoir for human infection, and in 20-40% of meat products in Canada and the USA, suggesting the possibility of food-borne transmission. It is likely that excessive antimicrobial exposure is driving the establishment of C. difficile in animals, in a manner analogous to human infection, rather than the organism just being normal flora of the animal gastrointestinal tract. Outside Australia, PCR ribotype 078 is the most common ribotype of C. difficile found in pigs (83% in one study in the USA) and cattle (up to 100%) and this ribotype is now the third most common ribotype of C. difficile found in humans in Europe. Human and pig strains of C. difficile are genetically identical in Europe confirming that a zoonosis exists. Rates of community-acquired C. difficile infection (CDI) are increasing world-wide, and a new community strain of unidentified origin has recently emerged in Australia. Environmental contamination may also play a role. C. difficile spores survive in treated piggery effluent, the by-products of which are used to irrigate crops and pasture and manufacture compost. There is abundant evidence that food products intended for human consumption contain toxigenic strains of C. difficile but food-borne transmission remains unproven. Thus there are four problems that require resolution: a human health issue, an animal health issue and the factors common to both these problems, environmental contamination and antimicrobial misuse.
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