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Rodriguez-Diaz C, Seyboldt C, Rupnik M. Non-human Clostridioides difficile Reservoirs and Sources: Animals, Food, Environment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1435:329-350. [PMID: 38175482 DOI: 10.1007/978-3-031-42108-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Clostridioides difficile is ubiquitous and is found in humans, animals and in variety of environments. The substantial overlap of ribotypes between all three main reservoirs suggests the extensive transmissions. Here we give the overview of European studies investigating farm, companion and wild animals, food and environments including water, soil, sediment, wastewater treatment plants, biogas plants, air, and households. Studies in Europe are more numerous especially in last couple of years, but are still fragmented in terms of countries, animal species, or type of environment covered. Soil seem to be the habitat of divergent unusual lineages of C. difficile. But the most important aspect of animals and environment is their role in C. difficile transmissions and their potential as a source for human infection is discussed.
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Affiliation(s)
- Cristina Rodriguez-Diaz
- Instituto de Investigación Biomédica de Málaga y Plataforma de Nanomedicina-IBIMA Plataforma BIONAND, UGC de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, Málaga, Spain
- Laboratory of Food Microbiology, Fundamental and Applied Research for Animals and Health (FARAH), Department of Food Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Christian Seyboldt
- Institute of Bacterial Infections and Zoonoses, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Jena, Germany
| | - Maja Rupnik
- National Laboratory for Health, Environment and Food, NLZOH, Maribor, Slovenia
- University of Maribor, Faculty of Medicine, Maribor, Slovenia
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2
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Borji S, Kadivarian S, Dashtbin S, Kooti S, Abiri R, Motamedi H, Moradi J, Rostamian M, Alvandi A. Global prevalence of Clostridioides difficile in 17,148 food samples from 2009 to 2019: a systematic review and meta-analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:36. [PMID: 37072805 PMCID: PMC10114346 DOI: 10.1186/s41043-023-00369-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/23/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND Clostridioides (Clostridium) difficile is an important infectious pathogen, which causes mild-to-severe gastrointestinal infections by creating resistant spores and producing toxins. Spores contaminated foods might be one of the most significant transmission ways of C. difficile-associated infections. This systematic review and meta-analysis study were conducted to investigate the prevalence of C. difficile in food. METHODS Articles that published the prevalence of C. difficile in food in PubMed, Web of Science, and Scopus databases were retrieved using selected keywords between January 2009 and December 2019. Finally, 17,148 food samples from 60 studies from 20 countries were evaluated. RESULTS The overall prevalence of C. difficile in various foods was 6.3%. The highest and lowest levels of C. difficile contamination were detected to seafood (10.3%) and side dishes (0.8%), respectively. The prevalence of C. difficile was 4% in cooked food, 6.2% in cooked chicken and 10% in cooked seafood. CONCLUSIONS There is still little known concerning the food-borne impact of C. difficile, but the reported contamination might pose a public health risk. Therefore, to improve the food safety and prevent contamination with C. difficile spores, it is necessary to observe hygienic issues during foods preparation, cooking and transfer.
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Affiliation(s)
- Soroush Borji
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sepide Kadivarian
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shirin Dashtbin
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Kooti
- Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Ramin Abiri
- Fertility and Infertility Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Motamedi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Student Research Committee, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jale Moradi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mosayeb Rostamian
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Postal Code: 6714415333, Iran.
| | - Amirhooshang Alvandi
- Department of Microbiology, School of Medicine, Medical Technology Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Postal Code: 6714415333, Iran.
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3
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Abay S, Ahmed EF, Aydin F, Karakaya E, Müştak HK. Presence of Clostridioides difficile in cattle feces, carcasses, and slaughterhouses: Molecular characterization and antibacterial susceptibility of the recovered isolates. Anaerobe 2022; 75:102575. [PMID: 35477095 DOI: 10.1016/j.anaerobe.2022.102575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 11/28/2022]
Abstract
The aims of this study were to isolate and identify Clostridioides difficile from cattle feces and carcasses, and slaughterhouse samples, and to determine the molecular characteristics and antibacterial susceptibility of the recovered isolates. A total of 220 samples, including 100 cattle fecal samples, 100 cattle carcass surface samples, and 20 slaughterhouse samples were used as the study material. In total, 12 (5.45%) samples, including 11 (11%) cattle fecal samples and 1 (5%) slaughterhouse sample, were found to be positive for C. difficile. On the other hand, all of the carcass samples were negative for C. difficile. A total of 11 (91.66%) isolates, including 10 fecal isolates and 1 slaughterhouse wastewater isolate, were found to be positive for the presence of the toxin genes tcdA and tcdB, whilst 1 fecal isolate was found to be negative for both genes. In addition, 3 different ERIC-PCR profiles were identified in the 11 fecal isolates. The ERIC-PCR profile of the slaughterhouse wastewater isolate was found to be similar to one of the ERIC-PCR profiles obtained from the fecal isolates. All of the isolates were resistant to ciprofloxacin and levofloxacin. Considering that the agent is a spore-forming bacterium shed in feces, the detection of C. difficile isolates of different genotypes, some carrying toxin genes, suggests that feces and slaughterhouse wastewater carrying this bacterium may pose a risk for the contamination of carcasses. The current study revealed that hygiene conditions should be performed to the maximum extent in slaughterhouses.
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Affiliation(s)
- Seçil Abay
- Erciyes University, Faculty of Veterinary Medicine, Department of Microbiology Kayseri, Turkey.
| | | | - Fuat Aydin
- Erciyes University, Faculty of Veterinary Medicine, Department of Microbiology Kayseri, Turkey
| | - Emre Karakaya
- Erciyes University, Faculty of Veterinary Medicine, Department of Microbiology Kayseri, Turkey
| | - Hamit Kaan Müştak
- Ankara University, Faculty of Veterinary Medicine, Department of Microbiology, Ankara, Turkey
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4
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Fayez M, El-Ghareeb WR, Elmoslemany A, Alsunaini SJ, Alkafafy M, Alzahrani OM, Mahmoud SF, Elsohaby I. Genotyping and Antimicrobial Susceptibility of Clostridium perfringens and Clostridioides difficile in Camel Minced Meat. Pathogens 2021; 10:1640. [PMID: 34959595 PMCID: PMC8708398 DOI: 10.3390/pathogens10121640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 12/19/2022] Open
Abstract
The present study aimed to determine the occurrence, genotypes, and antimicrobial resistance of Clostridium perfringens (C. perfringens) and Clostridioides difficile (C. difficile) in camel minced meat samples collected from small butcher shops and supermarkets in Al-Ahsa Governorate, Saudi Arabia. A total of 100 camel minced meat samples were randomly collected from small butcher's shops (n = 50) and supermarkets (n = 50) in Al-Ahsa Governorate, Saudi Arabia. C. perfringens and C. difficile were isolated and identified using the VITEK-2 compact system and 16S rRNA gene amplification. Genotypes, toxin genes, and antimicrobial susceptibility of the isolates were determined. Moreover, ELISA was used to detect C. perfringens and C. difficile toxins. C. perfringens and C. difficile were isolated from 14% and 4% of the tested minced meat samples, respectively. Out of the 14 C. perfringens isolates, type A (64.3%), type B (7.1%), type C (21.5%), and type D (7.1%) were detected. However, out of the four C. difficile isolates, three (75%) were type A+B+ and one (25%) was type A-B+. None of the C. perfringens or C. difficile toxins were identified using ELISA. C. perfringens and C. difficile isolates exhibited a high rate of resistance to tetracycline (56% and 75%, respectively). However, all isolates were susceptible to amoxicillin-clavulanate. Multidrug resistance was observed in three (21.4%) C. perfringens and one (25%) C. difficile isolates. In conclusion, camel minced meat was contaminated with C. perfringens and C. difficile, which present a potential risk of food poisoning. The majority of the isolates were resistant to at least one antimicrobial, and some isolates were multidrug-resistant. Therefore, food safety standards and frequent inspections of abattoirs, small butcher shops, and supermarkets should be enforced.
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Affiliation(s)
- Mahmoud Fayez
- Al-Ahsa Veterinary Diagnostic Lab, Ministry of Environment, Water and Agriculture, Al-Ahsa 31982, Saudi Arabia; (M.F.); (S.J.A.)
- Department of Bacteriology, Veterinary Serum and Vaccine Research Institute, Ministry of Agriculture, Cairo 11381, Egypt
| | - Waleed R. El-Ghareeb
- Department of Veterinary Public Health and Animal Husbandry, College of Veterinary Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia;
| | - Ahmed Elmoslemany
- Hygiene and Preventive Medicine Department, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt;
| | - Saleem J. Alsunaini
- Al-Ahsa Veterinary Diagnostic Lab, Ministry of Environment, Water and Agriculture, Al-Ahsa 31982, Saudi Arabia; (M.F.); (S.J.A.)
| | - Mohamed Alkafafy
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.A.); (S.F.M.)
| | - Othman M. Alzahrani
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Samy F. Mahmoud
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.A.); (S.F.M.)
| | - Ibrahim Elsohaby
- Department of Animal Medicine, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
- Department of Infectious Diseases and Public Health, Jockey Club of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
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5
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Taha AE. Raw Animal Meats as Potential Sources of Clostridium difficile in Al-Jouf, Saudi Arabia. Food Sci Anim Resour 2021; 41:883-893. [PMID: 34632406 PMCID: PMC8460330 DOI: 10.5851/kosfa.2021.e44] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 12/17/2022] Open
Abstract
Clostridium difficile present in feces of food animals may
contaminate their meats and act as a potential source of C.
difficile infection (CDI) to humans. C. difficile
resistance to antibiotics, its production of toxins and spores play major roles
in the pathogenesis of CDI. This is the first study to evaluate C.
difficile prevalence in retail raw animal meats, its antibiotics
susceptibilities and toxigenic activities in Al-Jouf, Saudi Arabia. Totally, 240
meat samples were tested. C. difficile was identified by
standard microbiological and biochemical methods. Vitek-2 compact system
confirmed C. difficile isolates were 15/240 (6.3%).
Toxins A/B were not detected by Xpect C. difficile toxin A/B
tests. Although all isolates were susceptible to vancomycin and metronidazole,
variable degrees of reduced susceptibilities to moxifloxacin, clindamycin or
tetracycline antibiotics were detected by Epsilon tests. C.
difficile strains with reduced susceptibility to antibiotics should
be investigated. Variability between the worldwide reported C.
difficile contamination levels could be due to absence of a gold
standard procedure for its isolation. Establishment of a unified testing
algorithm for C. difficile detection in food products is
definitely essential to evaluate the inter-regional variation in its prevalence
on national and international levels. Proper use of antimicrobials during animal
husbandry is crucial to control the selective drug pressure on C.
difficile strains associated with food animals. Investigating the
protective or pathogenic potential of non-toxigenic C.
difficile strains and the possibility of gene transfer from certain
toxigenic/ antibiotics-resistant to non-toxigenic/antibiotics-sensitive strains,
respectively, should be worthy of attention.
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Affiliation(s)
- Ahmed E Taha
- Microbiology and Immunology Unit, Department of Pathology, College of Medicine, Jouf University, Al-Jouf, Saudi Arabia.,Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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6
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Muratoglu K, Akkaya E, Hampikyan H, Bingol EB, Cetin O, Colak H. Detection, Characterization and Antibiotic Susceptibility of Clostridioides (Clostridium) difficile in Meat Products. Food Sci Anim Resour 2020; 40:578-587. [PMID: 32734265 PMCID: PMC7372980 DOI: 10.5851/kosfa.2020.e34] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/26/2020] [Accepted: 04/14/2020] [Indexed: 11/22/2022] Open
Abstract
Clostridioides (Clostridium) difficile is a Gram (+),
anaerobic, spore forming, rod shaped bacterium that can produce toxin. The
objective of this study is to reveal the presence of C.
difficile in meat products, to analyze the ribotype diversity by
PCR and to evaluate the antibiotic susceptibility of isolated strains. The
organism was isolated in 22 out of 319 (6.9%) examined meat product
samples and 9 out of 22 (40.9%) isolates were identified as RT027 and all
isolates had the ability of toxin production. In terms of antibiotic
susceptibility, all isolates were susceptive to amoxicillin-clavulanic acid,
tetracycline and vancomycin and 21 (95.4%) isolates to metronidazole. On
the other hand, imipenem and cefotaxim resistance was observed in all. In
conclusion, the results of this comprehensive study conducted in Turkey deduced
the presence of C. difficile in different meat products.
Therefore, these products can be evaluated as a potential contamination source
of C. difficile from animals to humans especially for elders,
youngsters, long terms wide spectrum antibiotic used and immuno-suppressed
individuals.
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Affiliation(s)
- Karlo Muratoglu
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, 34500, Istanbul, Turkey
| | - Esra Akkaya
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, 34500, Istanbul, Turkey
| | - Hamparsun Hampikyan
- Faculty of Fine Arts, Department of Gastronomy and Culinary Arts, Beykent University, 34500, Buyukcekmece, Istanbul, Turkey
| | - Enver Baris Bingol
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, 34500, Istanbul, Turkey
| | - Omer Cetin
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, 34500, Istanbul, Turkey
| | - Hilal Colak
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpasa, 34500, Istanbul, Turkey
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7
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Masarikova M, Simkova I, Plesko M, Eretova V, Krutova M, Cizek A. The Colonisation of Calves in Czech Large-Scale Dairy Farms by Clonally-Related Clostridioides difficile of the Sequence Type 11 Represented by Ribotypes 033 and 126. Microorganisms 2020; 8:microorganisms8060901. [PMID: 32549307 PMCID: PMC7356540 DOI: 10.3390/microorganisms8060901] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/04/2022] Open
Abstract
To investigate a possible Clostridioides difficile reservoir in the Czech Republic, we performed a study in 297 calves from 29 large-scale dairy farms. After enrichment, faecal samples were inoculated onto selective agar for C. difficile. From the 297 samples, 44 C. difficile isolates were cultured (prevalence of 14.8%, 10 farms). The Holstein breed and use of digestate were associated with C. difficile colonisation (p ˂ 0.05). C. difficile isolates belonged to the ribotype/sequence type: RT033/ST11 (n = 37), RT126/ST11 (n = 6) and RT046/ST35 (n = 1). A multiple-locus variable-number tandem-repeat analysis revealed four clonal complexes of RT033 isolates and one clonal complex of RT126 isolates. All isolates were sensitive to amoxicillin, metronidazole and vancomycin. Forty isolates were resistant to ciprofloxacin, twenty-one to clindamycin, seven to erythromycin, seven to tetracycline and six to moxifloxacin. Moxifloxacin resistant isolates revealed an amino-acid substitution Thr82Ile in the GyrA. In conclusion, the calves of Holstein breed from farms using digestate as a product of bio-gas plants are more likely to be colonised by clonally-related C. difficile of ST 11 represented by ribotypes 033 and 126. The identified resistance to moxifloxacin with a Thr82Ile substitution in the GyrA highlights the need for further monitoring by the "One health approach".
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Affiliation(s)
- Martina Masarikova
- Department of Infectious Diseases and Microbiology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, 612 42 Brno, Czech Republic
| | - Ivana Simkova
- Ruminant and Swine Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, 612 42 Brno, Czech Republic
| | - Martin Plesko
- Ruminant and Swine Clinic, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, 612 42 Brno, Czech Republic
| | - Veronika Eretova
- Department of Medical Microbiology, 2nd Faculty of Medicine and Motol University Hospital, Charles University, 150 06 Prague, Czech Republic
| | - Marcela Krutova
- Department of Medical Microbiology, 2nd Faculty of Medicine and Motol University Hospital, Charles University, 150 06 Prague, Czech Republic
| | - Alois Cizek
- Department of Infectious Diseases and Microbiology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, 612 42 Brno, Czech Republic
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8
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Boarini-Ferroni L, Cardozo MV, Casagrande MF, Nascimento KA, Almeida HMDS, Mechler-Dreibi ML, de Oliveira LG, Schocken-Iturrino RP. Experimental inoculation and nose-to-nose transmission of Clostridioides difficile between weaned piglets. Vet Microbiol 2020; 247:108754. [PMID: 32768208 DOI: 10.1016/j.vetmic.2020.108754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
In piglets, Clostridioides (C.) difficile infection presents mostly subclinical manifestation. As this agent became important in veterinary medicine due to a hypothesis of zoonosis, the objective of this study was to evaluate the transmission of C. difficile by nose-to-nose contact in young piglets. Six 20-day-old piglets were separated into three groups (infected, sentinel and control), and distributed in different isolation cabinets which allowed nose-to-nose contact only between infected and sentinel groups. The challenged group received an inoculum 106 CFU/mL of C. difficile 096 by oropharyngeal route. Rectal swab samples were daily collected for microbiological and molecular analysis. Euthanasia of all piglets was performed 18 days after challenge to evaluate anatomical, histological and microbiological lesions of the organs of these animals. The challenged and sentinel groups showed clinical signs of infection and genes encoding TcdB were detected by conventional PCR in both groups, confirming the transmission of the pathogen from the challenged to the sentinel piglets. At necropsy, tonsil, liver, spleen, mesenteric lymph nodes, ileocolic lymph nodes, jejunum, ileum, proximal colon, distal colon and cecum were collected for microbiological analysis; lesions were observed varying in degree and intensity. This study demonstrated a novel route of transmission of C. difficile between young piglets, which was proven to occur by nose-to-nose contact.
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Affiliation(s)
- Livia Boarini-Ferroni
- Sao Paulo State University, School of Agricultural and Veterinarian Sciences, Campus Jaboticabal, Brazil
| | - Marita Vedovelli Cardozo
- Sao Paulo State University, School of Agricultural and Veterinarian Sciences, Campus Jaboticabal, Brazil
| | - Mariana Froner Casagrande
- Sao Paulo State University, School of Agricultural and Veterinarian Sciences, Campus Jaboticabal, Brazil
| | - Karla Alvarenga Nascimento
- Sao Paulo State University, School of Agricultural and Veterinarian Sciences, Campus Jaboticabal, Brazil
| | | | | | - Luís Guilherme de Oliveira
- Sao Paulo State University, School of Agricultural and Veterinarian Sciences, Campus Jaboticabal, Brazil.
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9
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Rodriguez-Palacios A, Mo KQ, Shah BU, Msuya J, Bijedic N, Deshpande A, Ilic S. Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981-2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic. Front Med (Lausanne) 2020; 7:9. [PMID: 32175321 PMCID: PMC7056907 DOI: 10.3389/fmed.2020.00009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 01/10/2020] [Indexed: 12/21/2022] Open
Abstract
Clostridioides difficile (CD) is a spore-forming bacterium that causes life-threatening intestinal infections in humans. Although formerly regarded as exclusively nosocomial, there is increasing genomic evidence that person-to-person transmission accounts for only <25% of cases, supporting the culture-based hypothesis that foods may be routine sources of CD-spore ingestion in humans. To synthesize the evidence on the risk of CD exposure via foods, we conducted a systematic review and meta-analysis of studies reporting the culture prevalence of CD in foods between January 1981 and November 2019. Meta-analyses, risk-ratio estimates, and meta-regression were used to estimate weighed-prevalence across studies and food types to identify laboratory and geographical sources of heterogeneity. In total, 21886 food samples were tested for CD between 1981 and 2019 (96.4%, n = 21084, 2007–2019; 232 food-sample-sets; 79 studies; 25 countries). Culture methodology, sample size and type, region, and latitude were sources of heterogeneity (p < 0.05). Although non-strictly-anaerobic methods were reported in some studies, and we confirmed experimentally that improper anaerobiosis of media/sample-handling affects CD recovery in agar (Fisher, p < 0.01), most studies (>72%) employed the same (one-of-six) culture strategy. Because the prevalence was also meta-analytically similar across six culture strategies reported, all studies were integrated using three meta-analytical methods. At the study level (n = 79), the four-decade global cumulative-prevalence of CD in the human diet was 4.1% (95%CI = −3.71, 11.91). At the food-set level (n = 232, mean 12.9 g/sample, similar across regions p > 0.2; 95%CI = 9.7–16.2), the weighted prevalence ranged between 4.5% (95%CI = 3–6%; all studies) and 8% (95%CI = 7–8%; only CD-positive-studies). Risk-ratio ranking and meta-regression showed that milk was the least likely source of CD, while seafood, leafy green vegetables, pork, and poultry carried higher risks (p < 0.05). Across regions, the risk of CD in foods for foodborne exposure reproducibly decreased with Earth latitude (p < 0.001). In conclusion, CD in the human diet is a global non-random-source of foodborne exposure that occurs independently of laboratory culture methods, across regions, and at a variable level depending on food type and latitude. The latitudinal trend (high CD-food-prevalence toward tropic) is unexpectedly inverse to the epidemiological observations of CD-infections in humans (frequent in temperate regions). Findings suggest the plausible hypothesis that ecologically-richer microbiomes in the tropic might protect against intestinal CD colonization/infections despite CD ingestion.
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Affiliation(s)
- Alexander Rodriguez-Palacios
- Division of Gastroenterology and Liver Disease, Case Western Reserve University School of Medicine, Cleveland, OH, United States.,Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Kevin Q Mo
- Human Nutrition, Department of Human Sciences, The Ohio State University, Columbus, OH, United States.,College of Medicine, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Bhavan U Shah
- Informatics and Assessment Division, Lorain County General Health District, Elyria, OH, United States.,Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Joan Msuya
- Department of Health and Nutrition, World Vision, Arusha, Tanzania
| | - Nina Bijedic
- Department of Applied Mathematics and Formal Methods, Information Technologies, University Dzemal Bijedic, Mostar, Bosnia and Herzegovina.,Department of Mathematics, University of North Carolina, Charlotte, NC, United States
| | - Abhishek Deshpande
- Medicine Institute Center for Value-Based Care Research, Cleveland Clinic, Cleveland, OH, United States
| | - Sanja Ilic
- Human Nutrition, Department of Human Sciences, The Ohio State University, Columbus, OH, United States
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10
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Morelli G, Catellani P, Miotti Scapin R, Bastianello S, Conficoni D, Contiero B, Ricci R. Evaluation of microbial contamination and effects of storage in raw meat-based dog foods purchased online. J Anim Physiol Anim Nutr (Berl) 2019; 104:690-697. [PMID: 31789441 DOI: 10.1111/jpn.13263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 10/01/2019] [Accepted: 11/08/2019] [Indexed: 01/10/2023]
Abstract
Feeding raw-meat-based diets to companion animals has become a widespread practice, and many owners are now accustomed to buying frozen ingredients online. The goals of this study were to assess the microbiological quality of raw-meat dog foods obtained from specialized websites and to evaluate the effects of storage at different temperatures for a few days. Twenty-nine raw dog food products were processed for quantitative bacteriology (i.e. total viable count, TVC; Escherichia coli; faecal coliforms, FC) and sulphite-reducing clostridia, and analysed for the presence of Salmonella spp., Listeria monocytogenes, Yersinia enterocolitica and Clostridium difficile. Every sample was examined right after the delivery (T0), after 24 to 48 hr and after 72 hr, both at 2°C and 7°C. At T0, the mean score for the TVC was 5.9 × 106 cfu/g (SD = 4.8 × 107 cfu/g), while those for E. coli and FC were 1.1 × 104 cfu/g (SD = 2.5 × 105 cfu/g) and 3.3 × 103 cfu/g (SD = 6.5 × 104 cfu/g) respectively. The samples stored at 2°C had a significant increase of all parameters (TVC: p < .01; E. coli: p = .03; FC: p = .04) through time. Noteworthy differences between the analyses performed at 2°C and 7°C were found for TVC (p < .01), being the samples considerably more contaminated at higher temperatures. No sample tested positive for Salmonella spp., while L. monocytogenes was isolated from 19 products, Y. enterocolitica from three products and Clostridium perfringens and C. difficile from four and six products respectively. The microbiological quality of raw-meat dog foods sold online appears to be poor, carrying considerable amounts of potentially zoonotic bacteria and reaching greater levels of bacterial contaminations if not kept at proper refrigeration temperatures and fed soon after defrosting.
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Affiliation(s)
- Giada Morelli
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
| | - Paolo Catellani
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
| | - Riccardo Miotti Scapin
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
| | - Sofia Bastianello
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
| | - Daniele Conficoni
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
| | - Rebecca Ricci
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, PD, Italy
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11
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High Clostridium difficile contamination rates of domestic and imported potatoes compared to some other vegetables in Slovenia. Food Microbiol 2019; 78:194-200. [DOI: 10.1016/j.fm.2018.10.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/06/2018] [Accepted: 10/29/2018] [Indexed: 01/04/2023]
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12
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Agnoletti F, Arcangeli G, Barbanti F, Barco L, Brunetta R, Cocchi M, Conedera G, D'Este L, Drigo I, Spigaglia P, Mazzolini E. Survey, characterization and antimicrobial susceptibility of Clostridium difficile from marine bivalve shellfish of North Adriatic Sea. Int J Food Microbiol 2019; 298:74-80. [PMID: 30927688 DOI: 10.1016/j.ijfoodmicro.2019.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 03/05/2019] [Indexed: 01/08/2023]
Abstract
Clostridium difficile is a major cause of infectious diarrhea associated to healthcare settings. Community-acquired infections are increasingly reported in the last decade and exposure other than to symptomatic patients rather to contaminated foods or animals is feasible. Occurrence of C. difficile in shellfish raises concern because spores can survive the cooking temperatures given that shellfish is often consumed poorly cooked or raw. Aim of our study was to investigate whether shellfish represents a reservoir of C. difficile human PCR-ribotypes (RTs). 702 shellfish samples of farmed and wild bivalve mollusc species were collected over the 2015-2017 period in North Adriatic Italian Sea to investigate contamination with C. difficile and characterize the isolates in terms of genotypic variability and antimicrobial resistance profile. C. difficile was detected in 16.9% (CI: 14.1%-19.8%) samples: 11.6% mussels and 23.2% clams. Compared to mussels, clams were significantly associated with detection of C. difficile (OR = 2.4, P < 0.01). Overall 113 C. difficile isolates were genotyped and 75 (66.4%) were toxigenic. Fifty-three different RTs were identified. 40.7% C. difficile isolates were among the RTs most commonly involved in human infection in Europe. The profile of antimicrobial susceptibility was determined by E-test; microbiological resistance was frequent against clindamycin (17%), erythromycin (23%), rifampicin (8.8%) and moxifloxacin (10.6%). All isolates were susceptible to metronidazole and one showed MIC > ECOFF for vancomycin. C. difficile strains showed high variety in RTs, most of them already detected in other animals or known as highly virulent and epidemic in humans. These results prompt towards investigating on specific risk mitigation measures against C. difficile and are preliminary for any source attribution and risk assessment study.
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Affiliation(s)
- Fabrizio Agnoletti
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy.
| | - Giuseppe Arcangeli
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Fabrizio Barbanti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Lisa Barco
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Romina Brunetta
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Monia Cocchi
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Gabriella Conedera
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Laura D'Este
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Ilenia Drigo
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
| | - Patrizia Spigaglia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Elena Mazzolini
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020 Legnaro, PD, Italy
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Candel-Pérez C, Ros-Berruezo G, Martínez-Graciá C. A review of Clostridioides [Clostridium] difficile occurrence through the food chain. Food Microbiol 2019; 77:118-129. [DOI: 10.1016/j.fm.2018.08.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/01/2018] [Accepted: 08/21/2018] [Indexed: 12/18/2022]
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Affiliation(s)
- James L. Smith
- Eastern Regional Research Center, Agricultural Research Service, U.S. Department of Agriculture, Wyndmoor, Pennsylvania
| | - Pina M. Fratamico
- Eastern Regional Research Center, Agricultural Research Service, U.S. Department of Agriculture, Wyndmoor, Pennsylvania
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15
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Ersöz ŞŞ, Coşansu S. Prevalence of Clostridium difficile Isolated from Beef and Chicken Meat Products in Turkey. Korean J Food Sci Anim Resour 2018; 38:759-767. [PMID: 30206435 PMCID: PMC6131381 DOI: 10.5851/kosfa.2018.e14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/25/2022] Open
Abstract
The concern about the possibility of food can be a vehicle for the transmission
of Clostridium difficile to humans has been raised recently due
to the similarities among the strains isolated from patients, foods and food
animals. In this study, therefore, the prevalence of C.
difficile was investigated in beef and chicken meat products
collected from 57 different butcher shops, markets and fast food restaurants in
Sakarya province of Turkey. Two out of 101 samples (1.98%) was positive for
C. difficile indicating a very low prevalence. The pathogen
was isolated from an uncooked meatball sample and a cooked meat döner
sample, whereas not detected in chicken meat samples. The meatball isolate was
resistant to vancomycin and tetracycline, while the cooked meat döner
isolate was resistant to vancomycin and metronidazole. Both isolates were
sensitive to moxifloxacin and clindamycin. Toxins A and B were not detected.
This study reveals the presence of C. difficile in further
processed beef products in Turkey.
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Affiliation(s)
- Şeyma Şeniz Ersöz
- Food Engineering Department, Engineering Faculty, Sakarya University, Esentepe Campus, 54187, Sakarya, Turkey
| | - Serap Coşansu
- Food Engineering Department, Engineering Faculty, Sakarya University, Esentepe Campus, 54187, Sakarya, Turkey
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16
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Clostridioides difficile in the environment, food, animals and humans in southern Italy: Occurrence and genetic relatedness. Comp Immunol Microbiol Infect Dis 2018; 59:41-46. [PMID: 30290886 DOI: 10.1016/j.cimid.2018.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 05/09/2018] [Accepted: 08/29/2018] [Indexed: 12/19/2022]
Abstract
One hundred and thirty-eight C. difficile isolates from different sources (66 from the environment, 36 from animals, 9 from food and 27 from humans) were ribotyped by capillary electrophoresis PCR ribotyping (CE-PCR). A multilocus variable tandem repeat analysis (MLVA) was carried out on a sample subset. The most frequently isolated PCR ribotypes were 126 (15.9%), 078 (14.5%), 011/018 (11.6%), 014/020/077 (10.1%), and 010 (2.8%). In particular, strains of PCR ribotype 011/018 were isolated from human, raw milk and environmental samples. The hypervirulent PCR ribotype 027 was isolated from two human samples. The majority of the strains were toxigenic (34.1% showed the toxigenic profile A+B+CDT+ and 38.9% the profile A+B+CDT-). MLVA allowed to identify 4 clonal complexes of genetically related isolates: complex n. 1 grouped together human, environmental and food strains, whereas complex n. 3 included human and environmental isolates. The use of MLVA gave further evidence to the possible role of environment, animals and food as routes of transmission of C. difficile infections to human.
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17
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Presence of Clostridium difficile in poultry and poultry meat in Egypt. Anaerobe 2018; 51:21-25. [DOI: 10.1016/j.anaerobe.2018.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 12/15/2022]
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18
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Lee JY, Lee DY, Cho YS. Prevalence of Clostridium difficile isolated from various raw meats in Korea. Food Sci Biotechnol 2018; 27:883-889. [PMID: 30263815 PMCID: PMC6049684 DOI: 10.1007/s10068-018-0318-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/03/2018] [Accepted: 01/10/2018] [Indexed: 12/18/2022] Open
Abstract
Clostridium difficile is an anaerobic, toxin-producing pathogen that causes human infection possibly through the consumption of meat. Clostridium difficile was isolated from 45 of 415 (10.8%) various raw meat samples collected in nationwide markets in Korea between 2013 and 2014. Among the 45 isolated strains, the highest prevalence rate was found in September (28.6%) and detected in chicken (16.4%), pork (8.3%) and beef (6.8%). According to an antibiotic resistance test, resistance was found only for clindamycin (2.2%). The genetic similarity of ribotypes O78 and O27 and strains isolated from raw meats was determined using DiversiLab. Among the isolates studied, four different rep-PCR types were identified, genetically distinct from ribotypes O78 and O27. An ELISA reaction confirmed that the two strains have toxin A and toxin B and showed 89% genetic similarity. This study suggests that food animals could be potential routes of foodborne transmission in C. difficile-associated human infection.
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Affiliation(s)
- Joo Young Lee
- Food Analysis Center, Korea Food Research Institute, 245, Nongsaengmyeong-ro, Iseo-myeon, Wanju-gun, Jeollabuk-do 55365 Republic of Korea
- Department of Food Science and Biotechnology, Sungkyunkwan University, Jangan-gu, Suwon South Korea
| | - Da Yeon Lee
- Food Analysis Center, Korea Food Research Institute, 245, Nongsaengmyeong-ro, Iseo-myeon, Wanju-gun, Jeollabuk-do 55365 Republic of Korea
| | - Yong Sun Cho
- Food Analysis Center, Korea Food Research Institute, 245, Nongsaengmyeong-ro, Iseo-myeon, Wanju-gun, Jeollabuk-do 55365 Republic of Korea
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19
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Hampikyan H, Bingol EB, Muratoglu K, Akkaya E, Cetin O, Colak H. The prevalence of Clostridium difficile in cattle and sheep carcasses and the antibiotic susceptibility of isolates. Meat Sci 2018; 139:120-124. [DOI: 10.1016/j.meatsci.2018.01.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 02/02/2023]
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20
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Biasizzo M, Vadnjal S, Henigman U, Krizman M, Kirbis A, Jamnikar-Ciglenecki U. Development and Validation of a New Protocol for Detecting and Recovering Clostridium difficile from Meat Samples. J Food Prot 2018; 81:561-568. [PMID: 29517350 DOI: 10.4315/0362-028x.jfp-17-354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
There is no recommended protocol for detecting and isolating Clostridium difficile present in food samples. Here, we have evaluated the recovery of C. difficile in meat samples after incubating them in various enrichment broths. The media were as follows: cycloserine-cefoxitin fructose broth supplemented with taurocholic acid, d-cycloserine, cefoxitin, and lysozyme; cycloserine-cefoxitin mannitol broth with taurocholate and lysozyme; and cycloserine-cefoxitin fructose broth supplemented with taurocholic acid, C. difficile moxalactam norfloxacin selective supplement, and lysozyme. Samples were inoculated with various strains and quantities of C. difficile and then enriched in the different broths for 1, 4, and 7 days. C. difficile was isolated on agar plates and detected with quantitative real-time PCR (qPCR). The procedure using enrichment in cycloserine-cefoxitin fructose broth supplemented with taurocholic acid, d-cycloserine, cefoxitin, and lysozyme and incubation for 4 days for qPCR detection and 7 days for isolation (plating on C. difficile agar base with added C. difficile selective supplement and 7% [v/v] defibrinated horse blood after alcoholic shock and centrifugation) was validated. Samples of different kinds of meat and meat preparation were contaminated and used for validation of the chosen protocol. The sensitivity of detection with qPCR was 100%, and the sensitivity of the isolation method was 96%.
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Affiliation(s)
- Majda Biasizzo
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Stanka Vadnjal
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Urska Henigman
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Manja Krizman
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Andrej Kirbis
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Urska Jamnikar-Ciglenecki
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
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Abstract
This study was to optimize the detection methods for Clostridium difficile from the animal manure-based composts. Both autoclaved and unautoclaved dairy composts were inoculated with a 12-h old suspension of a non-toxigenic C. difficile strain (ATCC 43593) and then plated on selected agar for vegetative cells and endospores. Six types of enrichment broths supplemented with taurocholate and l-cysteine were assessed for detecting a low level of artificially inoculated C. difficile (ca. 5 spores/g) from dairy composts. The efficacy of selected enrichment broths was further evaluated by isolating C. difficile from 29 commercial compost samples. Our results revealed that using heat-shock was more effective than using ethanol-shock for inducing endospore germination, and the highest endospore count (p < 0.05) was yielded at 60 °C for 25 min. C. difficile agar base, supplemented with 0.1% l-cysteine, 7% defibrinated horse blood, and cycloserine-cefoxitin (CDA-CYS-H-CC agar) was the best medium (p < 0.05) for recovering vegetative cells from compost. C. difficile endospore populations from both types of composts enumerated on both CDA-CYS-H-CC agar supplemented with 0.1% sodium taurocholate (CDA-CYS-H-CC-T agar) and brain heart infusion agar supplemented with 0.5% yeast extract, 0.1% l-cysteine, cycloserine-cefoxitin, and 0.1% sodium taurocholate (BHIA-YE-CYS-CC-T agar) media were not significantly different from each other (p > 0.05). Overall, enrichment of inoculated compost samples in broths containing moxalactam-norfloxacin (MN) produced significantly higher (p < 0.05) spore counts than in non-selective broths or broths supplemented with CC. Enrichment in BHIB-YE-CYS-MN-T broth followed by culturing on an agar containing 7% horse blood and 0.1% taurocholate provided a more sensitive and selective combination of media for detecting a low population of C. difficile from environmental samples with high background microflora.
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Affiliation(s)
- Muthu Dharmasena
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC 29634, USA
| | - Xiuping Jiang
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, SC 29634, USA.
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22
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Non-human C. difficile Reservoirs and Sources: Animals, Food, Environment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1050:227-243. [DOI: 10.1007/978-3-319-72799-8_13] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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23
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Abstract
Clostridium difficile infections (CDIs) have emerged as one of the principal threats to the health of hospitalized and immunocompromised patients. The importance of C difficile colonization is increasingly recognized not only as a source for false-positive clinical testing but also as a source of new infections within hospitals and other health care environments. In the last five years, several new treatment strategies that capitalize on the increasing understanding of the altered microbiome and host defenses in patients with CDI have completed clinical trials, including fecal microbiota transplantation. This article highlights the changing epidemiology, laboratory diagnostics, pathogenesis, and treatment of CDI.
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Pathogens of Food Animals: Sources, Characteristics, Human Risk, and Methods of Detection. ADVANCES IN FOOD AND NUTRITION RESEARCH 2017; 82:277-365. [PMID: 28427535 DOI: 10.1016/bs.afnr.2016.12.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pathogens associated with food production (livestock) animals come in many forms causing a multitude of disease for humans. For the purpose of this review, these infectious agents can be divided into three broad categories: those that are associated with bacterial disease, those that are associated with viruses, and those that are parasitic in nature. The goal of this chapter is to provide the reader with an overview of the most common pathogens that cause disease in humans through exposure via the food chain and the consequence of this exposure as well as risk and detection methods. We have also included a collection of unusual pathogens that although rare have still caused disease, and their recognition is warranted in light of emerging and reemerging diseases. These provide the reader an understanding of where the next big outbreak could occur. The influence of the global economy, the movement of people, and food makes understanding production animal-associated disease paramount to being able to address new diseases as they arise.
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Kwon JH, Lanzas C, Reske KA, Hink T, Seiler SM, Bommarito KM, Burnham CAD, Dubberke ER. An Evaluation of Food as a Potential Source for Clostridium difficile Acquisition in Hospitalized Patients. Infect Control Hosp Epidemiol 2016; 37:1401-1407. [PMID: 27691986 PMCID: PMC5421383 DOI: 10.1017/ice.2016.218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine whether Clostridium difficile is present in the food of hospitalized patients and to estimate the risk of subsequent colonization associated with C. difficile in food. METHODS This was a prospective cohort study of inpatients at a university-affiliated tertiary care center, May 9, 2011-July 12, 2012. Enrolled patients submitted a portion of food from each meal. Patient stool specimens and/or rectal swabs were collected at enrollment, every 3 days thereafter, and at discharge, and were cultured for C. difficile. Clinical data were reviewed for evidence of infection due to C. difficile. A stochastic, discrete event model was developed to predict exposure to C. difficile from food, and the estimated number of new colonization events from food exposures per 1,000 admissions was determined. RESULTS A total of 149 patients were enrolled and 910 food specimens were obtained. Two food specimens from 2 patients were positive for C. difficile (0.2% of food samples; 1.3% of patients). Neither of the 2 patients was colonized at baseline with C. difficile. Discharge colonization status was available for 1 of the 2 patients and was negative. Neither was diagnosed with C. difficile infection while hospitalized or during the year before or after study enrollment. Stochastic modeling indicated contaminated hospital food would be responsible for less than 1 newly colonized patient per 1,000 hospital admissions. CONCLUSIONS The recovery of C. difficile from the food of hospitalized patients was rare. Modeling suggests hospital food is unlikely to be a source of C. difficile acquisition. Infect Control Hosp Epidemiol 2016;1401-1407.
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Affiliation(s)
- Jennie H. Kwon
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Cristina Lanzas
- Department of Population Health and Pathobiology, North Carolina State University, Raleigh, NC, USA
| | - Kimberly A. Reske
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Tiffany Hink
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Sondra M. Seiler
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Kerry M. Bommarito
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Carey-Ann D. Burnham
- Departments of Pathology & Immunology, Molecular Microbiology, and Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Erik R. Dubberke
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
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26
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Bloomfield LE, Riley TV. Epidemiology and Risk Factors for Community-Associated Clostridium difficile Infection: A Narrative Review. Infect Dis Ther 2016; 5:231-51. [PMID: 27370914 PMCID: PMC5019973 DOI: 10.1007/s40121-016-0117-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Indexed: 12/13/2022] Open
Abstract
Clostridium difficile infection (CDI) was once considered a primarily nosocomial concern. Emerging evidence from the last 20 years has highlighted a drastic shift in the known epidemiology of CDI, with disease outside of hospitals apparently occurring more frequently and causing severe disease in populations that were thought to be at low risk. This narrative review summarises potential pathways for infection outside of the hospital environment and highlights likely routes of transmission. Further, evidence is presented on potential risk factors for development of disease. Understanding the epidemiology of CDI outside of hospitals is essential to the ability to prevent and control disease in vulnerable populations.
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Affiliation(s)
- Lauren E Bloomfield
- School of Health Sciences, Flinders University, Bedford Park, SA, Australia
- Western Australian Department of Health, Communicable Diseases Control Directorate, Shenton Park, WA, Australia
| | - Thomas V Riley
- Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Joondalup Drive, Joondalup, 6027, WA, Australia.
- School of Veterinary and Life Sciences, Murdoch University, South Street, Murdoch, 6150, WA, Australia.
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27
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Bakri M. Prevalence of Clostridium difficile in raw cow, sheep, and goat meat in Jazan, Saudi Arabia. Saudi J Biol Sci 2016; 25:783-785. [PMID: 29740244 PMCID: PMC5936870 DOI: 10.1016/j.sjbs.2016.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 05/29/2016] [Accepted: 07/11/2016] [Indexed: 10/30/2022] Open
Abstract
Background:Clostridium difficile has been shown to be a nosocomial infection associated with diarrhoea and pseudomembranous colitis in hospitalized patients especially old patients. In my previous studies, it was shown the occurrence of C. difficile in animals feces and vegetables which may act as a source of infection to humans. The aim of the study was to determine the prevalence of C. difficile in retail raw cow, sheep, and goat, meat in Jazan, Saudi Arabia. Method: A total of 600 raw meat samples from cow, sheep, and goat were collected during June-December 2015, and tested for the presence of C. difficile. The method used to check for the presence of C. difficile was by choosing selective enrichment media in C. difficile broth, followed by alcohol shock-treatment and plating onto C. difficile selective medium. C. difficile isolates were typed using PCR ribotyping and also analyzed for antibiotic susceptibility. Results: It was shown that, 9 of 600 meat samples (1.5%) were contaminated with C. difficile. The prevalence of C. difficile was as follow: 7 out of 600 (1.17%) were found in cow, 2 out of 600 (0.3%) were found in sheep, while was no C. difficile was isolated from goat. Eleven out of 18 C. difficile isolates were positive for tcdA, tcdB and cdtB toxin genes and were classified as ribotype 078. Three strains were positive tcdA, and tcdB, and two strains possessed only tcdB. C. difficile strains showed high resistance to ampicillin, gentamycin, erythromycin and nalidixic acid. Conclusions: The present work shows the potential risk of raw meet in transmitting C. difficile to humans.
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Rodriguez C, Taminiau B, Van Broeck J, Delmée M, Daube G. Clostridium difficile in Food and Animals: A Comprehensive Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 932:65-92. [PMID: 27350639 DOI: 10.1007/5584_2016_27] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Zoonoses are infections or diseases that can be transmitted between animals and humans through direct contact, close proximity or the environment. Clostridium difficile is ubiquitous in the environment, and the bacterium is able to colonise the intestinal tract of both animals and humans. Since domestic and food animals frequently test positive for toxigenic C. difficile, even without showing any signs of disease, it seems plausible that C. difficile could be zoonotic. Therefore, animals could play an essential role as carriers of the bacterium. In addition, the presence of the spores in different meats, fish, fruits and vegetables suggests a risk of foodborne transmission. This review summarises the current available data on C. difficile in animals and foods, from when the bacterium was first described up to the present.
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Affiliation(s)
- C Rodriguez
- Department of Food Science, University of Liège-Faculty of Veterinary Medicine, Avenue de Cureghem 10, bât 43bis Sart-Tilman, 4000, Liège, Belgium.
| | - B Taminiau
- Department of Food Science, University of Liège-Faculty of Veterinary Medicine, Avenue de Cureghem 10, bât 43bis Sart-Tilman, 4000, Liège, Belgium
| | - J Van Broeck
- Belgian Reference Centre for Clostridium difficile (NRC), Pôle de microbiologie médicale, Université Catholique de Louvain, Brussels, Belgium
| | - M Delmée
- Belgian Reference Centre for Clostridium difficile (NRC), Pôle de microbiologie médicale, Université Catholique de Louvain, Brussels, Belgium
| | - G Daube
- Department of Food Science, University of Liège-Faculty of Veterinary Medicine, Avenue de Cureghem 10, bât 43bis Sart-Tilman, 4000, Liège, Belgium
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Vlková E, Salmonová H, Bunešová V, Geigerová M, Rada V, Musilová Š. A new medium containing mupirocin, acetic acid, and norfloxacin for the selective cultivation of bifidobacteria. Anaerobe 2015; 34:27-33. [DOI: 10.1016/j.anaerobe.2015.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/23/2015] [Accepted: 04/02/2015] [Indexed: 11/27/2022]
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Clostridium difficile in retail chicken meat parts and liver in the Eastern Region of Turkey. J Verbrauch Lebensm 2015. [DOI: 10.1007/s00003-015-0950-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Troiano T, Harmanus C, Sanders IMJG, Pasquale V, Dumontet S, Capuano F, Romano V, Kuijper EJ. Toxigenic Clostridium difficile PCR ribotypes in edible marine bivalve molluscs in Italy. Int J Food Microbiol 2015; 208:30-4. [PMID: 26022983 DOI: 10.1016/j.ijfoodmicro.2015.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 01/05/2023]
Abstract
Even though food of animal sources and different foodstuffs are well known to be potentially carrier of Clostridium difficile, few data are available on the occurrence of C. difficile in seafood. This work investigated the occurrence of C. difficile in edible bivalve molluscs in southern Italy. Out of the 925 investigated samples, 3.9% contained C. difficile. Eighteen strains harboured both genes for toxins A and B whereas 1 only had toxin B gene. Binary toxin genes were found in 22.2% of the isolates. The most frequently ribotypes found were 078/126 (22.2%), 010 (19.4%), and 001 (8.3%). All isolates were susceptible to metronidazole, vancomycin, fidaxomicin, and to the new semisynthetic thiopeptide antibiotic LFF571, whereas 19.4% of them were resistant to moxifloxacin, 30.5% to clindamycin, 38.8% to erythromycin, and 100% to ciprofloxacin. This study points out that edible molluscs could be a potential source of toxigenic C. difficile ribotypes and a potential risk for human health.
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Affiliation(s)
- Tiziana Troiano
- Department of Science and Technology, Parthenope University of Naples, 80143 Naples, Italy
| | - Celine Harmanus
- Department of Medical Microbiology, National Reference Laboratory for Clostridium difficile, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Ingrid M J G Sanders
- Department of Medical Microbiology, National Reference Laboratory for Clostridium difficile, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Vincenzo Pasquale
- Department of Science and Technology, Parthenope University of Naples, 80143 Naples, Italy.
| | - Stefano Dumontet
- Department of Science and Technology, Parthenope University of Naples, 80143 Naples, Italy
| | - Federico Capuano
- Department of Food Inspection, Istituto Zooprofilattico Sperimentale per il Mezzogiorno di Portici, 80055 Portici (Naples), Italy
| | - Vincenza Romano
- Department of Science and Technology, Parthenope University of Naples, 80143 Naples, Italy
| | - Ed J Kuijper
- Department of Medical Microbiology, National Reference Laboratory for Clostridium difficile, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
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Nikaeen M, Aghili Dehnavi H, Hssanzadeh A, Jalali M. Occurrence of Clostridium difficile in two types of wastewater treatment plants. J Formos Med Assoc 2015; 114:663-5. [PMID: 25957122 DOI: 10.1016/j.jfma.2014.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 12/27/2014] [Accepted: 12/29/2014] [Indexed: 12/26/2022] Open
Abstract
Wastewater is a potential environmental source of Clostridium difficile, although a direct link with community-acquired C. difficile infection (CA-CDI) in humans has not yet been established. The present study was performed to determine the occurrence of C. difficile in two types of wastewater treatment plants (WWTPs) in Isfahan, Iran. A total of 95 samples were taken from a conventional activated sludge treatment plant and a waste stabilization ponds system, and analyzed for the presence of C. difficile. C. difficile was found in 13.6% (3/22) of digested sludge samples. However, no C. difficile was detected in inlet and outlet samples or in raw sludge of activated sludge. C. difficile was also detected in 5% (2/40) of the samples from waste stabilization ponds. Polymerase chain reaction (PCR) analysis showed that all strains of C. difficile detected were toxigenic (tcdB gene positive). This study shows that C. difficile was present in WWTPs, which might constitute a potential source of community-acquired C. difficile infection.
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Affiliation(s)
- Mahnaz Nikaeen
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Hajar Aghili Dehnavi
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hssanzadeh
- Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Rahimi E, Afzali ZS, Baghbadorani ZT. Clostridium difficile in ready-to-eat foods in Isfahan and Shahrekord, Iran. Asian Pac J Trop Biomed 2015. [DOI: 10.1016/s2221-1691(15)30156-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Non-selective and selective enrichment media for the recovery of Clostridium difficile from chopped beef. J Microbiol Methods 2015; 109:20-4. [DOI: 10.1016/j.mimet.2014.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/01/2014] [Accepted: 12/01/2014] [Indexed: 01/05/2023]
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New and Emerging Bacterial Food Pathogens. Food Saf (Tokyo) 2015. [DOI: 10.1016/b978-0-12-800245-2.00014-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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Squire MM, Knight DR, Riley TV. Community-acquired Clostridium difficile infection and Australian food animals. MICROBIOLOGY AUSTRALIA 2015. [DOI: 10.1071/ma15040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Clostridium difficile is an anaerobic Gram positive spore-forming bacterium, the leading cause of infectious diarrhoea (C. difficile infection; CDI) in hospitalised humans. The assumption that CDI is primarily a hospital-acquired infection is being questioned. Community-acquired CDI (CA-CDI) is increasing1 particularly in groups previously considered at low risk2,3. In Australia, CA-CDI rates doubled during 2011 and increased by 24% between 2011 and 20124. Two potentially high-risk practices in Australian food animal husbandry may present a risk for CA-CDI: slaughtering of neonatal animals for food, and effluent recycling to agriculture.
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Dahms C, Hübner NO, Wilke F, Kramer A. Mini-review: Epidemiology and zoonotic potential of multiresistant bacteria and Clostridium difficile in livestock and food. GMS HYGIENE AND INFECTION CONTROL 2014; 9:Doc21. [PMID: 25285265 PMCID: PMC4184042 DOI: 10.3205/dgkh000241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM Information on the epidemiology of multiresistant bacteria (MRB) with zoonotic potential is growing but still remains quite incomplete. This narrative mini-review provides a general overview of the epidemiology of the most important zoonotic MRB in cattle, swine and poultry in Europe. METHODS A literature search was conducted mainly on the PubMed website including articles published until April 2012. RESULTS Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) especially poses a zoonotic risk to people working in close contact with livestock. These people may become carriers themselves and the hazard of transmission into health-care facilities needs surveillance. Extended-spectrum beta-lactamases (ESBL) producing bacteria are widely spread in both humans and livestock, sharing similar genotypes, especially of the CTX-M-group, which makes a zoonotic transfer very likely. Identical strains of vancomycin-resistant enterococci (VRE) were found both in humans and animals, after ingestion of animal strains transient colonization of the human gut may be possible. Only a few data are available on the transmission of methicillin-resistant coagulase-negative staphylococci (MR-CoNS) between humans and animals. Direct contact to colonized animals may be a risk factor as well as the exchange of resistance genes between human and animal staphylococci. Clostridium difficile (C. difficile) ribotype 078 emerges in livestock and humans and a zoonotic transmission seems probable as genotypes and diseases resemble each other. CONCLUSION All discussed MRB and C. difficile are important nosocomial agents which also occur in livestock and were found in foods of animal origin. Further analysis is needed to reveal the exact transmission routes and to perform a reliable risk assessment.
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Affiliation(s)
- Carmen Dahms
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
| | - Nils-Olaf Hübner
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
- Institute of Medical Diagnostics (IMD), Greifswald, Germany
| | - Florian Wilke
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany
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Rodriguez C, Taminiau B, Avesani V, Van Broeck J, Delmée M, Daube G. Multilocus sequence typing analysis and antibiotic resistance of Clostridium difficile strains isolated from retail meat and humans in Belgium. Food Microbiol 2014; 42:166-71. [DOI: 10.1016/j.fm.2014.03.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 03/14/2014] [Accepted: 03/17/2014] [Indexed: 11/30/2022]
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Esfandiari Z, Jalali M, Ezzatpanah H, Weese J, Chamani M. Prevalence and Characterization of Clostridium difficile in Beef and Mutton Meats of Isfahan Region, Iran. Jundishapur J Microbiol 2014; 7:e16771. [PMID: 25485054 PMCID: PMC4255216 DOI: 10.5812/jjm.16771] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 02/25/2014] [Accepted: 05/25/2014] [Indexed: 11/28/2022] Open
Abstract
Background: Clostridium difficile (C. difficile) is a frequent cause of nosocomial infections. During last few years, the mortality rate of C. difficile infection (CDI) increased in healthcare facilities. This organism has become a major public health concern in developed nations. Because of the increasing incidence of acquired-CDI (CA-CDI) and notable genetic overlap between C. difficile isolates from animals and humans, meat has defined as one of the probable transmission route of C. diffiicle to humans. Objectives: This study was performed to determine the prevalence of toxigenic C. difficile in beef and mutton meats consumed as human food in Isfahan, central part of Iran. Furthermore the polymerase chain reaction (PCR)-ribotyping employed to compare the genetic pattern of positive isolates in meat with clinical ones. Materials and Methods: A total of 200 raw meat samples (81 beef and 119 mutton) were purchased from meat packaging plants. The samples were anaerobically cultured in C. difficile moxalactam norfloxacin (CDMN) broth and plated on selective enrichment medium. The suspicious colonies were recultured on blood agar anaerobically. All C. difficile isolates identified by morphological and biochemical testing were screened by PCR for the presence of genes encoding the triose phosphate isomerase (tpi), toxin A (tcdA), toxin B (tcdB) and binary toxin (cdtB). The genomes of extracted isolates were analyzed by 16S-23S rRNA-based PCR ribotyping. Results: The overall prevalence of C. difficile with two toxigenic genes including tcdA and tcdB was estimated at 4.0%. C. difficile was detected in 2.8%, 2.1%, 3.6% and 6.2% of chopped beef, ground beef, chopped mutton and ground mutton, respectively. The cdtB gene was not found in positive isolates. Eight different ribotypes were found in isolated strains that were not identical with those belonging to patients with CDI. Conclusions: The results of PCR-ribotyping indicate that no relationship exists between clinical and meat isolates. We therefore conclude that other sources than meat may function as a vector for CA-CDI.
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Affiliation(s)
- Zahra Esfandiari
- Department of Food Science and Technology, College of Food Science and Technology, Tehran Science and Research Branch, Islamic Azad University, Tehran, IR Iran
| | - Mohammad Jalali
- Infectious Diseases and Tropical Medicine Research Center, School of Food Sciences and Nutrition, Isfahan University of Medical Sciences, Isfahan, IR Iran
| | - Hamid Ezzatpanah
- Department of Food Science and Technology, College of Food Science and Technology, Tehran Science and Research Branch, Islamic Azad University, Tehran, IR Iran
- Corresponding author: Hamid Ezzatpanah, Department of Food Science and Technology, College of Food Science and Technology, Tehran Science and Research Branch, Islamic Azad University, Tehran, 14515.775, IR Iran. Tel: +98-2144865023, Fax: +98-2144865025, E-mail:
| | - J.Scott Weese
- Department of Pathobiology, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Mohammad Chamani
- Department of Animal Science, Faculty of Agriculture and Natural Resources, Tehran Science and Research Branch, Islamic Azad University, Tehran, IR Iran
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Yun B, Oh S, Griffiths MW. Lactobacillus acidophilus modulates the virulence of Clostridium difficile. J Dairy Sci 2014; 97:4745-58. [PMID: 24856984 DOI: 10.3168/jds.2014-7921] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/24/2014] [Indexed: 12/14/2022]
Abstract
Clostridium difficile is a spore-forming, toxin-producing, anaerobic bacterium that colonizes the human gastrointestinal tract. This pathogen causes antibiotic-associated diarrhea and colitis in animals and humans. Antibiotic-associated diseases may be treated with probiotics, and interest is increasing in such uses of probiotics. This study investigated the effect of Lactobacillus strains on the quorum-sensing signals and toxin production of C. difficile. In addition, an in vivo experiment was designed to assess whether Lactobacillus acidophilus GP1B is able to control C. difficile-associated disease. Autoinducer-2 activity was measured for C. difficile using the Vibrio harveyi coupled bioluminescent assay. Cell extract (10μg/mL) of L. acidophilus GP1B exhibited the highest inhibitory activity among 5 to 40μg/mL cell-extract concentrations. Real-time PCR data indicated decreased transcriptional levels in luxS, tcdA, tcdB, and txeR genes in the presence of 10μg/mL of cell extract of L. acidophilus GP1B. Survival rates at 5d for mice given the pathogen alone with L. acidophilus GP1B cell extract or L. acidophilus GP1B were 10, 70, and 80%, respectively. In addition, the lactic acid-produced L. acidophilus GP1B exhibits an inhibitory effect against the growth of C. difficile. Both the L. acidophilus GP1B and GP1B cell extract have significant antipathogenic effects on C. difficile.
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Affiliation(s)
- B Yun
- Division of Animal Science, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500-757, Korea
| | - S Oh
- Division of Animal Science, Chonnam National University, 77 Yongbong-ro, Buk-gu, Gwangju 500-757, Korea.
| | - M W Griffiths
- Department of Food Science, University of Guelph, Canadian Research Institute for Food Safety, Guelph, ON, N1G 2W1, Canada
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Rahimi E, Jalali M, Weese JS. Prevalence of Clostridium difficile in raw beef, cow, sheep, goat, camel and buffalo meat in Iran. BMC Public Health 2014; 14:119. [PMID: 24499381 PMCID: PMC3918140 DOI: 10.1186/1471-2458-14-119] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 01/08/2014] [Indexed: 01/05/2023] Open
Abstract
Background Clostridium difficile has been shown to be a nosocomial pathogen associated with diarrhoea and pseudomembranous colitis in hospitalised patients and the infection is believed to be acquired nosocomially. Recent studies have shown the occurrence of C. difficile in food animals which may act as a source of infection to humans.The aim of this study was to determine the occurrence of C. difficile in retail raw beef, cow, sheep, goat, camel and buffalo meat in Iran. Method From April to October 2012, a total of 660 raw meat samples from beef, cow, sheep, goat, camel and buffalo were purchased from 49 butcheries in Isfahan and Khuzestan provinces, Iran, and were evaluated for the presence of C. difficile using a method including selective enrichment in C. difficile broth, subsequent alcohol shock-treatment and plating onto C. difficile selective medium. C. difficile isolates were tested for the presence of toxin genes and were typed using PCR ribotyping. Results In this study, 13 of 660 meat samples (2%) were contaminated with C. difficile. The highest prevalence of C. difficile was found in buffalo meat (9%), followed by goat meat (3.3%), beef meat (1.7%), cow (0.94%) and sheep meat (0.9%). Seven of the 13C. difficile strains (53.9%) were positive for tcdA, tcdB and cdtB toxin genes and were classified as ribotype 078. Four strains (30.8%) were positive tcdA, and tcdB, and one strain (7.7%) was possessed only tcdB. The remaining isolate was non-toxigenic. Susceptibilities of 13C. difficile isolates were determined for 11 antimicrobial drugs using the disk diffusion assay. Resistance to clindamycin, gentamycin, and nalidixic acid was the most common finding. Conclusions To our knowledge, the present study is the first report of the isolation of C. difficile from raw buffalo meat. This study indicates the potential importance of food, including buffalo meat, as a source of transmission of C. difficile to humans.
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Affiliation(s)
- Ebrahim Rahimi
- Department of Food Hygiene, Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, P,O, Box: 166 Shahrekord, Iran.
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Abstract
This article presents information related to emerging pathogens that are foodborne or have the potential to be foodborne including bacteria, viruses, and parasites. The phenotypic characteristics of these pathogens, their epidemiology, prevalence in foods, and transmission routes to humans as well as means for their control are also discussed.
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Saad NM, Amin WF, Shaker EM. Detection of toxigenic Clostridium difficile in powdered infant and follow-up formulae in Egypt. Vet World 2013. [DOI: 10.14202/vetworld.2013.862-864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kalchayanand N, Arthur TM, Bosilevac JM, Brichta-Harhay DM, Shackelford SD, Wells JE, Wheeler TL, Koohmaraie M. Isolation and characterization of Clostridium difficile associated with beef cattle and commercially produced ground beef. J Food Prot 2013; 76:256-64. [PMID: 23433373 DOI: 10.4315/0362-028x.jfp-12-261] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The incidence of Clostridium difficile infection has recently increased in North American and European countries. This pathogen has been isolated from retail pork, turkey, and beef products and reported associated with human illness. This increase in infections has been attributed to the emergence of a toxigenic strain designated North America pulsed-field gel electrophoresis type 1 (NAP1). The NAP1 strain has been isolated from calves as well as ground meat products, leading to speculation of illness from consumption of contaminated meat products. However, information on C. difficile associated with beef cattle during processing and commercially produced ground beef is limited. To address this data gap, samples from various steps during beef production were collected. Samples from hides (n = 525), preevisceration carcasses (n = 475), postintervention carcasses (n = 471), and 956 commercial ground beef samples were collected from across the United States. The prevalence of C. difficile spores on hides was 3.2%. C. difficile spores were not detected on preevisceration and postintervention carcasses or in commercially produced ground beef. Phenotypic and genetic characterizations were carried out for all 18 isolates collected from hide samples. Twenty-two percent of the isolates were nontoxigenic strains, while 78% of the isolates were toxigenic. Toxinotyping and PCR ribotyping patterns revealed that 6 and 33% of the isolates were identified as NAP1 and NAP7 strains, respectively. This article evidences that the prevalence of C. difficile, specifically pathogenic strains, in the U.S. beef production chain is low.
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Affiliation(s)
- Norasak Kalchayanand
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, NE 68933-0166, USA.
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Hell M, Sickau K, Chmelizek G, Kern JM, Maass M, Huhulescu S, Allerberger F. Absence of Clostridium difficile in asymptomatic hospital staff. Am J Infect Control 2012; 40:1023-4. [PMID: 22572458 DOI: 10.1016/j.ajic.2012.01.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 01/24/2012] [Indexed: 11/16/2022]
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Hensgens M, Keessen E, Squire M, Riley T, Koene M, de Boer E, Lipman L, Kuijper E. Clostridium difficile infection in the community: a zoonotic disease? Clin Microbiol Infect 2012; 18:635-45. [DOI: 10.1111/j.1469-0691.2012.03853.x] [Citation(s) in RCA: 228] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Prevalence of Clostridium difficile in uncooked ground meat products from Pittsburgh, Pennsylvania. Appl Environ Microbiol 2012; 78:4183-6. [PMID: 22504814 DOI: 10.1128/aem.00842-12] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The prevalence of Clostridium difficile in retail meat samples has varied widely. The food supply may be a source for C. difficile infections. A total of 102 ground meat and sausage samples from 3 grocers in Pittsburgh, PA, were cultured for C. difficile. Brand A pork sausages were resampled between May 2011 and January 2012. Two out of 102 (2.0%) meat products initially sampled were positive for C. difficile; both were pork sausage from brand A from the same processing facility (facility A). On subsequent sampling of brand A products, 10/19 samples from processing facility A and 1/10 samples from 3 other facilities were positive for C. difficile. The isolates recovered were inferred ribotype 078, comprising 6 genotypes. The prevalence of C. difficile in retail meat may not be as high as previously reported in North America. When contamination occurs, it may be related to events at processing facilities.
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Costa MC, Reid-Smith R, Gow S, Hannon SJ, Booker C, Rousseau J, Benedict KM, Morley PS, Weese JS. Prevalence and molecular characterization of Clostridium difficile isolated from feedlot beef cattle upon arrival and mid-feeding period. BMC Vet Res 2012; 8:38. [PMID: 22455611 PMCID: PMC3353841 DOI: 10.1186/1746-6148-8-38] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 03/28/2012] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The presence of indistinguishable strains of Clostridium difficile in humans, food animals and food, as well as the apparent emergence of the food-animal-associated ribotype 078/toxinotype V as a cause of community-associated C. difficile infection have created concerns about the potential for foodborne infection. While studies have reported C. difficile in calves, studies of cattle closer to the age of harvest are required. Four commercial feedlots in Alberta (Canada) were enrolled for this study. Fecal samples were collected at the time of arrival and after acclimation (< 62, 62-71 or > 71 days on feed). Selective culture for Clostridium difficile was performed, and isolates were characterized by ribotyping and pulsed-field gel electrophoresis. A logistic regression model was built to investigate the effect of exposure to antimicrobial drugs on the presence of C. difficile. RESULTS Clostridium difficile was isolated from 18 of 539 animals at the time of feedlot arrival (CI = 2.3-6.1) and from 18 of 335 cattle at mid-feeding period (CI = 2.9-13.1). Overall, there was no significant difference in the prevalence of C. difficile shedding on arrival versus mid-feeding period (P = 0.47). No association between shedding of the bacterium and antimicrobial administration was found (P = 0.33). All the isolates recovered were ribotype 078, a toxinotype V strain with genes encoding toxins A, B and CDT. In addition, all strains were classified as NAP7 by pulsed field gel electrophoresis (PFGE) and had the characteristic 39 base pairs deletion and upstream truncating mutation on the tcdC gene. CONCLUSIONS It is apparent that C. difficile is carried in the intestinal tracts of a small percentage of feedlot cattle arriving and later in the feeding period and that ribotype 078/NAP7 is the dominant strain in these animals. Herd management practices associated with C. difficile shedding were not identified, however further studies of the potential role of antimicrobials on C. difficile acquisition and shedding are required.
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Affiliation(s)
- Marcio C Costa
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Canada
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Harvey RB, Norman KN, Andrews K, Norby B, Hume ME, Scanlan CM, Hardin MD, Scott HM. Clostridium difficile in retail meat and processing plants in Texas. J Vet Diagn Invest 2012; 23:807-11. [PMID: 21908329 DOI: 10.1177/1040638711407893] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The incidence and severity of disease associated with toxigenic Clostridium difficile have increased in hospitals in North America from the emergence of newer, more virulent strains. Toxigenic C. difficile has been isolated from food animals and retail meat with potential implications of transfer to human beings. The objective of the present study was to determine the prevalence of C. difficile in pork from sausage manufacturing plants and retail meat in Texas. Twenty-three C. difficile isolates were detected from 243 meat samples (9.5%) from 3 sausage-manufacturing plants and 5 retail meat outlets from 2004 to 2009. Twenty-two isolates were positive for toxins A, B, and binary toxin, and were characterized as toxinotype V, PFGE type-NAP7, or "NAP7-variant." Susceptibilities to 11 antimicrobial agents in the current study were similar to those reported previously for toxinotype V isolates, although the results suggested somewhat reduced resistance than reported for other meat, animal, or human clinical toxinotype V isolates.
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Affiliation(s)
- Roger B Harvey
- Food and Feed Safety Research Unit, SPARC, Agricultural Research Service, USDA, 2881 F&B Road, College Station, TX 77845, USA.
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