1
|
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.
Collapse
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
| |
Collapse
|
2
|
Blau K, Berger FK, Mellmann A, Gallert C. Clostridioides difficile from Fecally Contaminated Environmental Sources: Resistance and Genetic Relatedness from a Molecular Epidemiological Perspective. Microorganisms 2023; 11:2497. [PMID: 37894155 PMCID: PMC10608975 DOI: 10.3390/microorganisms11102497] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Clostridioides difficile is the most important pathogen causing antimicrobial-associated diarrhea and has recently been recognized as a cause of community-associated C. difficile infection (CA-CDI). This study aimed to characterize virulence factors, antimicrobial resistance (AMR), ribotype (RT) distribution and genetic relationship of C. difficile isolates from diverse fecally contaminated environmental sources. C. difficile isolates were recovered from different environmental samples in Northern Germany. Antimicrobial susceptibility testing was determined by E-test or disk diffusion method. Toxin genes (tcdA and tcdB), genes coding for binary toxins (cdtAB) and ribotyping were determined by PCR. Furthermore, 166 isolates were subjected to whole genome sequencing (WGS) for core genome multi-locus sequence typing (cgMLST) and extraction of AMR and virulence-encoding genes. Eighty-nine percent (148/166) of isolates were toxigenic, and 51% (76/148) were positive for cdtAB. Eighteen isolates (11%) were non-toxigenic. Thirty distinct RTs were identified. The most common RTs were RT127, RT126, RT001, RT078, and RT014. MLST identified 32 different sequence types (ST). The dominant STs were ST11, followed by ST2, ST3, and ST109. All isolates were susceptible to vancomycin and metronidazole and displayed a variable rate of resistance to moxifloxacin (14%), clarithromycin (26%) and rifampicin (2%). AMR genes, such as gyrA/B, blaCDD-1/2, aph(3')-llla-sat-4-ant(6)-la cassette, ermB, tet(M), tet(40), and tetA/B(P), conferring resistance toward fluoroquinolone, beta-lactam, aminoglycoside, macrolide and tetracycline antimicrobials, were found in 166, 137, 29, 32, 21, 72, 17, and 9 isolates, respectively. Eleven "hypervirulent" RT078 strains were detected, and several isolates belonged to RTs (i.e., RT127, RT126, RT023, RT017, RT001, RT014, RT020, and RT106) associated with CA-CDI, indicating possible transmission between humans and environmental sources pointing out to a zoonotic potential.
Collapse
Affiliation(s)
- Khald Blau
- Department of Microbiology–Biotechnology, Faculty of Technology, University of Applied Sciences Emden/Leer, 26723 Emden, Germany;
| | - Fabian K. Berger
- Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, 66421 Homburg, Germany;
- German National Reference Center for Clostridioides Difficile, 66421 Homburg, Germany;
| | - Alexander Mellmann
- German National Reference Center for Clostridioides Difficile, 66421 Homburg, Germany;
- Institute of Hygiene, University of Münster, 48149 Münster, Germany
| | - Claudia Gallert
- Department of Microbiology–Biotechnology, Faculty of Technology, University of Applied Sciences Emden/Leer, 26723 Emden, Germany;
| |
Collapse
|
3
|
Marcos P, Whyte P, Burgess C, Ekhlas D, Bolton D. Detection and Genomic Characterisation of Clostridioides difficile from Spinach Fields. Pathogens 2022; 11:1310. [PMID: 36365061 PMCID: PMC9695345 DOI: 10.3390/pathogens11111310] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/27/2022] [Accepted: 11/02/2022] [Indexed: 10/29/2023] Open
Abstract
Despite an increased incidence of Clostridioides difficile infections, data on the reservoirs and dissemination routes of this bacterium are limited. This study examined the prevalence and characteristics of C. difficile isolates in spinach fields. C. difficile was detected in 2/60 (3.3%) of spinach and 6/60 (10%) of soil samples using culture-based techniques. Whole genome sequencing (WGS) analysis identified the spinach isolates as belonging to the hypervirulent clade 5, sequence type (ST) 11, ribotypes (RT) 078 and 126 and carried the genes encoding toxins A, B and CDT. The soil isolates belonged to clade 1 with different toxigenic ST/RT (ST19/RT614, ST12/RT003, ST46/RT087, ST16/RT050, ST49/RT014/0) strains and one non-toxigenic ST79/RT511 strain. Antimicrobial resistance to erythromycin (one spinach isolate), rifampicin (two soil isolates), clindamycin (one soil isolate), both moxifloxacin and rifampicin (one soil isolate), and multi-drug resistance to erythromycin, vancomycin and rifampicin (two soil isolates) were observed using the E test, although a broader range of resistance genes were detected using WGS. Although the sample size was limited, our results demonstrate the presence of C. difficile in horticulture and provide further evidence that there are multiple sources and dissemination routes for these bacteria.
Collapse
Affiliation(s)
- Pilar Marcos
- Teagasc Food Research Centre, Ashtown, 15 Dublin, D15 DY05 Dublin, Ireland
- School of Veterinary Medicine, University College Dublin, Belfield, 4 Dublin, D04 V1W8 Dublin, Ireland
| | - Paul Whyte
- School of Veterinary Medicine, University College Dublin, Belfield, 4 Dublin, D04 V1W8 Dublin, Ireland
| | - Catherine Burgess
- Teagasc Food Research Centre, Ashtown, 15 Dublin, D15 DY05 Dublin, Ireland
| | - Daniel Ekhlas
- Teagasc Food Research Centre, Ashtown, 15 Dublin, D15 DY05 Dublin, Ireland
- School of Veterinary Medicine, University College Dublin, Belfield, 4 Dublin, D04 V1W8 Dublin, Ireland
| | - Declan Bolton
- Teagasc Food Research Centre, Ashtown, 15 Dublin, D15 DY05 Dublin, Ireland
| |
Collapse
|
4
|
Sitovs A, Sartini I, Giorgi M. Levofloxacin in veterinary medicine: a literature review. Res Vet Sci 2021; 137:111-126. [PMID: 33964616 DOI: 10.1016/j.rvsc.2021.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/26/2021] [Accepted: 04/27/2021] [Indexed: 01/10/2023]
Abstract
A potent third-generation antimicrobial fluoroquinolone drug, levofloxacin was introduced into human clinical practice in 1993. Levofloxacin is also used in veterinary medicine, however its use is limited: it is completely banned for veterinary use in the EU, and used extralabel in only companion animals in the USA. Since its introduction to clinical practice, many studies have been published on levofloxacin in animal species, including pharmacokinetic studies, tissue drug depletion, efficacy, and animal microbial isolate susceptibility to levofloxacin. This literature overview highlights the most clinically relevant and scientifically important levofloxacin studies linked to the field of veterinary medicine.
Collapse
Affiliation(s)
- Andrejs Sitovs
- Department of Pharmacology, Rīga Stradiņš University, Riga, Latvia.
| | - Irene Sartini
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Pisa, Italy
| |
Collapse
|
5
|
Molecular epidemiology and antimicrobial resistance of Clostridioides difficile detected in chicken, soil and human samples from Zimbabwe. Int J Infect Dis 2020; 96:82-87. [DOI: 10.1016/j.ijid.2020.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 01/05/2023] Open
|
6
|
Abstract
Clostridium (Clostridioides) difficile is a gram-positive, spore-forming bacterium that is an important cause of disease in people, a variably important cause of disease in some animal species, and an apparently harmless commensal in others. Regardless of whether it is a known pathogen in a particular species, it can also be found in healthy individuals, sometimes at high prevalences and typically with higher rates of carriage in young individuals. As it is investigated in more animal species, it is apparent that this bacterium is widely disseminated in a diverse range of domestic and wild animal species. Although it can be found in most species in which investigations have been performed, there are pronounced intra- and inter-species differences in prevalence and clinical relevance. A wide range of strains can be identified, some that appear to be animal associated and others that are found in humans and animals. A large percentage of strains that cause disease in people can at least sporadically be found in animals. It is a potentially important zoonotic pathogen, but there is limited direct evidence of animal-human transmission. Although C. difficile has been studied extensively over the past few decades, it remains an enigmatic organism in many ways.
Collapse
Affiliation(s)
- J Scott Weese
- Department of Pathobiology and Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Weese)
| |
Collapse
|
7
|
Saha S, Kapoor S, Tariq R, Schuetz AN, Tosh PK, Pardi DS, Khanna S. Increasing antibiotic resistance in Clostridioides difficile: A systematic review and meta-analysis. Anaerobe 2019; 58:35-46. [PMID: 31330183 DOI: 10.1016/j.anaerobe.2019.102072] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/14/2019] [Accepted: 07/15/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Decreases in clinical response of Clostridioides difficile to antibiotics used for its treatment have raised concerns regarding antibiotic resistance. We conducted a systematic review and meta-analysis to study the resistance rates of C. difficile to various antibiotics over time. METHODS We systematically searched MEDLINE, Embase, and Web of Science from inception through 03/31/2017 for observational studies assessing antibiotic resistance rates in C. difficile. Weighted summary estimates were calculated using inverse variance heterogeneity models [MetaXL software (v. 5.3)]. A priori subgroup analyses were done (by study year, continent, susceptibility testing method, origin of isolates); ribotype 027 strains were analyzed separately. RESULTS From 1982 to 2017, 60 studies (8336 isolates) were analyzed. Fifty-three studies reported vancomycin resistance; weighted pooled resistance (WPR), 2.1% (95% CI, 0%-5.1%; I2 = 95%). Fifty-five studies reported metronidazole resistance; WPR, 1.9% (95% CI, 0.5%-3.6%; I2 = 89%). Compared to the period before 2012, vancomycin resistance increased by 3.6% (95% CI, 2.9%-4.2%; P < 0.001) after 2012, and metronidazole resistance decreased by 0.8% (95% CI, 0.1%-1.5%; P = 0.02). No isolates were resistant to fidaxomicin. CONCLUSION Resistance of C. difficile to vancomycin is increasing, with a smaller, declining resistance to metronidazole; there is significant heterogeneity between studies. Ongoing monitoring of resistance to commonly used antibiotics is required.
Collapse
Affiliation(s)
- Srishti Saha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Saloni Kapoor
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Raseen Tariq
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Audrey N Schuetz
- Division of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Pritish K Tosh
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, 55905, USA
| | - Darrell S Pardi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Sahil Khanna
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA.
| |
Collapse
|
8
|
Villagómez-Estrada S, Blanco JL, Melo-Duran D, Martín C, Harmanus C, Kuijper EJ, García ME. Detection of Clostridium difficile in the environment in a veterinary teaching hospital. Anaerobe 2019; 57:55-58. [PMID: 30898637 DOI: 10.1016/j.anaerobe.2019.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 12/15/2022]
Abstract
The present study focused on detecting the presence of Clostridium difficile on veterinary hospital surfaces of large and small animal areas at the Universidad Complutense of Madrid. Isolated C. difficile strains were further characterized and investigated for antimicrobial susceptibility testing. Of n = 23 sampling area, 17% were positive for the presence of C. difficile. The isolates belonged to PCR ribotypes 078, 014, 039, and 154, of which RT 078 and 014 are also frequently found as human pathogens. Two isolates had high level resistance to metronidazole. These results suggest that the veterinary hospital environment constitutes a potential reservoir of zoonotical transferable C. difficile.
Collapse
Affiliation(s)
- Sandra Villagómez-Estrada
- Department of Animal Health, Faculty of Veterinary Science, Universidad Complutense de Madrid, Madrid, Spain
| | - José L Blanco
- Department of Animal Health, Faculty of Veterinary Science, Universidad Complutense de Madrid, Madrid, Spain; Hospital Clinico Veterinario Complutense, Universidad Complutense, Madrid, Spain.
| | - Diego Melo-Duran
- Department of Animal Health, Faculty of Veterinary Science, Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Martín
- Department of Animal Health, Faculty of Veterinary Science, Universidad Complutense de Madrid, Madrid, Spain; Hospital Clinico Veterinario Complutense, Universidad Complutense, Madrid, Spain
| | - Celine Harmanus
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Ed J Kuijper
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - Marta E García
- Department of Animal Health, Faculty of Veterinary Science, Universidad Complutense de Madrid, Madrid, Spain; Hospital Clinico Veterinario Complutense, Universidad Complutense, Madrid, Spain
| |
Collapse
|
9
|
Álvarez-Pérez S, Blanco JL, Astorga RJ, Gómez-Laguna J, Barrero-Domínguez B, Galán-Relaño A, Harmanus C, Kuijper E, García ME. Distribution and tracking of Clostridium difficile and Clostridium perfringens in a free-range pig abattoir and processing plant. Food Res Int 2018; 113:456-464. [PMID: 30195542 DOI: 10.1016/j.foodres.2018.07.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/10/2018] [Accepted: 07/28/2018] [Indexed: 12/14/2022]
Abstract
The presence and genetic diversity of Clostridium difficile and C. perfringens along the slaughtering process of pigs reared in a free-range system was assessed. A total of 270 samples from trucks, lairage, slaughter line and quartering were analyzed, and recovered isolates were toxinotyped and genotyped. C. difficile and C. perfringens were retrieved from 14.4% and 12.6% of samples, respectively. The highest percentage of positive samples for C. difficile was detected in trucks (80%) whereas C. perfringens was more prevalent in cecal and colonic samples obtained in the slaughter line (85% and 45%, respectively). C. difficile isolates (n = 105) were classified into 17 PCR ribotypes (including 010, 078, and 126) and 95 AFLP genotypes. C. perfringens isolates (n = 85) belonged to toxinotypes A (94.1%) and C (5.9%) and were classified into 80 AFLP genotypes. The same genotypes of C. difficile and C. perfringens were isolated from different pigs and occasionally from environmental samples, suggesting a risk of contaminated meat products.
Collapse
Affiliation(s)
- Sergio Álvarez-Pérez
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | - José L Blanco
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain.
| | - Rafael J Astorga
- Department of Animal Health, Faculty of Veterinary Medicine, University of Cordoba, Cordoba, Spain
| | - Jaime Gómez-Laguna
- Department of Anatomy and Comparative Pathology, Faculty of Veterinary Medicine, University of Cordoba, Cordoba, Spain
| | - Belén Barrero-Domínguez
- Department of Animal Health, Faculty of Veterinary Medicine, University of Cordoba, Cordoba, Spain
| | - Angela Galán-Relaño
- Department of Animal Health, Faculty of Veterinary Medicine, University of Cordoba, Cordoba, Spain
| | - Celine Harmanus
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Ed Kuijper
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Marta E García
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
10
|
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]
|
11
|
Martín-Burriel I, Andrés-Lasheras S, Harders F, Mainar-Jaime RC, Ranera B, Zaragoza P, Falceto V, Bolea Y, Kuijper E, Bolea R, Bossers A, Chirino-Trejo M. Molecular analysis of three Clostridium difficile strain genomes isolated from pig farm-related samples. Anaerobe 2017; 48:224-231. [PMID: 28928035 DOI: 10.1016/j.anaerobe.2017.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/08/2017] [Accepted: 09/14/2017] [Indexed: 02/08/2023]
Abstract
Clostridium difficile is an anaerobic spore-forming bacillus that usually causes gastrointestinal disorders in man and other animal species. Most of the strains isolated from animals are toxigenic being the virulent ribotype (RT) 078 predominant in several animal species. Although C. difficile is pathogenic to both humans and animals, there is no direct evidence of zoonosis. Deep genome sequencing provides sufficient resolution to analyse which strains found in animals might be related to human pathogens. So far, there are only a few fully sequenced genomes of C. difficile strains isolated from domestic and wild animals. Using Illumina technology, we have sequenced the genome of three isolates; a strain isolated from the vagina of a sow (5754), one from rat (Rattus spp) intestinal content (RC10) and a third one isolated from environmental rat faeces (RF17). Both, rat and rat faeces were sampled in fattening pig farms. Our study reveals a close genetic relationship of two of these isolates with the virulent strain M120 (RT078) isolated from a human patient. The analysis of the sequences has revealed the presence of antibiotic resistance genes, mobile elements, including the transposon linked with virulence Tn6164, and the similarity of virulence factors between these isolates and human strains. This is the first study focused on the sequencing of C. difficile genomes obtained from wild animals like rats, which can be considered as potential reservoirs for humans and other animal species. This study can help to understand the genome composition and epidemiology of this bacterium species.
Collapse
Affiliation(s)
- I Martín-Burriel
- Laboratorio de Genética Bioquímica (LAGENBIO), Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain.
| | - S Andrés-Lasheras
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - F Harders
- Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - R C Mainar-Jaime
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - B Ranera
- Laboratorio de Genética Bioquímica (LAGENBIO), Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - P Zaragoza
- Laboratorio de Genética Bioquímica (LAGENBIO), Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - V Falceto
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - Y Bolea
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - E Kuijper
- Department of Medical Microbiology, Centre of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - R Bolea
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón - IA2 - (Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - A Bossers
- Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - M Chirino-Trejo
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| |
Collapse
|
12
|
Orden C, Neila C, Blanco JL, Álvarez-Pérez S, Harmanus C, Kuijper EJ, García ME. Recreational sandboxes for children and dogs can be a source of epidemic ribotypes of Clostridium difficile. Zoonoses Public Health 2017; 65:88-95. [PMID: 28686001 DOI: 10.1111/zph.12374] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Indexed: 12/13/2022]
Abstract
Different studies have suggested that the sand of public playgrounds could have a role in the transmission of infections, particularly in children. Furthermore, free access of pets and other animals to the playgrounds might increase such a risk. We studied the presence of Clostridium difficile in 20 pairs of sandboxes for children and dogs located in different playgrounds within the Madrid region (Spain). Clostridium difficile isolation was performed by enrichment and selective culture procedures. The genetic (ribotype and amplified fragment length polymorphism [AFLP]) diversity and antibiotic susceptibility of isolates was also studied. Overall, 52.5% (21/40) of samples were positive for the presence of C. difficile. Eight of the 20 available isolates belonged to the toxigenic ribotypes 014 (n = 5) and 106 (n = 2), both regarded as epidemic, and CD047 (n = 1). The other 12 isolates were non-toxigenic, and belonged to ribotypes 009 (n = 5), 039 (n = 4), and 067, 151 and CD048 (one isolate each). Nevertheless, all isolates (even those of a same ribotype) were classified into different AFLP genotypes indicating non-relatedness. In conclusion, our results revealed the presence of epidemic ribotypes of C. difficile in children's and dog's sandboxes located nearby, which constitutes a major health risk.
Collapse
Affiliation(s)
- Cristina Orden
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| | - Carlos Neila
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| | - José L Blanco
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| | - Sergio Álvarez-Pérez
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| | - Celine Harmanus
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Ed J Kuijper
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Marta E García
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
13
|
Diseases of the Alimentary Tract. Vet Med (Auckl) 2017. [PMCID: PMC7167529 DOI: 10.1016/b978-0-7020-5246-0.00007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
14
|
Andrés-Lasheras S, Bolea R, Mainar-Jaime RC, Kuijper E, Sevilla E, Martín-Burriel I, Chirino-Trejo M. Presence of Clostridium difficile in pig faecal samples and wild animal species associated with pig farms. J Appl Microbiol 2016; 122:462-472. [PMID: 27990723 DOI: 10.1111/jam.13343] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 01/05/2023]
Abstract
AIMS To determine the presence of Clostridium difficile on fattening pig farms in north-eastern Spain. METHODS AND RESULTS Twenty-seven farms were sampled. Pools of pig faecal samples (n = 210), samples of intestinal content from common farm pest species (n = 95) and environment-related samples (n = 93) were collected. Isolates were tested for toxin genes of C. difficile, and typed by PCR-ribotyping and toxinotyping. The minimal inhibitory concentrations of six antimicrobial agents were determined using Etest. Thirty-four isolates were obtained from 12 farms, and 30 (88·2%) had toxin genes. Seven ribotypes were identified. Ribotype 078 and its variant 126 were predominant (52·9%). The same ribotypes were isolated from different animal species on the same farm. None of the isolates were resistant to metronidazole or vancomycin. CONCLUSIONS Clostridium difficile was common within the pig farm environment. Most of the positive samples came from pest species or were pest-related environmental samples. SIGNIFICANCE AND IMPACT OF THE STUDY Pest species were colonized with toxigenic and antimicrobial-resistant C. difficile strains of the same ribotypes that are found in humans and pigs. Rodents and pigeons may transmit toxigenic and antimicrobial-resistant C. difficile strains that are of the same ribotypes as those occuring in humans.
Collapse
Affiliation(s)
- S Andrés-Lasheras
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - R Bolea
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - R C Mainar-Jaime
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - E Kuijper
- Department of Medical Microbiology, Centre of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - E Sevilla
- Departamento de Patología Animal, Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - I Martín-Burriel
- Laboratorio de Genética Bioquímica (LAGENBIO), Facultad de Veterinaria, Instituto Agroalimentario de Aragón-IA2-(Universidad de Zaragoza-CITA), Zaragoza, Spain
| | - M Chirino-Trejo
- Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|
15
|
Orden C, Blanco JL, Álvarez-Pérez S, Garcia-Sancho M, Rodriguez-Franco F, Sainz A, Villaescusa A, Harmanus C, Kuijper E, Garcia ME. Isolation of Clostridium difficile from dogs with digestive disorders, including stable metronidazole-resistant strains. Anaerobe 2016; 43:78-81. [PMID: 27965048 DOI: 10.1016/j.anaerobe.2016.12.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/29/2016] [Accepted: 12/08/2016] [Indexed: 02/08/2023]
Abstract
The prevalence of Clostridium difficile in 107 dogs with diverse digestive disorders attended in a Spanish veterinary teaching hospital was assessed. The microorganism was isolated from 13 dogs (12.1%) of different disease groups. Isolates belonged to PCR ribotypes 078, 106, 154 and 430 (all of them toxigenic) and 110 (non-toxigenic), and were resistant to several antimicrobial drugs. Notably, seven isolates obtained from different dogs displayed stable resistance to metronidazole. The results of this study provide further evidence that dogs can act as a reservoir of C. difficile strains of epidemic ribotypes with resistance to multiple antibiotics.
Collapse
Affiliation(s)
- Cristina Orden
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, 28040, Madrid, Spain
| | - Jose L Blanco
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, 28040, Madrid, Spain; Hospital Clínico Veterinario Complutense, Universidad Complutense, 28040, Madrid, Spain.
| | - Sergio Álvarez-Pérez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, 28040, Madrid, Spain
| | | | | | - Angel Sainz
- Hospital Clínico Veterinario Complutense, Universidad Complutense, 28040, Madrid, Spain
| | - Alejandra Villaescusa
- Hospital Clínico Veterinario Complutense, Universidad Complutense, 28040, Madrid, Spain
| | - Celine Harmanus
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Ed Kuijper
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Marta E Garcia
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, 28040, Madrid, Spain; Hospital Clínico Veterinario Complutense, Universidad Complutense, 28040, Madrid, Spain
| |
Collapse
|
16
|
Álvarez-Pérez S, Blanco JL, Harmanus C, Kuijper E, García ME. Subtyping and antimicrobial susceptibility of Clostridium difficile PCR ribotype 078/126 isolates of human and animal origin. Vet Microbiol 2016; 199:15-22. [PMID: 28110780 DOI: 10.1016/j.vetmic.2016.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/22/2016] [Accepted: 12/01/2016] [Indexed: 01/05/2023]
Abstract
The Clostridium difficile PCR ribotype complex 078/126 (RT078/126) is often involved in human disease and is also frequently isolated from diverse animal species. The high genetic relatedness between human and animal RT078/126 isolates found in different regions has encouraged discussion about the zoonotic potential of this lineage. We compared for the first time the genetic diversity and antimicrobial susceptibility profiles of human and animal C. difficile RT078/126 isolates from Spain. A collection of 96 isolates (50 of human and 46 of animal origin; 63 and 33 of ribotypes 078 and 126, respectively) was subtyped by an improved amplified fragment length polymorphism (AFLP) fingerprinting method and tested for in vitro antimicrobial susceptibility. A total of 67 genotypes were distinguished, three of which grouped together isolates of human and animal origin. Furthermore, two main groups of isolates that mostly correlated with PCR ribotypes could be distinguished in the AFLP dendrogram. Human origin was significantly associated with resistance to ertapenem, erythromycin and moxifloxacin; resistance to clindamycin and erythromycin was associated with RT126 and AFLP group 1. Twenty-nine isolates (30.2% of total) displayed heteroresistance to metronidazole. Substantial differences were observed in the susceptibility profiles of isolates belonging to a same genotype. Altogether, these results provide a valuable baseline for future studies on the epidemiology of C. difficile RT078/126.
Collapse
Affiliation(s)
- Sergio Álvarez-Pérez
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| | - José L Blanco
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain.
| | - Celine Harmanus
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Ed Kuijper
- Department of Medical Microbiology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Marta E García
- Department of Animal Health, Faculty of Veterinary, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
17
|
Moono P, Foster NF, Hampson DJ, Knight DR, Bloomfield LE, Riley TV. Clostridium difficile Infection in Production Animals and Avian Species: A Review. Foodborne Pathog Dis 2016; 13:647-655. [PMID: 27602596 DOI: 10.1089/fpd.2016.2181] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Clostridium difficile is the leading cause of antibiotic-associated diarrhea and colitis in hospitalized humans. Recently, C. difficile infection (CDI) has been increasingly recognized as a cause of neonatal enteritis in food animals such as pigs, resulting in stunted growth, delays in weaning, and mortality, as well as colitis in large birds such as ostriches. C. difficile is a strictly anaerobic spore-forming bacterium, which produces two toxins A (TcdA) and B (TcdB) as its main virulence factors. The majority of strains isolated from animals produce an additional binary toxin (C. difficile transferase) that is associated with increased virulence. C. difficile is ubiquitous in the environment and has a wide host range. This review summarizes the epidemiology, clinical presentations, risk factors, and laboratory diagnosis of CDI in animals. Increased awareness by veterinarians and animal owners of the significance of clinical disease caused by C. difficile in livestock and avians is needed. Finally, this review provides an overview on methods for controlling environmental contamination and potential therapeutics available.
Collapse
Affiliation(s)
- Peter Moono
- 1 Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia , Nedlands, WA, Australia
| | - Niki F Foster
- 2 Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre , Nedlands, WA, Australia
| | - David J Hampson
- 3 School of Veterinary & Life Sciences, Murdoch University , Murdoch, WA, Australia
| | - Daniel R Knight
- 1 Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia , Nedlands, WA, Australia
| | - Lauren E Bloomfield
- 4 Healthcare Associated Infection Unit, Department of Health, Communicable Disease Control Directorate, Shenton Park, WA, Australia
| | - Thomas V Riley
- 1 Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia , Nedlands, WA, Australia .,2 Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre , Nedlands, WA, Australia .,3 School of Veterinary & Life Sciences, Murdoch University , Murdoch, WA, Australia .,4 Healthcare Associated Infection Unit, Department of Health, Communicable Disease Control Directorate, Shenton Park, WA, Australia .,5 School of Medical & Health Sciences, Edith Cowan University , Joondalup, WA, Australia
| |
Collapse
|
18
|
Rodriguez C, Van Broeck J, Taminiau B, Delmée M, Daube G. Clostridium difficile infection: Early history, diagnosis and molecular strain typing methods. Microb Pathog 2016; 97:59-78. [PMID: 27238460 DOI: 10.1016/j.micpath.2016.05.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/18/2016] [Accepted: 05/02/2016] [Indexed: 01/05/2023]
Abstract
Recognised as the leading cause of nosocomial antibiotic-associated diarrhoea, the incidence of Clostridium difficile infection (CDI) remains high despite efforts to improve prevention and reduce the spread of the bacterium in healthcare settings. In the last decade, many studies have focused on the epidemiology and rapid diagnosis of CDI. In addition, different typing methods have been developed for epidemiological studies. This review explores the history of C. difficile and the current scope of the infection. The variety of available laboratory tests for CDI diagnosis and strain typing methods are also examined.
Collapse
Affiliation(s)
- C Rodriguez
- Food Science Department, FARAH, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
| | - J Van Broeck
- Belgian Reference Centre for Clostridium Difficile (NRC), Pôle de microbiologie médicale, Université Catholique de Louvain, Brussels, Belgium
| | - B Taminiau
- Food Science Department, FARAH, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - M Delmée
- Belgian Reference Centre for Clostridium Difficile (NRC), Pôle de microbiologie médicale, Université Catholique de Louvain, Brussels, Belgium
| | - G Daube
- Food Science Department, FARAH, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| |
Collapse
|
19
|
Wu YC, Lee JJ, Tsai BY, Liu YF, Chen CM, Tien N, Tsai PJ, Chen TH. Potentially hypervirulent Clostridium difficile PCR ribotype 078 lineage isolates in pigs and possible implications for humans in Taiwan. Int J Med Microbiol 2016; 306:115-22. [PMID: 26915500 DOI: 10.1016/j.ijmm.2016.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/02/2016] [Accepted: 02/07/2016] [Indexed: 12/30/2022] Open
Abstract
Clostridium difficile is a human and animal pathogen. Recently, the incidence of community-acquired C. difficile infection has increased, and many studies have indicated that C. difficile might be food-borne. The correlation between C. difficile infection in humans and in animals has been a topic of debate. The objective of this study was to determine the genetic relatedness of C. difficile from human and pigs in Taiwan. We investigated the molecular epidemiology of C. difficile in healthy humans and pigs from 2011 to 2015. The isolation rate of C. difficile from pigs in 13 commercial farms was 49% (100/204), and a high proportion of hypervirulent (C. difficile carrying tcdA, tcdB, and cdtA/B genes and a 39-bp deletion in the tcdC gene) ribotype 078 lineage isolates (90%, 90/100; including 078, 126, 127, and 066-like isolates) were identified. In addition, the C. difficile ribotype 127 isolates from pigs typically exhibited moxifloxacin resistance (37/43; 86%). In healthy humans, the isolation rate was 4.3% (3/69), and all healthy human isolates were non-toxigenic. In particular, we compared the porcine isolates with two patient strains (ribotype 127) obtained from two hospitals in central Taiwan. The multilocus variable number tandem repeat analysis revealed a high genetic relatedness between ribotype 127 from patients and pigs. This study indicated that isolates of the ribotype 078 lineage, and especially ribotype 127, were widely distributed in pig farms and showed a high frequency of moxifloxacin resistance. The closely related ribotype 127 from patients and pigs may have had a common origin or low diversity. In conclusion, C. difficile ribotype 127 is a noteworthy pathogen in pigs and poses a potential public health threat.
Collapse
Affiliation(s)
- Ying-Chen Wu
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, No.250, Guoguang Rd., South Dist., Taichung 402, Taiwan.
| | - Jen-Jie Lee
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, No.250, Guoguang Rd., South Dist., Taichung 402, Taiwan.
| | - Bo-Yang Tsai
- Department of Microbiology and Immunology, National Cheng Kung University, Medical College, No. 1, University Rd., Tainan 70101, Taiwan.
| | - Yi-Fen Liu
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, No.250, Guoguang Rd., South Dist., Taichung 402, Taiwan.
| | - Chih-Ming Chen
- Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, No.699, Sec. 8, Taiwan Blvd., Taichung 435, Taiwan.
| | - Ni Tien
- Department of Laboratory Medicine, China Medical University Hospital, No.91 Hsuehshih Rd., Taichung 404, Taiwan.
| | - Pei-Jane Tsai
- Department of Medical Laboratory Science and Biotechnology, National Cheng Kung University, Medical College, No. 1, University Rd., Tainan 70101, Taiwan.
| | - Ter-Hsin Chen
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, No.250, Guoguang Rd., South Dist., Taichung 402, Taiwan.
| |
Collapse
|
20
|
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.
Collapse
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
| |
Collapse
|
21
|
Moono P, Putsathit P, Knight DR, Squire MM, Hampson DJ, Foster NF, Riley TV. Persistence of Clostridium difficile RT 237 infection in a Western Australian piggery. Anaerobe 2015; 37:62-6. [PMID: 26679487 DOI: 10.1016/j.anaerobe.2015.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/26/2015] [Accepted: 11/29/2015] [Indexed: 12/17/2022]
Abstract
Clostridium difficile is commonly associated with healthcare-related infections in humans, and is an emerging pathogen in food animal species. There is potential for transmission of C. difficile from animals or animal products to humans. This study aimed to determine if C. difficile RT 237 had persisted in a Western Australian piggery or if there had been a temporal change in C. difficile diversity. C. difficile carriage in litters with and without diarrhea was investigated, as was the acquisition of C. difficile over time using cohort surveys. Rectal swabs were obtained from piglets aged 1-10 days to determine prevalence of C. difficile carriage and samples were obtained from 20 piglets on days 1, 7, 13, 20, and 42 of life to determine duration of shedding. Isolation of C. difficile from feces was achieved by selective enrichment culture. All isolates were characterized by standard molecular typing. Antimicrobial susceptibility testing was performed on selected isolates (n = 29). Diarrheic piglets were more likely to shed C. difficile than the non-diseased (p = 0.0124, χ2). In the cohort study, C. difficile was isolated from 40% samples on day 1, 50% on day 7, 20% on day 13, and 0% on days 20 and 42. All isolates were RT 237 and no antimicrobial resistance was detected. The decline of shedding of C. difficile to zero has public health implications because slaughter age pigs have a low likelihood of spreading C. difficile to consumers via pig meat.
Collapse
Affiliation(s)
- Peter Moono
- Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Papanin Putsathit
- Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Daniel R Knight
- Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Michele M Squire
- Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Western Australia, Australia
| | - David J Hampson
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - Niki F Foster
- Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Western Australia, Australia; Department of Microbiology, PathWest Laboratory Medicine (WA), Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Thomas V Riley
- Microbiology & Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Western Australia, Australia; Department of Microbiology, PathWest Laboratory Medicine (WA), Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia.
| |
Collapse
|
22
|
Álvarez-Pérez S, Blanco JL, Peláez T, Lanzarot MP, Harmanus C, Kuijper E, García ME. Faecal shedding of antimicrobial-resistant Clostridium difficile
strains by dogs. J Small Anim Pract 2014; 56:190-5. [DOI: 10.1111/jsap.12311] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/30/2014] [Accepted: 11/05/2014] [Indexed: 02/04/2023]
Affiliation(s)
- S. Álvarez-Pérez
- Departamento de Sanidad Animal, Facultad de Veterinaria; Universidad Complutense; Madrid Spain
| | - J. L. Blanco
- Departamento de Sanidad Animal, Facultad de Veterinaria; Universidad Complutense; Madrid Spain
| | - T. Peláez
- Servicio de Microbiología Clínica y Enfermedades Infecciosas; Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón; Madrid Spain
- Departamento de Medicina, Facultad de Medicina; Universidad Complutense; Madrid Spain
| | - M. P. Lanzarot
- Departamento de Sanidad Animal, Facultad de Veterinaria; Universidad Complutense; Madrid Spain
| | - C. Harmanus
- Department of Medical Microbiology, Center of Infectious Diseases; Leiden University Medical Center; Leiden The Netherlands
| | - E. Kuijper
- Department of Medical Microbiology, Center of Infectious Diseases; Leiden University Medical Center; Leiden The Netherlands
| | - M. E. García
- Departamento de Sanidad Animal, Facultad de Veterinaria; Universidad Complutense; Madrid Spain
| |
Collapse
|
23
|
Clostridium difficile ribotype 126 in southern Taiwan: A cluster of three symptomatic cases. Anaerobe 2014; 30:188-92. [DOI: 10.1016/j.anaerobe.2014.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 06/05/2014] [Indexed: 11/18/2022]
|
24
|
Knetsch CW, Connor TR, Mutreja A, van Dorp SM, Sanders IM, Browne HP, Harris D, Lipman L, Keessen EC, Corver J, Kuijper EJ, Lawley TD. Whole genome sequencing reveals potential spread of Clostridium difficile between humans and farm animals in the Netherlands, 2002 to 2011. ACTA ACUST UNITED AC 2014; 19:20954. [PMID: 25411691 DOI: 10.2807/1560-7917.es2014.19.45.20954] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Farm animals are a potential reservoir for human Clostridium difficile infection (CDI), particularly PCR ribotype 078 which is frequently found in animals and humans. Here, whole genome single-nucleotide polymorphism (SNP) analysis was used to study the evolutionary relatedness of C. difficile 078 isolated from humans and animals on Dutch pig farms. All sequenced genomes were surveyed for potential antimicrobial resistance determinants and linked to an antimicrobial resistance phenotype. We sequenced the whole genome of 65 C. difficile 078 isolates collected between 2002 and 2011 from pigs (n = 19), asymptomatic farmers (n = 15) and hospitalised patients (n = 31) in the Netherlands. The collection included 12 pairs of human and pig isolates from 2011 collected at 12 different pig farms. A mutation rate of 1.1 SNPs per genome per year was determined for C. difficile 078. Importantly, we demonstrate that farmers and pigs were colonised with identical (no SNP differences) and nearly identical (less than two SNP differences) C. difficile clones. Identical tetracycline and streptomycin resistance determinants were present in human and animal C. difficile 078 isolates. Our observation that farmers and pigs share identical C. difficile strains suggests transmission between these populations, although we cannot exclude the possibility of transmission from a common environmental source.
Collapse
Affiliation(s)
- C W Knetsch
- Section Experimental Bacteriology, Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Taori SK, Wroe A, Hardie A, Gibb AP, Poxton IR. A prospective study of community-associated Clostridium difficile infections: the role of antibiotics and co-infections. J Infect 2014; 69:134-44. [PMID: 24780765 DOI: 10.1016/j.jinf.2014.04.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 03/12/2014] [Accepted: 04/16/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This prospective study was performed to determine the incidence, risk factors, severity and outcomes of community-associated Clostridium difficile infection (CA-CDI) in the SE of Scotland. METHODS All patients (335) diagnosed with laboratory confirmed CDI in the city of Edinburgh, East Lothian and Midlothian regions of Scotland between August 2010 and July 2011 were followed up for one year after diagnosis. Clinical details and laboratory markers were recorded. Stool samples were tested for C. difficile, other bacterial pathogens and norovirus. Molecular epidemiology of C. difficile isolates was studied by PCR-ribotyping. RESULTS Of the total 335 confirmed CDI cases, PCR-ribotype 001 was the commonest (14.1%), followed by PCR-ribotypes 078 (12.9%) and 015 (11.7%), respectively. CA-CDI represented 12.5% of the cases. In these, PCR-ribotype 078 was the commonest (19.0%), followed by PCR-ribotypes 014/020 (16.7%), PCR-ribotype 015 (14.3% and PCR-ribotype 001 (11.9%). A lower Charlson co-morbidity index and a lower age was observed in the CA-CDI group as was total number of different antibiotic classes whereas age >75 was more common in the HA-CDI group. On multivariable analysis presence of PCR-ribotype 078 was significantly associated with community acquisition (p = 0.006) whereas a greater proportion of immunosuppressed patients and those on antibiotics 8 weeks preceding diagnosis (p = 0.035 and p = 0.005 respectively) were found among HA-CDI cases. Charlson co-morbidity index, number of different antibiotics given in the eight weeks preceding onset, severity of infection and rural residence were not significantly different between the two groups. CONCLUSION This study demonstrates that patients with CA-CDI may also present with severe infection, are less likely to receive antibiotics prior to CDI, more likely to be younger in age and have a greater proportion of PCR-ribotype 078 compared with CDI acquired in a hospital setting. Hence a high level of vigilance must be maintained to detect CDI cases which present in the community without the traditional predisposing factors.
Collapse
Affiliation(s)
- Surabhi K Taori
- Microbial Pathogenicity Research Laboratory, Medical Microbiology, The Chancellors Building, University of Edinburgh, 49, Little France Crescent, Edinburgh EH16 4SB, UK.
| | - Allison Wroe
- Microbial Pathogenicity Research Laboratory, Medical Microbiology, The Chancellors Building, University of Edinburgh, 49, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Alison Hardie
- Specialist Virology Centre, Royal Infirmary of Edinburgh, 51, Little France Crescent, Edinburgh EH16 4SA, UK
| | - Alan P Gibb
- Department of Clinical Microbiology, Royal Infirmary of Edinburgh, 51, Little France Crescent, Edinburgh EH16 4SA, UK
| | - Ian R Poxton
- Microbial Pathogenicity Research Laboratory, Medical Microbiology, The Chancellors Building, University of Edinburgh, 49, Little France Crescent, Edinburgh EH16 4SB, UK
| |
Collapse
|
26
|
Álvarez-Pérez S, Blanco JL, Martínez-Nevado E, Peláez T, Harmanus C, Kuijper E, García ME. Shedding of Clostridium difficile PCR ribotype 078 by zoo animals, and report of an unstable metronidazole-resistant isolate from a zebra foal (Equus quagga burchellii). Vet Microbiol 2014; 169:218-22. [DOI: 10.1016/j.vetmic.2013.12.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/04/2013] [Accepted: 12/20/2013] [Indexed: 01/26/2023]
|