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Uchida-Fujii E, Niwa H, Senoh M, Kato H, Kinoshita Y, Mita H, Ueno T. Clostridioides difficile infection in thoroughbred horses in Japan from 2010 to 2021. Sci Rep 2023; 13:13099. [PMID: 37567893 PMCID: PMC10421859 DOI: 10.1038/s41598-023-40157-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
We encountered 34 Clostridioides difficile (C. difficile) infection (CDI) cases among Thoroughbred horses in Japan from 2010 to 2021. Among them, 79.4% (27/34) either died or were euthanised. The risk factors associated with CDI and mortality among Japanese Thoroughbred horses remain unclear. We used genetic methods to examine C. difficile strains and their relationships with prognosis. Twenty-two (64.7%) cases were hospitalised at the onset of colitis. Outcomes were balanced for hospitalisation rates at the onset of colitis. The mortality rates of cases treated with metronidazole (65.0%) were significantly lower than untreated cases (100%). The predominant genotype of C. difficile isolate was polymerase chain reaction ribotype (RT) 078, isolated from 12 cases (35.3%), followed by RT014 (six cases, 17.6%). Binary toxin (C. difficile transferase [CDT])-positive strains, including all RT078 strains, were isolated from 16 horses. Mortality rates in RT078 strain (75.0%) or CDT-positive strain (83.3%) cases were comparable to that in cases of other types. Sufficient infection control is needed to prevent CDI in Thoroughbred horses. A timely and prompt CDI diagnosis leading to metronidazole treatment would improve CDI outcomes.
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Affiliation(s)
- Eri Uchida-Fujii
- Microbiology Division, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi, 329-0412, Japan
| | - Hidekazu Niwa
- Microbiology Division, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi, 329-0412, Japan.
| | - Mitsutoshi Senoh
- Department of Bacteriology II, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo, 208-0011, Japan
| | - Haru Kato
- Antimicrobial Resistance Center, National Institute of Infectious Diseases, Aoba-Cho 4-2-1, Higashimurayama, Tokyo, 189-0002, Japan
| | - Yuta Kinoshita
- Microbiology Division, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi, 329-0412, Japan
| | - Hiroshi Mita
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi, 329-0412, Japan
| | - Takanori Ueno
- Microbiology Division, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi, 329-0412, Japan
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2
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Hain‐Saunders N, Knight DR, Bruce M, Riley TV. Clostridioides difficile
infection and One Health: An Equine Perspective. Environ Microbiol 2022; 24:985-997. [PMID: 35001483 PMCID: PMC9304292 DOI: 10.1111/1462-2920.15898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 11/29/2022]
Abstract
Clostridioides (Clostridium) difficile presents a significant health risk to humans and animals. The complexity of the bacterial–host interaction affecting pathogenesis and disease development creates an ongoing challenge for epidemiological studies, control strategies and prevention planning. The recent emergence of human disease caused by strains of C. difficile found in animals adds to mounting evidence that C. difficile infection (CDI) may be a zoonosis. In equine populations, C. difficile is a known cause of diarrhoea and gastrointestinal inflammation, with considerable mortality and morbidity. This has a significant impact on both the well‐being of the animal and, in the case of performance and production animals, it may have an adverse economic impact on relevant industries. While C. difficile is regularly isolated from horses, many questions remain regarding the impact of asymptomatic carriage as well as optimization of diagnosis, testing and treatment. This review provides an overview of our understanding of equine CDI while also identifying knowledge gaps and the need for a holistic One Health approach to a complicated issue.
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Affiliation(s)
- Natasza Hain‐Saunders
- Biosecurity and One Health Research Centre, Harry Butler Institute Murdoch University Murdoch Western Australia Australia
| | - Daniel R. Knight
- Biosecurity and One Health Research Centre, Harry Butler Institute Murdoch University Murdoch Western Australia Australia
- School of Biomedical Sciences, The University of Western Australia, Queen Elizabeth II Medical Centre Nedlands 6009 WA Australia
| | - Mieghan Bruce
- School of Veterinary Medicine, Centre for Biosecurity and One Health Murdoch University Murdoch Western Australia Australia
| | - Thomas V. Riley
- Biosecurity and One Health Research Centre, Harry Butler Institute Murdoch University Murdoch Western Australia Australia
- School of Biomedical Sciences, The University of Western Australia, Queen Elizabeth II Medical Centre Nedlands 6009 WA Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia Australia
- Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre Nedlands Western Australia Australia
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3
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Shaughnessy MK, Snider T, Sepulveda R, Boxrud D, Cebelinski E, Jawahir S, Holzbauer S, Johnston BD, Smith K, Bender JB, Thuras P, Diez-Gonzalez F, Johnson JR. Prevalence and Molecular Characteristics of Clostridium difficile in Retail Meats, Food-Producing and Companion Animals, and Humans in Minnesota. J Food Prot 2018; 81:1635-1642. [PMID: 30198756 DOI: 10.4315/0362-028x.jfp-18-104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Community-associated Clostridium difficile infection (CA-CDI) now accounts for approximately 50% of CDI cases in central Minnesota; animals and meat products are potential sources. From November 2011 to July 2013, we cultured retail meat products and fecal samples from food-producing and companion animals in central Minnesota for C. difficile by using standard methods. The resulting 51 C. difficile isolates, plus 30 archived local veterinary C. difficile isolates and 208 human CA-CDI case isolates from central Minnesota (from 2012) from the Minnesota Department of Health, were characterized molecularly, and source groups were compared using discriminant analysis. C. difficile was recovered from 0 (0%) of 342 retail meat samples and 51 (9%) of 559 animal fecal samples. Overall, the 81 animal source isolates and 208 human source isolates were highly diverse genetically. Molecular traits segregated extensively in relation to animal versus human origin. Discriminant analysis classified 95% of isolates correctly by source group; only five (2.5%) human source isolates were classified as animal source. These data do not support meat products or food-producing and companion animals as important sources of CA-CDI in the central Minnesota study region.
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Affiliation(s)
- Megan K Shaughnessy
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | - Tim Snider
- 2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | | | - David Boxrud
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Elizabeth Cebelinski
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Selina Jawahir
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Stacy Holzbauer
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975.,5 Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30329-4027, USA
| | - Brian D Johnston
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | - Kirk Smith
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Jeff B Bender
- 3 University of Minnesota, St. Paul, Minnesota 55108
| | - Paul Thuras
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | | | - James R Johnson
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
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4
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Kovač M, Huskamp B, Scheidemann W, Toth J, Tambur Z. Survival and Evaluation of Clinical and Laboratory Variables as Prognostic Indicators in Horses Hospitilized with Acute Diarrhea: 342 Cases (1995-2015). ACTA VET-BEOGRAD 2017. [DOI: 10.1515/acve-2017-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
A retrospective study was performed on 342 horses with acute diarrhea (equine colitis). Clinical and laboratory data were obtained upon arrival at the equine hospital. The main focus of this study was to find the difference between the clinical and laboratory variables of surviving and deceased acute colitis horses before the beginning of medical treatment, with the aim to provide a better guideline for determining the prognosis of survival. According to this retrospective study the lethality rate of acute equine colitis was 41.93 %. The time interval from the onset of acute diarrhea to the horse being taken to the clinic was significantly longer in the case of horses which had not survived. The heart rate, hematocrit, blood pH, blood hydrogen carbonate concentration, base excess and HCT/TPP ratio were shown to be significantly related to the survival of horses with colitis. Thus, the hematocrit, appeared to be the most relevant predictor of the outcome of acute equine colitis. Body temperature, respiration rate, total plasma protein and white blood cell count, did not show any prognostic significance.
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Affiliation(s)
- Milomir Kovač
- Veterinary Clinic – New Century, Skryabin Moscow State Veterinary Academy; Moskow, Krasnogorsky district, Nikolo-Uryupino , 143421, Russian Federation
| | | | | | - Joseph Toth
- Veterinary Clinic – Gescher-Hochmoor, Gescher , Germany
| | - Zoran Tambur
- Instittute of Hygiene, Military Medical Academy, Belgrade, Serbia and Faculty of Stomatology in Pančevo, Pančevo , Serbia
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5
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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]
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6
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Robinson C, Timofte D, Singer E, Rimmington L, Rubio-Martínez L. Prevalence and antimicrobial susceptibility of bacterial isolates from horses with synovial sepsis: A cross-sectional study of 95 cases. Vet J 2016; 216:117-21. [DOI: 10.1016/j.tvjl.2016.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 07/01/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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Abstract
The gastrointestinal system of horses is affected by a large variety of inflammatory infectious and noninfectious conditions. The most prevalent form of gastritis is associated with ulceration of the pars esophagea. Although the diagnostic techniques for alimentary diseases of horses have improved significantly over the past few years, difficulties still exist in establishing the causes of a significant number of enteric diseases in this species. This problem is compounded by several agents of enteric disease also being found in the intestine of clinically normal horses, which questions the validity of the mere detection of these agents in the intestine.
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Affiliation(s)
- Francisco A Uzal
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California Davis, 105 West Central Avenue, San Bernardino, CA 92409, USA.
| | - Santiago S Diab
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA
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Abstract
The view of Clostridium difficile infection as a hospital-acquired infection transmitted only by symptomatic patients is changing. Although C difficile is present in food for human consumption, food-borne infection caused by C difficile has never been confirmed. More information on the infective dose and the level of contamination is needed to determine the risk for food-borne exposure to C difficile in humans. The emergence of C difficile polymerase chain reaction (PCR) ribotype 078 in humans is epidemiologically linked to its presence in piglets and calves and their environment, suggesting zoonotic transmission.
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Affiliation(s)
- Martijn P Bauer
- Department of Infectious Diseases, Center for Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands
| | - Ed J Kuijper
- Department of Medical Microbiology, Center for Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
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9
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Gerding DN, Johnson S, Rupnik M, Aktories K. Clostridium difficile binary toxin CDT: mechanism, epidemiology, and potential clinical importance. Gut Microbes 2014; 5:15-27. [PMID: 24253566 PMCID: PMC4049931 DOI: 10.4161/gmic.26854] [Citation(s) in RCA: 295] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Binary toxin (CDT) is frequently observed in Clostridium difficile strains associated with increased severity of C. difficile infection (CDI). CDT belongs to the family of binary ADP-ribosylating toxins consisting of two separate toxin components: CDTa, the enzymatic ADP-ribosyltransferase which modifies actin, and CDTb which binds to host cells and translocates CDTa into the cytosol. CDTb is activated by serine proteases and binds to lipolysis stimulated lipoprotein receptor. ADP-ribosylation induces depolymerization of the actin cytoskeleton. Toxin-induced actin depolymerization also produces microtubule-based membrane protrusions which form a network on epithelial cells and increase bacterial adherence. Multiple clinical studies indicate an association between binary toxin genes in C. difficile and increased 30-d CDI mortality independent of PCR ribotype. Further studies including measures of binary toxin in stool, analyses of CDI mortality caused by CDT-producing strains, and examination of the relationship of CDT expression to TcdA and TcdB toxin variants and PCR ribotypes are needed.
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Affiliation(s)
- Dale N Gerding
- Loyola University Chicago Stritch School of Medicine; Hines Veterans Affairs Hospital; Hines, IL USA,Correspondence to: Dale N Gerding,
| | - Stuart Johnson
- Loyola University Chicago Stritch School of Medicine; Hines Veterans Affairs Hospital; Hines, IL USA
| | - Maja Rupnik
- Institute of Public Health Maribor; University of Maribor, Medical Faculty, and Centre of Excellence for Integrated Approaches in Chemistry and Biology of Proteins; Ljubljana, Slovenia
| | - Klaus Aktories
- Institute of Experimental and Clinical Pharmacology and Toxicology; Albert-Ludwigs-University Freiburg; Freiburg, Germany
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10
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11
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Niwa H, Kato H, Hobo S, Kinoshita Y, Ueno T, Katayama Y, Hariu K, Oku K, Senoh M, Kuroda T, Nakai K. Postoperative Clostridium difficile infection with PCR ribotype 078 strain identified at necropsy in five Thoroughbred racehorses. Vet Rec 2013; 173:607. [PMID: 24336792 DOI: 10.1136/vr.101960] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Clostridium difficile is an important cause of acute enterocolitis in horses. We describe five cases of C difficile infection occurring postoperatively in Thoroughbred racehorses. Following diarrhoea or colic accompanied by a marked increase in packed cell volume (to ≥60 per cent) and leucopenia (≤4000 cells/μl) within two to four days after surgery in all five horses, four of them died or were euthanased because of colitis or severe diarrhoea. In these four horses, necrotising entero-typhlo-colitis was revealed by postmortem examination, and C difficile was recovered from the contents of the small and/or large intestine. The remaining horse was euthanased because of marked decline in general condition and the presence of a lung abscess, from which C difficile was isolated. The horse had had severe postoperative diarrhoea before the onset of respiratory disorder; laboratory tests for C difficile were not performed on the faeces. All C difficile isolates were toxin-A-positive, toxin-B-positive and actin-specific ADP-ribosyltransferase (CDT)-positive. The isolates were indistinguishable by pulsed field gel electrophoresis analysis, PCR ribotyping, and slpA sequence typing, and the slpA sequences and PCR ribotype patterns were identical to those of known PCR type 078. This case sequence might have been healthcare-associated infection, although there was about a four-month interval between each disease onset.
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Affiliation(s)
- H Niwa
- Microbiology Division, Epizootic Research Center, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi 329-0412, Japan
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12
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Diab S, Songer G, Uzal F. Clostridium difficile infection in horses: A review. Vet Microbiol 2013; 167:42-9. [DOI: 10.1016/j.vetmic.2013.03.032] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 03/05/2013] [Accepted: 03/27/2013] [Indexed: 11/26/2022]
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13
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Silva ROS, Ribeiro MG, Palhares MS, Borges AS, Maranhão RPA, Silva MX, Lucas TM, Olivo G, Lobato FCF. Detection of A/B toxin and isolation of Clostridium difficile and Clostridium perfringens from foals. Equine Vet J 2013; 45:671-5. [PMID: 23452044 DOI: 10.1111/evj.12046] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 12/29/2012] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING THE STUDY Toxin detection and screening could contribute to knowledge of the transmission patterns, risk factors and epidemiology of Clostridium difficile and Clostridium perfringens. OBJECTIVE To isolate C. difficile and C. perfringens and to detect A/B toxins in faecal samples from diarrhoeic and nondiarrhoeic foals. STUDY DESIGN Cross-sectional observational study. METHODS A total of 153 samples from foals were collected: 139 samples from farms and 14 samples from diarrhoeic foals admitted to a veterinary hospital. The A/B toxins were detected by cytotoxicity assay. All suspected colonies of C. perfringens were subjected to polymerase chain reaction for detection of the major toxin genes (α, β, ε and ι) and for detection of β2-, NetB- and enterotoxin-encoding genes. Furthermore, C. difficile and C. perfringens isolates were evaluated for in vitro antimicrobial susceptibility. RESULTS Seven of 153 (4.6%) samples, all from diarrhoeic foals, were positive for C. difficile A/B toxin. Of these, 5 of 14 (35.7%) were from hospitalised foals, and only 2 of 63 (3.2%) diarrhoeic foal samples were from farms (P = 0.002). Clostridium perfringens was isolated from 31 (20.3%) foals, of which 21 of 76 (27.6%) were diarrhoeic and 10 of 76 (13.2%) were nondiarrhoeic, demonstrating a difference between these 2 groups (P = 0.045). Only 4 strains were positive for the β2-encoding gene (cpb2). All C. difficile and C. perfringens isolates were susceptible to metronidazole and vancomycin. CONCLUSIONS The present report highlights the need for laboratory diagnostics to differentiate C. difficile-associated infection in foals from other causes of diarrhoea to facilitate adequate antimicrobial therapy. POTENTIAL RELEVANCE More studies are needed to clarify the role of C. perfringens as a primary agent of diarrhoea in foals.
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Affiliation(s)
- R O S Silva
- Veterinary School, Universidade Federal de Minas Gerais (UFMG), Brazil
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14
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Clostridium difficile in foods and animals: history and measures to reduce exposure. Anim Health Res Rev 2013; 14:11-29. [PMID: 23324529 DOI: 10.1017/s1466252312000229] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Many articles have summarized the changing epidemiology of Clostridium difficile infections (CDI) in humans, but the emerging presence of C. difficile in foods and animals and possible measures to reduce human exposure to this important pathogen have been infrequently addressed. CDIs have traditionally been assumed to be restricted to health-care settings. However, recent molecular studies indicate that this is no longer the case; animals and foods might be involved in the changing epidemiology of CDIs in humans; and genome sequencing is disproving person-to-person transmission in hospitals. Although zoonotic and foodborne transmission have not been confirmed, it is evident that susceptible people can be inadvertently exposed to C. difficile from foods, animals, or their environment. Strains of epidemic clones present in humans are common in companion and food animals, raw meats, poultry products, vegetables, and ready-to-eat foods, including salads. In order to develop science-based prevention strategies, it is critical to understand how C. difficile reaches foods and humans. This review contextualizes the current understanding of CDIs in humans, animals, and foods. Based on available information, we propose a list of educational measures that could reduce the exposure of susceptible people to C. difficile. Enhanced educational efforts and behavior change targeting medical and non-medical personnel are needed.
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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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16
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Schoster A, Staempfli HR, Arroyo LG, Reid-Smith RJ, Janecko N, Shewen PE, Weese JS. Longitudinal study of Clostridium difficile and antimicrobial susceptibility of Escherichia coli in healthy horses in a community setting. Vet Microbiol 2012; 159:364-70. [PMID: 22554764 DOI: 10.1016/j.vetmic.2012.04.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 10/28/2022]
Abstract
Point prevalence studies have reported carriage rates of enteric pathogens in healthy horses, but longitudinal data are lacking. Commensal E. coli is an indicator organism to evaluate antimicrobial resistance of enteric bacteria, yet there are limited data for horses. The objectives of this study were to investigate and molecularly characterize isolates of Clostridium difficile, Clostridium perfringens and Salmonella, collected sequentially over a one year period, and to determine the antibiotic susceptibility profile for E. coli. Fecal samples were collected monthly from 25 adult horses for one year. Selective cultures were performed for all above bacteria. C. difficile isolates were characterized via PCR toxin gene profiling and ribotyping. Broth microdilution was performed to assess antimicrobial susceptibility profiles of E. coli. Toxigenic Clostridium difficile was isolated from 15/275 (5.45%) samples from 10/25 (40%) horses. Four horses were positive at multiple sampling times but different ribotypes were found in three. Ribotypes included 078 (n=6), 001 (n=6) and C (n=3). C. perfringens was not isolated, nor was Salmonella. E. coli was isolated from 232/300 (77%) fecal samples. Resistance to ≥ 1 and ≥ 3 antimicrobials was present in 31/232 (13.4%) and 6/232 (2.6%) respectively. Only two horses shed the same strain of toxigenic C. difficile for more than one month, indicating that shedding is transient. The high number of ribotype 078 is consistent with recent emergence of this strain in the local horse population. The low prevalence of antibiotic resistance in commensal E. coli suggests that healthy horses are not likely a major reservoir of resistance for enteric bacteria.
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Affiliation(s)
- A Schoster
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, N1G2W1 ON, Canada.
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17
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Squire MM, Riley TV. Clostridium difficile infection in humans and piglets: a 'One Health' opportunity. Curr Top Microbiol Immunol 2012; 365:299-314. [PMID: 22695920 DOI: 10.1007/82_2012_237] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Clostridium difficile causes infectious diarrhoea in humans and animals. It has been found in both diarrhoeal and non-diarrhoeal pigs, horses and cattle, suggesting a potential reservoir for human insection, and in 20-40 % of meat products in Canada and the USA, suggesting the possibility, albeit not proven, of food-borne transmission. Although it is not yet completely clear, it is likely that excessive antimicrobial exposure is driving the establishment of C. difficile in animals, in a manner analogous to human infection, rather than the organism just being normal flora of the animal gastrointestinal tract. PCR ribotype 078 is the most common ribotype of C. difficile found in pigs (83 % in one study in the USA) and cattle (up to 100 %) and this ribotype is now the third most common ribotype of C. difficile found in human infection in Europe. Human and pig strains of C. difficile are genetically identical in Europe confirming that a zoonosis exists. Rates of community-acquired C. difficile infection (CDI) are increasing world wide, a fact that sits well with the notion that animals are a reservoir for human infection. Thus, there are three problems that require resolution: a human health issue, an animal health issue and the factor common to both these problems, environmental contamination. To successfully deal with these recent changes in the epidemiology of CDI will require a 'one health' approach involving human health physicians, veterinarians and environmental scientists.
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Affiliation(s)
- Michele M Squire
- Microbiology and Immunology, School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, Australia,
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18
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Clostridium difficile Infection in Humans and Piglets: A ‘One Health’ Opportunity. Curr Top Microbiol Immunol 2012. [DOI: 10.1007/978-3-662-45792-4_237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Medina-Torres CE, Weese JS, Staempfli HR. Prevalence of Clostridium difficile in horses. Vet Microbiol 2011; 152:212-5. [PMID: 21570780 DOI: 10.1016/j.vetmic.2011.04.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 04/08/2011] [Accepted: 04/14/2011] [Indexed: 11/19/2022]
Abstract
Fecal samples were collected to establish the apparent prevalence of Clostridium difficile shedding in Standardbred and Thoroughbred racehorses housed at 4 racetracks and 2 breeding facilities, and in horses admitted to a referral large animal clinic. Forty-one (7.59%) of 540 racetrack horses, seven (5.83%) of 120 breeding farm horses, and four (4.88%) out of 82 horses admitted to the referral clinic were culture-positive for C. difficile. An overall fecal culture prevalence of 7.01% for C. difficile was identified in 742 fecal samples. PCR-ribotyping and toxin gene identification was performed and seventeen 17 PCR-ribotypes were identified among the 52 C. difficile isolates.
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Affiliation(s)
- Carlos E Medina-Torres
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
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Thean S, Elliott B, Riley TV. Clostridium difficile in horses in Australia--a preliminary study. J Med Microbiol 2011; 60:1188-1192. [PMID: 21436371 DOI: 10.1099/jmm.0.030908-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
During a 24 month period from 2007 to 2009, 174 faecal specimens from horses in Australia (predominantly from Western Australia) were tested for Clostridium difficile. C. difficile was isolated from 14 (23 %) of 62 diarrhoeal animals (including 10 foals) and from none of 112 healthy adult horses. These isolates were toxin profiled by PCR for toxin A, toxin B and binary toxin, and ribotyped. Ten of the equine isolates were A(+)B(+)CDT(-). Other toxin profiles detected were A(-)B(-)CDT(+) (one isolate), A(+)B(+)CDT(+) (two isolates) and A(-)B(-)CDT(-) (three isolates). There were six different ribotypes detected in the horses, ribotype 012 being the most common with six isolates. Two horses (one adult and one foal) had two strains of C. difficile isolated on different days. These strains had the same toxin profile but different ribotypes. None of the equine isolates was ribotype 078, which is A(+)B(+)CDT(+) and a significant cause of animal disease overseas. All isolates were susceptible to metronidazole and vancomycin. These results suggest that the epidemiology of C. difficile in horses in Australia is currently similar to that in other parts of the world, but requires further surveillance to monitor changes.
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Affiliation(s)
- Sara Thean
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Nedlands 6009, Western Australia, Australia
| | - Briony Elliott
- Microbiology and Immunology, University of Western Australia, Nedlands 6009, Western Australia, Australia
| | - Thomas V Riley
- Microbiology and Immunology, University of Western Australia, Nedlands 6009, Western Australia, Australia.,Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Nedlands 6009, Western Australia, Australia
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Freeman J, Bauer MP, Baines SD, Corver J, Fawley WN, Goorhuis B, Kuijper EJ, Wilcox MH. The changing epidemiology of Clostridium difficile infections. Clin Microbiol Rev 2010; 33 Suppl 1:S42-5. [PMID: 20610822 DOI: 10.1016/s0924-8579(09)70016-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The epidemiology of Clostridium difficile infection (CDI) has changed dramatically during this millennium. Infection rates have increased markedly in most countries with detailed surveillance data. There have been clear changes in the clinical presentation, response to treatment, and outcome of CDI. These changes have been driven to a major degree by the emergence and epidemic spread of a novel strain, known as PCR ribotype 027 (sometimes referred to as BI/NAP1/027). We review the evidence for the changing epidemiology, clinical virulence and outcome of treatment of CDI, and the similarities and differences between data from various countries and continents. Community-acquired CDI has also emerged, although the evidence for this as a distinct new entity is less clear. There are new data on the etiology of and potential risk factors for CDI; controversial issues include specific antimicrobial agents, gastric acid suppressants, potential animal and food sources of C. difficile, and the effect of the use of alcohol-based hand hygiene agents.
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Affiliation(s)
- J Freeman
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom
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Freeman J, Bauer MP, Baines SD, Corver J, Fawley WN, Goorhuis B, Kuijper EJ, Wilcox MH. The changing epidemiology of Clostridium difficile infections. Clin Microbiol Rev 2010; 23:529-49. [PMID: 20610822 PMCID: PMC2901659 DOI: 10.1128/cmr.00082-09] [Citation(s) in RCA: 619] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The epidemiology of Clostridium difficile infection (CDI) has changed dramatically during this millennium. Infection rates have increased markedly in most countries with detailed surveillance data. There have been clear changes in the clinical presentation, response to treatment, and outcome of CDI. These changes have been driven to a major degree by the emergence and epidemic spread of a novel strain, known as PCR ribotype 027 (sometimes referred to as BI/NAP1/027). We review the evidence for the changing epidemiology, clinical virulence and outcome of treatment of CDI, and the similarities and differences between data from various countries and continents. Community-acquired CDI has also emerged, although the evidence for this as a distinct new entity is less clear. There are new data on the etiology of and potential risk factors for CDI; controversial issues include specific antimicrobial agents, gastric acid suppressants, potential animal and food sources of C. difficile, and the effect of the use of alcohol-based hand hygiene agents.
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Affiliation(s)
- J. Freeman
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - M. P. Bauer
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - S. D. Baines
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - J. Corver
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - W. N. Fawley
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - B. Goorhuis
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - E. J. Kuijper
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - M. H. Wilcox
- Department of Microbiology, Old Medical School, Leeds Teaching Hospitals and University of Leeds, Leeds, United Kingdom, Departments of Medical Microbiology and Infectious Diseases, Centre for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
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Clostridium difficile PCR ribotype 027: assessing the risks of further worldwide spread. THE LANCET. INFECTIOUS DISEASES 2010; 10:395-404. [PMID: 20510280 PMCID: PMC7185771 DOI: 10.1016/s1473-3099(10)70080-3] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Highly virulent strains of Clostridium difficile have emerged since 2003, causing large outbreaks of severe, often fatal, colitis in North America and Europe. In 2008–10, virulent strains spread between continents, with the first reported cases of fluoroquinolone-resistant C difficile PCR ribotype 027 in three Asia-Pacific countries and Central America. We present a risk assessment framework for assessing risks of further worldwide spread of this pathogen. This framework first requires identification of potential vehicles of introduction, including international transfers of hospital patients, international tourism and migration, and trade in livestock, associated commodities, and foodstuffs. It then calls for assessment of the risks of pathogen release, of exposure of individuals if release happens, and of resulting outbreaks. Health departments in countries unaffected by outbreaks should assess the risk of introduction or reintroduction of C difficile PCR ribotype 027 using a structured risk-assessment approach.
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