Clostridium difficile infection in humans and animals, differences and similarities

Keessen, E. C.; Gaastra, Wim; Lipman, L.J.A.

doi:10.1016/j.vetmic.2011.03.020

Cited by 90 publications

(100 citation statements)

References 141 publications

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“…In animals, some strains are species specifi c but others aff ect humans as well. Th e epidemic strain NAP1 / BI / 027 has been isolated from food and from domestic pets; however, there are no documented studies that this route of transmission has caused human illness ( 230,231 ).…”

Section: Conflict Of Interestmentioning

confidence: 99%

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Surawicz

Brandt

Binion

et al. 2013

American Journal of Gastroenterology

1,479

1,408

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Clostridium diffi cile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. Patients with CDI typically have extended lengths-of-stay in hospitals, and CDI is a frequent cause of large hospital outbreaks of disease. This guideline provides recommendations for the diagnosis and management of patients with CDI as well as for the prevention and control of outbreaks while supplementing previously published guidelines. New molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. We suggest treatment of patients be stratifi ed depending on whether they have mild-to-moderate, severe, or complicated disease. Therapy with metronidazole remains the choice for mildto-moderate disease but may not be adequate for patients with severe or complicated disease. We propose a classifi cation of disease severity to guide therapy that is useful for clinicians. We review current treatment options for patients with recurrent CDI and recommendations for the control and prevention of outbreaks of CDI. Am J Gastroenterol 2013; 108:478-498; doi: 10.1038/ajg.2013 12. In patients in whom oral antibiotics cannot reach a segment of the colon, such as with Hartman's pouch, ileostomy, or colon diversion, vancomycin therapy delivered via enema should be added to treatments above until the patient improves. (Conditional recommendation, low-quality evidence)13. The use of anti-peristaltic agents to control diarrhea from confi rmed or suspected CDI should be limited or avoided, as they may obscure symptoms and precipitate complicated disease. Use of anti-peristaltic agents in the setting of CDI must always be accompanied by medical therapy for CDI. (Strong recommendation, low-quality evidence) Management of severe and complicated CDI14. Supportive care should be delivered to all patients and includes intravenous fl uid resuscitation, electrolyte replacement, and pharmacological venous thromboembolism prophylaxis. Furthermore, in the absence of ileus or signifi cant abdominal distention, oral or enteral feeding should be continued. 17. Vancomycin delivered orally (500 mg four times per day) and per rectum (500 mg in a volume of 500 ml four times a day) plus intravenous metronidazole (500 mg three times a day) is the treatment of choice for patients with complicated CDI with ileus or toxic colon and / or signifi cant abdominal distention. (Strong recommendation, low-quality evidence)18. Surgical consult should be obtained in all patients with complicated CDI. Surgical therapy should be considered in patients with any one of the following attributed to CDI: hypotension requiring vasopressor therapy; clinical signs of sepsis and organ dysfunction (renal and pulmonary); mental status changes; white blood cell count ≥ 50,000 cells / μ l, lactate ≥ 5 mmol / l; or failure to improve on medical therapy after 5 days. (Strong recommendation, moderate-quality evidence) Management of recurrent CDI (RCDI)19. The fi rst recurrence of CDI can be treated ...

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Section: Conflict Of Interestmentioning

confidence: 99%

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Surawicz

Brandt

Binion

et al. 2013

American Journal of Gastroenterology

1,479

1,408

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“…C. difficile is widely recognized as a commensal and enteric pathogen in a wide range of host species (178)(179)(180). To date, C. difficile been recovered from numerous animal sources, including livestock (pigs, piglets, cows, calves, sheep, lambs, goats, and chickens), domestic animals (cats and dogs), equines (horses and foals), wildlife (rabbits, wild birds, shrews, raccoons, feral swine, ostriches, Kodiak bears, zebras, kangaroos, elephants, ibex, tamarin monkeys, and chimpanzees), and marine organisms (bivalve molluscs) (103,178,(181)(182)(183)(184)(185)(186)(187)(188)(189)(190)(191)(192)(193)(194)(195)(196).…”

Section: Animal Reservoirs and Zoonotic Potentialmentioning

confidence: 99%

“…To date, C. difficile been recovered from numerous animal sources, including livestock (pigs, piglets, cows, calves, sheep, lambs, goats, and chickens), domestic animals (cats and dogs), equines (horses and foals), wildlife (rabbits, wild birds, shrews, raccoons, feral swine, ostriches, Kodiak bears, zebras, kangaroos, elephants, ibex, tamarin monkeys, and chimpanzees), and marine organisms (bivalve molluscs) (103,178,(181)(182)(183)(184)(185)(186)(187)(188)(189)(190)(191)(192)(193)(194)(195)(196). Many of these studies described differences in prevalence (particularly a decline with age), toxigenic status, antibiotic resistance, clonal lineage, and host susceptibility to disease, as well as differences in veterinary and agricultural practices (178,180). Furthermore, these studies highlight the ability of C. difficile to adapt to a wide range of host immune systems and gastrointestinal environments, again reflecting the diversity seen in the pangenome.…”

Section: Animal Reservoirs and Zoonotic Potentialmentioning

confidence: 99%

Diversity and Evolution in the Genome of Clostridium difficile

et al. 2015

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SUMMARY Clostridium difficile infection (CDI) is the leading cause of antimicrobial and health care-associated diarrhea in humans, presenting a significant burden to global health care systems. In the last 2 decades, PCR- and sequence-based techniques, particularly whole-genome sequencing (WGS), have significantly furthered our knowledge of the genetic diversity, evolution, epidemiology, and pathogenicity of this once enigmatic pathogen. C. difficile is taxonomically distinct from many other well-known clostridia, with a diverse population structure comprising hundreds of strain types spread across at least 6 phylogenetic clades. The C. difficile species is defined by a large diverse pangenome with extreme levels of evolutionary plasticity that has been shaped over long time periods by gene flux and recombination, often between divergent lineages. These evolutionary events are in response to environmental and anthropogenic activities and have led to the rapid emergence and worldwide dissemination of virulent clonal lineages. Moreover, genome analysis of large clinically relevant data sets has improved our understanding of CDI outbreaks, transmission, and recurrence. The epidemiology of CDI has changed dramatically over the last 15 years, and CDI may have a foodborne or zoonotic etiology. The WGS era promises to continue to redefine our view of this significant pathogen.

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“…Contamination of food with this ribotype suggests a possible human health concern. Ribotype 078 has been reported to be the predominant type in food animals such as cattle and pigs [9,24] , and other food sources [3,25] . None of the isolates was resistant to vancomycin, metronidazole, chloramphenicol and tetracycline.…”

Section: Discussionmentioning

confidence: 99%

“…difficile also appears to be an important cause of enteric disease in a wide variety of animal species [7][8][9][10] , suggesting that animals and humans may share a common source [11,12] . In accordance herewith, recent reports show a remarkable overlap between isolates from animals and humans [13] .…”

Section: Introductionmentioning

confidence: 99%

Occurrence of Clostridium difficile in Raw Bovine, Ovine, Caprine, Camel and Buffalo Milk in Iran

Rahimi¹,

Momtaz²,

Hemmati³

2014

Kafkas Univ Vet Fak Derg

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SummaryThis study was conducted to determine the prevalence of Clostridium difficile in raw milk in Iran. From January to August 2013, a total of 430 raw milk samples from bovine (n=135), ovine (n=100), caprine (n=80), buffalo (n=49) and camel (n=66) were purchased from randomly selected from 111 dairy farm in Iran and were evaluated for the presence of C. difficile. In this study, only 2 of 135 bovine milk samples (1.43%) were contaminated with C. difficile. One of the two C. difficile strains was positive for tcdA and tcdB toxin genes that was classified as ribotype 078. Susceptibilities of isolates were determined for 11 antimicrobial drugs using the disk diffusion assay. None of the isolates was resistant to vancomycin, metronidazole, chloramphenicol and tetracycline. To our knowledge, this study is the first report of direct identification of C. difficile in bulk milk samples from dairy herds in Iran and the first report of direct identification of C. difficile in bulk milk samples from dairy bovine herds. Keywords: Clostridium difficile, Raw milk, Camel, Buffalo, Bovine, Antimicrobial resistance İran'da Sığır, Koyun, Keçi, Deve ve Manda Çiğ SütlerindeClostridium difficile'nin Tespiti ÖzetBu çalışma İran'da çiğ sütlerde Clostridium difficile'nin prevalansını belirlemek amacıyla yapılmıştır. Çalışmada, rastgele seçilmiş 111 süt çiftliğinden toplanmış sığır (n=135), koyun (n=100), keçi (n=80), manda (n=49) ve deve (n=66) toplam 430 çiğ süt örneği C. difficile'nin varlığını ortaya koymak maksadıyla incelendi. Çalışmada, sığır süt örneklerinden 135'inden sadece 2'sinde (1.43%) C. difficile kontaminasyonu tespit edildi. İki C. difficile suşundan birisi ribotip 078 olarak sınıflandırılan tcdA ve tcdB toksin genine pozitiflik gösterdi. Disk difüzyon testi kullanılarak 11 antimikrobial ilaca karşı izolatların hassasiyetlikleri belirlendi. İzolatların hiçbiri vankomisin, metronidazol, kloramfenikol ve tetrasikline karşı dayanıklı değildi. Bilgimiz dahilinde, bu çalışma İran'da sütçü sürülerden ve sığırlardan elde edilen ham süt örneklerinde C. difficile'nin direkt olarak tespit edildiği ilk çalışmadır.

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Clostridium difficile infection in humans and animals, differences and similarities

Cited by 90 publications

References 141 publications

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Diversity and Evolution in the Genome of Clostridium difficile

Occurrence of Clostridium difficile in Raw Bovine, Ovine, Caprine, Camel and Buffalo Milk in Iran

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