<i>Clostridium difficile</i>
            PCR Ribotype 078: an Emerging Strain in Humans and in Pigs?

Goorhuis, Abraham; Debast, Sylvia B.; Leengoed, L.A.M.G. van; Harmanus, Céline; Notermans, Daan W.; Bergwerff, Aldert A.; Kuijper, Ed J.

doi:10.1128/jcm.01536-07

Cited by 114 publications

(89 citation statements)

References 3 publications

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“…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] . Food animals are an important source of human enteropathogenic micro-organisms and can be spread to humans through consumption of foods of animal origin.…”

Section: Introductionsupporting

confidence: 75%

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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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Section: Introductionsupporting

confidence: 75%

“…Similar results were reported in other studies [7,23] . Ribotype 078 has been associated with hypervirulent properties [13] , a toxin regulatory gene, and which is RAHIMI, MOMTAZ HEMMATI Occurrence of Clostridium difficile ...…”

Section: Discussionmentioning

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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“…However, several studies have failed to demonstrate an association between NAP1 / BI / 027 strains and severe disease ( 217 -220 ). Moreover, non-027 ribotype strains have been associated with severe clinical outcomes in at least two studies ( 221,222 ).…”

Section: Appendixmentioning

confidence: 99%

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

Surawicz

Brandt

Binion

et al. 2013

American Journal of Gastroenterology

1,477

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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“…Weese et al (2002) reported a risk of zoonotic transmission of some animal diseases, including C. difficile, especially in small veterinary hospitals. Goorhuis et al (2008) described PCR-ribotype 078 as frequently encountered in human CDI and in pigs with diarrhoea in The Netherlands. A further study reported that this ribotype was the most prevalent type in pig, cattle and horse species worldwide, and also reported an increase in its prevalence in humans in different countries .…”

mentioning

confidence: 99%

Clostridium difficile in Food and Animals: A Comprehensive Review

Rodríguez

Taminiau

Broeck

et al. 2016

Advances in Experimental Medicine and Biology

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Zoonoses are infections or diseases that can be transmitted between animals and humans through direct contact, close proximity or the environment. Clostridium difficile is ubiquitous in the environment, and the bacterium is able to colonise the intestinal tract of both animals and humans. Since domestic and food animals frequently test positive for toxigenic C. difficile, even without showing any signs of disease, it seems plausible that C. difficile could be zoonotic. Therefore, animals could play an essential role as carriers of the bacterium. In addition, the presence of the spores in different meats, fish, fruits and vegetables suggests a risk of foodborne transmission. This review summarises the current available data on C. difficile in animals and foods, from when the bacterium was first described up to the present.

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Clostridium difficile PCR Ribotype 078: an Emerging Strain in Humans and in Pigs?

Cited by 114 publications

References 3 publications

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

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

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

Clostridium difficile in Food and Animals: A Comprehensive Review

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