Nationwide Surveillance Study of Clostridium difficile in Australian Neonatal Pigs Shows High Prevalence and Heterogeneity of PCR Ribotypes

Knight, Daniel R.; Squire, Michele M.; Riley, Thomas V.

doi:10.1128/aem.03032-14

Cited by 79 publications

(81 citation statements)

References 35 publications

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“…While there is no conclusive evidence that contaminated food leads to CDI in humans, studies have found that retail vegetables are contaminated with C. difficile strains similar to those affecting humans (31,32). Likewise, the C. difficile ribotypes frequently isolated in the current study, such as 014/020 and 056, are common ribotypes found in piglets and veal calves, respectively, in Australia (33,34). Therefore, the possibility of food being a vehicle of C. difficile transmission cannot be ruled out.…”

Section: Discussionmentioning

confidence: 81%

Comparison of Clostridium difficile Ribotypes Circulating in Australian Hospitals and Communities

et al. 2017

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Clostridium difficile infection (CDI) is becoming less exclusively a health care-associated CDI (HA-CDI). The incidence of community-associated CDI (CA-CDI) has increased over the past few decades. It has been postulated that asymptomatic toxigenic C. difficile (TCD)-colonized patients may play a role in the transfer of C. difficile between the hospital setting and the community. Thus, to investigate the relatedness of C. difficile across the hospital and community settings, we compared the characteristics of symptomatic and asymptomatic host patients and the pathogens from these patients in these two settings over a 3-year period. Two studies were simultaneously conducted; the first study enrolled symptomatic CDI patients from two tertiary care hospitals and the community in two Australian states, while the second study enrolled asymptomatic TCD-colonized patients from the same tertiary care hospitals. A total of 324 patients (96 with HA-CDI, 152 with CA-CDI, and 76 colonized with TCD) were enrolled. The predominant C. difficile ribotypes isolated in the hospital setting corresponded with those isolated in the community, as it was found that for 79% of the C. difficile isolates from hospitals, an isolate with a matching ribotype was isolated in the community, suggesting that transmission between these two settings is occurring. The toxigenic C. difficile strains causing symptomatic infection were similar to those causing asymptomatic infection, and patients exposed to antimicrobials prior to admission were more likely to develop a symptomatic infection (odds ratio, 2.94; 95% confidence interval, 1.20 to 7.14). Our findings suggest that the development of CDI symptoms in a setting without establishment of hospital epidemics with binary toxin-producing C. difficile strains may be driven mainly by host susceptibility and exposure to antimicrobials, rather than by C. difficile strain characteristics.

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Section: Discussionmentioning

confidence: 81%

Comparison of Clostridium difficile Ribotypes Circulating in Australian Hospitals and Communities

et al. 2017

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“…Potential sources of CDI in Australian food production animals C. difficile is commonly found in Australian piglets, with 67% period prevalence in a study of neonatal herds 29 . These rates are higher than that reported in major pork-producing countries [30][31][32] .…”

Section: Under the Microscopementioning

confidence: 99%

Community-acquired Clostridium difficile infection and Australian food animals

2015

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Clostridium difficile is an anaerobic Gram positive spore-forming bacterium, the leading cause of infectious diarrhoea (C. difficile infection; CDI) in hospitalised humans. The assumption that CDI is primarily a hospital-acquired infection is being questioned. Community-acquired CDI (CA-CDI) is increasing1 particularly in groups previously considered at low risk2,3. In Australia, CA-CDI rates doubled during 2011 and increased by 24% between 2011 and 20124. Two potentially high-risk practices in Australian food animal husbandry may present a risk for CA-CDI: slaughtering of neonatal animals for food, and effluent recycling to agriculture.

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“…2 However, meticulous adherence to these interventions is unlikely to remove the risk of CDI entirely due the widespread presence of C. difficile in healthcare settings, the environment, livestock and (occasionally) food. [3][4][5] Therefore, there is an urgent need for effective CDI prevention and treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

New and emerging therapies for Clostridium difficile infection

Martin

Wilcox²

2016

Current Opinion in Infectious Diseases

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(max 200 words)Purpose of review: Clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. Multiple new approaches to the prevention and treatment of CDI are undergoing clinical trials. Recent findings:Bezlotoxumab is a monoclonal antibody against toxin B that has successfully completed phase three studies, demonstrating a significant reduction in recurrent CDI when given with standard of care antibiotics. Antibiotics under development include cadazolid and ridinilazole, while surotomycin has had disappointing phase 3 results. Multiple live biotherapeutics are being developed, including freeze thawed and encapsulated versions of faecal microbiota transplantation to improve the practicality of treating patients with recurrent CDI. Alternatives to faecal microbiota transplantation, that aim to improve safety, including a microbial suspension, RBX2660, and a complex spore formulation, SER-109, have progressed to phase 2 studies. A non-toxigenic C. difficile strain has also shown promise to prevent recurrent CDI. In addition, three C. difficile vaccines have progressed to phase 2/3 clinical trials. Summary:The diverse approaches to treating and preventing CDI offer substantial promise that new treatment options will soon emerge, particular ones that reduce the risk of recurrences.3

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Nationwide Surveillance Study of Clostridium difficile in Australian Neonatal Pigs Shows High Prevalence and Heterogeneity of PCR Ribotypes

Cited by 79 publications

References 35 publications

Comparison of Clostridium difficile Ribotypes Circulating in Australian Hospitals and Communities

Comparison of Clostridium difficile Ribotypes Circulating in Australian Hospitals and Communities

Community-acquired Clostridium difficile infection and Australian food animals

New and emerging therapies for Clostridium difficile infection

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