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

Rahimi, Ebrahim; Momtaz, Hassan; Hemmati, Maryam

doi:10.9775/kvfd.2013.10175

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…From 1,939 studies identified, 79 fulfilled the inclusion criteria for meta-analysis, involving >231 authors and 25 countries over the past 37 years. The list of studies in chronological order from North America (10,16,17,, Europe (21,, Asia (80)(81)(82)(83)(84)(85)(86)(87)(88)(89)(90)(91)(92)(93)(94)(95)(96), Africa (97)(98)(99)(100)(101)(102), Oceania (18, 103) (Australia/New Zealand) and Latin American (104,105) is presented in Table 1 (10, 16-18, 21, 30-32, 34-61, 63-78, 80-93, 96-110). The majority of studies, 92.4% (73 of 79 studies) since 2007, encompass 96.4% of all food samples tested (over the last 12 years) making this analysis current and relevant to the modern concerns of food transmission of CD via the food supply.…”

Section: Global Distribution Of Studies Reporting C Difficile In Foomentioning

confidence: 99%

Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981–2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic

Rodriguez-Palacios

Shah

et al. 2020

Front. Med.

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Clostridioides difficile (CD) is a spore-forming bacterium that causes life-threatening intestinal infections in humans. Although formerly regarded as exclusively nosocomial, there is increasing genomic evidence that person-to-person transmission accounts for only <25% of cases, supporting the culture-based hypothesis that foods may be routine sources of CD-spore ingestion in humans. To synthesize the evidence on the risk of CD exposure via foods, we conducted a systematic review and meta-analysis of studies reporting the culture prevalence of CD in foods between January 1981 and November 2019. Meta-analyses, risk-ratio estimates, and meta-regression were used to estimate weighed-prevalence across studies and food types to identify laboratory and geographical sources of heterogeneity. In total, 21886 food samples were tested for CD between 1981 and 2019 (96.4%, n = 21084, 2007-2019; 232 food-sample-sets; 79 studies; 25 countries). Culture methodology, sample size and type, region, and latitude were sources of heterogeneity (p < 0.05). Although non-strictly-anaerobic methods were reported in some studies, and we confirmed experimentally that improper anaerobiosis of media/sample-handling affects CD recovery in agar (Fisher, p < 0.01), most studies (>72%) employed the same (one-of-six) culture strategy. Because the prevalence was also meta-analytically similar across six culture strategies reported, all studies were integrated using three meta-analytical methods. At the study level (n = 79), the four-decade global cumulative-prevalence of CD in the human diet was 4.1% (95%CI = −3.71, 11.91). At the food-set level (n = 232, mean 12.9 g/sample, similar across regions p > 0.2; 95%CI = 9.7-16.2), the weighted prevalence ranged between Rodriguez-Palacios et al. Clostridium difficile in Human Diet 4.5% (95%CI = 3-6%; all studies) and 8% (95%CI = 7-8%; only CD-positive-studies). Risk-ratio ranking and meta-regression showed that milk was the least likely source of CD, while seafood, leafy green vegetables, pork, and poultry carried higher risks (p < 0.05). Across regions, the risk of CD in foods for foodborne exposure reproducibly decreased with Earth latitude (p < 0.001). In conclusion, CD in the human diet is a global non-random-source of foodborne exposure that occurs independently of laboratory culture methods, across regions, and at a variable level depending on food type and latitude. The latitudinal trend (high CD-food-prevalence toward tropic) is unexpectedly inverse to the epidemiological observations of CD-infections in humans (frequent in temperate regions). Findings suggest the plausible hypothesis that ecologically-richer microbiomes in the tropic might protect against intestinal CD colonization/infections despite CD ingestion.

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Section: Global Distribution Of Studies Reporting C Difficile In Foomentioning

confidence: 99%

Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981–2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic

Rodriguez-Palacios

Shah

et al. 2020

Front. Med.

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“…https://doi.org/10.1101/19012450 doi: medRxiv preprint . Contextualization of food items tested in America, 6,18,19,34,35, , Europe, 23, Asia, [89][90][91][92][93][94][95][96][97][98][99][100][101][102][103] Africa, [104][105][106][107][108][109] and Oceania, 20,110,111 . For a historic narrative see is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Discussionmentioning

confidence: 99%

Global and Historical Distribution ofClostridioides difficilein the Human Diet (1981-2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Towards the Tropic

Rodriguez-Palacios

Shah

et al. 2019

Preprint

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Clostridioides difficile (CD) is a spore-forming bacterium that causes life-threatening intestinal infections in humans. Although formerly regarded as exclusively nosocomial, there is increasing genomic evidence that person-to-person transmission accounts for only <25% of cases, supporting the culture-based hypothesis that foods may be routine sources of CD-spore ingestion in humans. To synthesize the evidence on the risk of CD exposure via foods, we conducted a systematic review and meta-analysis of studies reporting the culture prevalence of CD in foods between January 1981 and November 2019. Meta-analyses, risk-ratio estimates, and meta-regression were used to estimate weighed-prevalence across studies and food types to identify laboratory and geographical sources of heterogeneity. In total, 21,886 food samples were tested for CD between 1981 and 2019 (232 food-sample-sets; 79 studies; 25 countries). Culture methodology, sample size and type, region, and latitude were significant sources of heterogeneity (p<0.05). Although non-strictly-anaerobic methods were reported in some studies, and we confirmed experimentally that improper anaerobiosis of media/sample-handling affects CD recovery in agar (Fisher, p<0.01), most studies (>72%) employed the same (one-of-six) culture strategy. Because the prevalence was also meta-analytically similar across six culture strategies reported, all studies were integrated using three meta-analytical methods. At the study level (n=79), the four-decade global cumulative-prevalence of CD in the human diet was 4.1% (95%CI=-3.71, 11.91). At the food-set level (n=232), the weighted prevalence ranged between 4.5% (95%CI=3-6%; all studies) and 8% (95%CI=7-8%; only CD-positive-studies). Risk-ratio ranking and meta-regression showed that milk was the least likely source of CD, while seafood, leafy green vegetables, pork, and poultry carried higher risks (p<0.05). Across regions, the risk of CD in foods for foodborne exposure reproducibly decreased with Earth latitude (p<0.001). In conclusion, CD in the human diet is a global nonrandom-source of foodborne exposure that occurs independently of laboratory culture methods, across regions, and at variable level depending on food type and latitude. The latitudinal trend (high CD-food-prevalence towards tropic) is inverse to the epidemiological observations of CD-infections (frequent in temperate regions). Findings suggests the plausible hypothesis that ecologically-richer microbiomes in the tropic might protect against intestinal CD colonization/infections despite CD ingestion.

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“…Te presence of both 027 and 078 ribotypes has been described in C. difcile strains isolated from human clinical infections [63,64]. Te presence of both 027 and 078 ribotypes has also been reported in C. difcile strains isolated from a wide range of foods, particularly meat [38,39,43,[65][66][67][68], milk [69], vegetable [70,71], and ready-to-eat food [72,73] samples. Ribotype 078 was also detected in C. difcile isolates from raw meat in the Netherlands [25].…”

Section: Distribution Of Toxigenic Genes Tablementioning

confidence: 93%

Clostridioides difficile in Foods with Animal Origins; Prevalence, Toxigenic Genes, Ribotyping Profile, and Antimicrobial Resistance

Bacheno

Ahmadi

Fazeli

et al. 2022

Journal of Food Quality

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Clostridioides difficile is an important nosocomial pathogen and is considered as a reason of diarrhea and gastrointestinal infections. As a majority of community-originated C. difficile cases are not related to antibiotic prescription and hospitalization, the food portion as a vector of infection transmission has been raised. An existing survey was aimed evaluating the prevalence, antimicrobial resistance, profile of toxigenic genes, and ribotypes of C. difficile isolated from raw meat and carcass surface swab samples. In total, 485 raw meat and carcass surface swab samples were collected. C. difficile was isolated via culture and a diverse biochemical examination. The assessment of minimum inhibitory concentration (MIC) was addressed to evaluate the antibiotic resistance of isolates. Toxin genes detection and ribotyping were used for isolates characterization. The prevalence of C. difficile contamination in all examined samples was 3.71%. The bacterium was detected in 2.91% of raw meat and 4.48% of carcass surface swab samples. Raw sheep meat (5%) and sheep carcass swab (7.50%) samples harbored the highest C. difficile prevalence. The highest rate of antibiotic resistance was observed toward clindamycin (38.88%), ciprofloxacin (38.88%), metronidazole (44.44%), erythromycin (72.22%), and tetracycline (77.77%). C. difficile bacteria showed the minimum rate of resistance meropenem (16.66%) and chloramphenicol (16.66%). TcdA, tcdB, cdtA, and cdtB toxigenic genes were detected in 22.22%, 44.44%, and 16.66% of isolates, respectively. TcdB + tcdA (27.77%) were the most prevalent combined toxigenic gene profile. Both 027 and 078 ribotypes were identified in C. difficile isolates. The role of raw meat and carcass surface swab samples as toxigenic and antibiotic-resistant C. difficile strains vectors was signified. This study authorizes that food animals, particularly sheep and cattle, are C. difficile carriers at slaughter stages and ribotypes are equal in human cases. Subsequently, contamination of carcasses occurs inside the slaughterhouse.

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

Cited by 4 publications

References 24 publications

Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981–2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic

Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981–2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic

Global and Historical Distribution ofClostridioides difficilein the Human Diet (1981-2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Towards the Tropic

Clostridioides difficile in Foods with Animal Origins; Prevalence, Toxigenic Genes, Ribotyping Profile, and Antimicrobial Resistance

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