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

Abstract

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.

Foodborne Clostridioides Species: Pathogenicity, Virulence and Biocontrol Options

“…Ribotype 078 has been detected in up to 100% of piglets and 56% of young cattle, with varying distribution globally [70]. The studies of Bacheno et al, (2022) report the presence of MDR C. difficile (having resistance to metronidazole, ciprofloxacin, and clindamycin amongst others) including ribotypes 027 and 078 on surface swabs of meat and carcasses where strains also possessed two toxigenic genes, imparting increased virulence and high pathogenicity [71]. The presence of C. difficile in meat and RTE food items is a public health risk, as mild cooking is not sufficient to destroy C. difficile spores [30].…”

“…The onset of C. difficile infection is associated with antibiotic therapy, with clindamycin, moxifloxacin, and tetracycline often associated with disease recurrence [71]. Currently, metronidazole is no longer considered a first-line antibiotic for adults; vancomycin and fidaxomicin are the therapeutics of choice for C. difficile infection where oral administration of non-absorbable antibiotics that target the GIT is required [16].…”

“…MDR strains of C. difficile are increasing, with approximately 60% of clinical isolates having resistance to three or more antibiotics [5]. Studies have shown that food isolates of C. difficile possess MDR to tetracyclines, macrolides, penems and fluoroquinolones [71]. C. botulinum is not currently treated with antibiotic therapy due to the potential for BoNT release post bacterial cell lysis [15].…”