Clostridioides difficile infection and One Health: an equine perspective

Abstract

Clostridioides (Clostridium) difficile presents a significant health risk to humans and animals. The complexity of the bacterial-host interaction affecting pathogenesis and disease development creates an ongoing challenge for epidemiological studies, control strategies and prevention planning. The recent emergence of human disease caused by strains of C. difficile found in animals adds to mounting evidence that C. difficile infection (CDI) may be a zoonosis. In equine populations, C. difficile is a known cause of diarrhoea and gastrointestinal inflammation, with considerable mortality and morbidity. This has a significant impact on both the well-being of the animal and, in the case of performance and production animals, it may have an adverse economic impact on relevant industries. While C. difficile is regularly isolated from horses, many questions remain regarding the impact of asymptomatic carriage as well as optimization of diagnosis, testing and treatment. This review provides an overview of our understanding of equine CDI while also identifying knowledge gaps and the need for a holistic One Health approach to a complicated issue.

Design and Development of Molecular Beacon-Based Real-Time PCR Assays to Identify Clostridioides difficile Types of Main Evolutionary Clades

“…In general, although the pathological lesions observed in animals with CDI are similar to those described in humans [9], clinical manifestations can vary among the different animal species [4,16]. Among food-producing animals, CDI prevalence has been reported globally in both swine (mean value 43%, range 0-100%) and cattle (mean value 14%, range 0.5-56.4%) [19]. In particular, CDI prevalence and mortality is very high in neonatal piglets with rates that can reach up to 100% and 50%, respectively [4,16,[18][19][20][21].…”

Update on Commonly Used Molecular Typing Methods for Clostridioides difficile

“…In horses, there have been inconsistencies in the reported prevalence and perceived impact of C. difficile , with prevalence ranging from 5% to 90%, although it seems to be higher in foals. At a molecular level, strains not associated with other species as well as those identified in other animals, the environment, and humans have been isolated [ 9 ].…”

“…Several studies have identified C. difficile in a great variety of animal species, including livestock, pets, and wildlife [ 9 , 10 , 11 , 12 , 13 , 14 ]. This fact has raised concerns about potential zoonotic transmission, where animals may serve as reservoirs and a source of infection for humans through direct contact or consumption of contaminated animal products.…”

A local-scale One Health genomic surveillance of Clostridioides difficile demonstrates highly related strains from humans, canines, and the environment

“…C. difficile has been isolated from the gut of most mammals [20] including cattle, horses, pigs, and poultry [21][22][23][24][25][26][27] as well as companion animals such as dogs and cats [28][29][30]. Studies have also demonstrated the prevalence of C. difficile in the environment, including sand playgrounds [31], public gardens [32], rivers [33], soil [17,34,35], water [36], and environments in contact with farm animals [23].…”

“… C. difficile has been isolated from the gut of most mammals [20] including cattle, horses, pigs, and poultry [21–27] as well as companion animals such as dogs and cats [28–30]. Studies have also demonstrated the prevalence of C.…”