The distribution of Clostridium difficile in the environment of South Wales

Saif, N. Al; Brazier, Jon S.

doi:10.1099/00222615-45-2-133

Cited by 229 publications

(178 citation statements)

References 18 publications

(16 reference statements)

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“…These findings compare with a study which isolated C. difficile from 15 % of environmental surfaces in a chronic care ward for the elderly (Bender et al, 1986) and an investigation by Al Saif & Brazier (1996) which isolated C. difficile from 20 % of inanimate objects from various hospital environments.…”

Section: Discussionsupporting

confidence: 54%

Clostridium difficile in a geriatric unit: a prospective epidemiological study employing a novel S-layer typing method

McCoubrey

Starr

Martin

et al. 2003

Journal of Medical Microbiology

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Clostridium difficile is the major identifiable cause of antibiotic-associated diarrhoea in the UK. The aim of this study was to employ traditional culture, toxin detection and a novel typing method to determine the level of C. difficile colonization and disease in a population of elderly patients and to investigate the association between strains in the patients and their environment. Three hundred and ninety patients between 62 and 101 years of age admitted to a geriatric unit in the Royal Victoria Hospital (RVH), Edinburgh, were investigated for the presence of C. difficile. C. difficile was cultured from 100 (26 %) patients using pre-reduced cycloserine-cefoxitin egg yolk agar, and toxin(s) was detected in the faeces of 34 of these patients using the Techlab ELISA test kit for the detection of C. difficile toxins A and/or B. Toxin(s) was detected in a further 18 patients from whom no C. difficile was detected in culture. Of the patients in whom C. difficile was detected, 49 % had diarrhoea, with the highest proportion of patients with diarrhoea being both culture-and toxin-positive for C. difficile. Environmental sampling of the patient environment yielded C. difficile from 14 % of samples. The organism was most frequently isolated from floors, sluice-rooms and toilet areas. The variation in the molecular mass of the C. difficile S-layer proteins was exploited as the basis of a novel typing method for C. difficile. Isolates from patients in the RVH were given a four-digit 'S-type' number based on their S-layer protein profile. A total of seven S-types were identified, with one type, toxigenic S-type 5236, accounting for 73 % of all clinical isolates and 91 % of environmental isolates.

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Section: Discussionsupporting

confidence: 54%

Clostridium difficile in a geriatric unit: a prospective epidemiological study employing a novel S-layer typing method

McCoubrey

Starr

Martin

et al. 2003

Journal of Medical Microbiology

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“…Much more work is required to determine whether C. difficile contamination of retail meat is of clinical relevance, and results should be taken in context with studies that have identified C. difficile spores in treated water (1), vegetables (1), and the household environment (unpublished data). Exposure to low levels of C. difficile might indeed be a common occurrence, with meat being just one of many possible sources.…”

Section: Discussionmentioning

confidence: 99%

Detection and Enumeration ofClostridium difficileSpores in Retail Beef and Pork

Weese

Avery

Rousseau

et al. 2009

Appl Environ Microbiol

158

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Recent studies have identified Clostridium difficile in food animals and retail meat, and concern has been raised about the potential for food to act as a source of C. difficile infection in humans. Previous studies of retail meat have relied on enrichment culture alone, thereby preventing any assessment of the level of contamination in meat. This study evaluated the prevalence of C. difficile contamination of retail ground beef and ground pork in Canada. Ground beef and ground pork were purchased from retail outlets in four Canadian provinces. Quantitative and enrichment culture was performed. Clostridium difficile was isolated from 28/230 (12%) samples overall: 14/115 (12%) ground beef samples and 14/115 (12%) ground pork samples (P ‫؍‬ 1.0). For ground beef, 10/14 samples (71%) were positive by enrichment culture only. Of the 4 ground beef samples that were positive by direct culture, 20 spores/g were present in 2 while 120 and 240 spores/g were present in 1 each. For ground pork, 10/14 (71%) samples were positive by enrichment culture only. Of the 4 ground pork samples that were positive by direct culture, 20 spores/g were present in 3 while 60 spores/g were present in 1. Ribotype 078 predominated, consistent with some previous studies of C. difficile in food animals. Ribotype 027/North American pulsotype 1 was also identified in both retail beef and pork. This study has identified relatively common contamination of retail ground beef and pork with C. difficile spores; however, the levels of contamination were very low.

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“…113 The prevalence of C. difficile, including epidemic strains, has been documented in cooked and un-cooked meats, 109,[114][115][116] as well as in produce. 117,118 Molecular typing of organisms isolated from food has revealed, in multiple cases, identical genotypes to C. difficile strains recovered from human CDI patients as well as food animals.…”

Section: Antibiotic Resistancementioning

confidence: 99%