1887

Abstract

Introduction:

infection (CDI) is a significant gastrointestinal disease in the developed world and increasingly recognised as a zoonotic infection. In North America and Europe, the PCR ribotype (RT) 078 strain of is commonly found in production animals and as a cause of disease in humans although proof of transmission from animals is lacking. This strain is absent in Australian livestock. We report a case of human CDI caused by a strain of belonging to known Australian livestock-associated RT 237.

Case presentation:

A young male was admitted for multiple trauma following a motor vehicle accident and placed on piperacillin/tazobactam for pneumonia. After 4 days of treatment, he developed symptoms of CDI, which was confirmed in the laboratory. His symptoms resolved after 6 days of intravenous metronidazole. The strain of isolated was identified as RT 237, an unusual RT previously found in with several Western Australia piggeries.

Conclusion:

This case of CDI caused by an unusual livestock-associated RT 237 supports the hypothesis of zoonotic transmission. The case highlights the potential of livestock to act as reservoir for and the need for continued surveillance of CDI in both human and animal populations.

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2016-07-11
2024-05-05
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References

  1. Al Saif N., Brazier J. S. 1996; The distribution of Clostridium difficile in the environment of South Wales. J Med Microbiol 45:133–137 [View Article][PubMed]
    [Google Scholar]
  2. Androga G. O., McGovern A. M., Elliott B., Chang B. J., Perkins T. T., Foster N. F., Riley T. V. 2015; Evaluation of the Cepheid Xpert C. difficile/Epi and meridian bioscience illumigene C. difficile assays for detecting Clostridium difficile ribotype 033 strains. J Clin Microbiol 53:973–975 [View Article][PubMed]
    [Google Scholar]
  3. Boseiwaqa L. V., Foster N. F., Thean S. K., Squire M. M., Riley T. V., Carson K. C. 2013; Comparison of ChromID C. difficile agar and cycloserine-cefoxitin-fructose agar for the recovery of Clostridium difficile . Pathology 45:495–500 [View Article][PubMed]
    [Google Scholar]
  4. Burnham C. A., Carroll K. C. 2013; Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clin Microbiol Rev 26:604–630 [View Article][PubMed]
    [Google Scholar]
  5. CLSI 2011; Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria. Seventh Edition: Approved Standard M11-A7. Wayne, PA. USA: CLSI;
  6. CLSI 2013; Performance Standards for Antimicrobial Susceptibility Testing: Twenty-third Informational Supplement M100-S23. Wayne, PA, USA: CLSI;
  7. EUCAST 2016 Clinical Breakpoint Tables for Interpretation of MICs and Zone Diameters, Version 66.0 [Online] Available http://www.eucast.org/clinical_breakpoints/ [Accessed 21/04/20116]
  8. Eyre D. W., Cule M. L., Wilson D. J., Griffiths D., Vaughan A., O'Connor L., Ip C. L., Golubchik T., Batty E. M. et al. 2013; Diverse sources of C. difficile infection identified on whole-genome sequencing. N Engl J Med 369:1195–1205 [View Article][PubMed]
    [Google Scholar]
  9. Foster N. F., Collins D. A., Ditchburn S. L., Duncan C. N., Van Schalkwyk J. W., Golledge C. L., Keed A. B., Riley T. V. 2014; Epidemiology of Clostridium difficile infection in two tertiary-care hospitals in Perth, Western Australia: a cross-sectional study. New Microbes New Infect 2:64–71 [View Article][PubMed]
    [Google Scholar]
  10. Goorhuis A., Bakker D., Corver J., Debast S. B., Harmanus C., Notermans D. W., Bergwerff A. A., Dekker F. W., Kuijper E. J. 2008; Emergence of Clostridium difficile infection due to a new hypervirulent strain, polymerase chain reaction ribotype 078. Clin Infect Dis 47:1162–1170 [View Article][PubMed]
    [Google Scholar]
  11. Gould L. H., Limbago B. 2010; Clostridium difficile in food and domestic animals: a new foodborne pathogen?. Clin Infect Dis 51:577–582 [View Article][PubMed]
    [Google Scholar]
  12. Janezic S., Zidaric V., Pardon B., Indra A., Kokotovic B., Blanco J. L., Seyboldt C., Diaz C. R., Poxton I. R. et al. 2014; International Clostridium difficile animal strain collection and large diversity of animal associated strains. BMC Microbiol 14: [View Article][PubMed]
    [Google Scholar]
  13. Knetsch C. W., Connor T. R., Mutreja A., Van Dorp S. M., Sanders I. M., Browne H. P., Harris D., Lipman L., Keessen E. C. et al. 2014; Whole genome sequencing reveals potential spread of Clostridium difficile between humans and farm animals in the Netherlands, 2002 to 2011. Euro Surveill 19:20954 [View Article][PubMed]
    [Google Scholar]
  14. Knight D. R., Riley T. V. 2013; Prevalence of gastrointestinal Clostri- dium difficile carriage in Australian sheep and lambs. Appl Environ Microbiol 79:5689–5692 [View Article][PubMed]
    [Google Scholar]
  15. Knight D. R., Thean S., Putsathit P., Fenwick S., Riley T. V. 2013; Cross-sectional study reveals high prevalence of Clostridium difficile non-PCR ribotype 078 strains in Australian veal calves at slaughter. Appl Environ Microbiol 79:2630–2635 [View Article][PubMed]
    [Google Scholar]
  16. Knight D. R., Giglio S., Huntington P. G., Korman T. M., Kotsanas D., Moore C. V., Paterson D. L., Prendergast L., Huber C. A. et al. 2015a; Surveillance for antimicrobial resistance in Australian isolates of Clostridium difficile, 2013-14. J Antimicrob Chemother 70:2992–2999 [View Article][PubMed]
    [Google Scholar]
  17. Knight D. R., Hart J., Gottardo N. G., Eyre D. W., Crook D. W., Riley T. V. 2015b; Two cases of Clostridium difficile infection in unrelated oncology patients attributable to a single clone of C. difficile PCR ribotype 126. JMM Case Reports 2: [CrossRef]
    [Google Scholar]
  18. Knight D. R., Squire M. M., Riley T. V. 2015c; Nationwide surveillance study of Clostridium difficile in Australian Neonatal pigs shows high prevalence and heterogeneity of PCR ribotypes. Appl Environ Microbiol 81:119–123 [View Article][PubMed]
    [Google Scholar]
  19. Knight D. R., Riley T. V. 2016; Clostridium difficile clade 5 in Australia: antimicrobial susceptibility profiling of PCR ribotypes of human and animal origin. J Antimicrob Chemother 71:2213–2217 [View Article]
    [Google Scholar]
  20. Lessa F. C., Mu Y., Bamberg W. M., Beldavs Z. G., Dumyati G. K., Dunn J. R., Farley M. M., Holzbauer S. M., Meek J. I. et al. 2015; Burden of Clostridium difficile infection in the United States. N Engl J Med 372:825–834 [View Article][PubMed]
    [Google Scholar]
  21. McDonald L. C., Coignard B., Dubberke E., Song X., Horan T., Kutty P. K. Ad Hoc Clostridium difficile Surveillance Working Group 2007; Recommendations for surveillance of Clostridium difficile-associated disease. Infect Control Hosp Epidemiol 28:140–145 [View Article][PubMed]
    [Google Scholar]
  22. Moono P., Putsathit P., Knight D. R., Squire M. M., Hampson D. J., Foster N. F., Riley T. V. 2016; Persistence of Clostridium difficile RT 237 infection in a Western Australian piggery. Anaerobe 37:62–66 [View Article][PubMed]
    [Google Scholar]
  23. O'Connor J. R., Galang M. A., Sambol S. P., Hecht D. W., Vedantam G., Gerding D. N., Johnson S. 2008; Rifampin and rifaximin resistance in clinical isolates of Clostridium difficile . Antimicrob Agents Chemother 52:2813–2817 [View Article][PubMed]
    [Google Scholar]
  24. Rupnik M. 2007; Is Clostridium difficile-associated infection a potentially zoonotic and foodborne disease?. Clin Microbiol Infect 13:457–459 [View Article][PubMed]
    [Google Scholar]
  25. Rupnik M., Janezic S. 2016; An update on Clostridium difficile toxinotyping. J Clin Microbiol 54:13–18 [View Article][PubMed]
    [Google Scholar]
  26. Slimings C., Armstrong P., Beckingham W. D., Bull A. L., Hall L., Kennedy K. J., Marquess J., McCann R., Menzies A. et al. 2014; Increasing incidence of Clostridium difficile infection, Australia, 2011-2012. Med J Aust 200:272–276 [View Article][PubMed]
    [Google Scholar]
  27. Squire M. M., Carter G. P., Mackin K. E., Chakravorty A., Noren T., Elliott B., Lyras D., Riley T. V 2013; Novel molecular type of Clostridium difficile in neonatal pigs, Western Australia. Emerg Infect Dis 19:790–792 [CrossRef]
    [Google Scholar]
  28. Weese J. S. 2010; Clostridium difficile in food-innocent bystander or serious threat?. Clin Microbiol Infect 16:3–10 [View Article][PubMed]
    [Google Scholar]
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