Clostridium difficile and One Health

Area of Science:

• Microbiology
• Epidemiology
• Public Health

Background:

• Clostridium difficile is a significant enteric pathogen in humans, often linked to antimicrobial use disrupting gut microbiota.
• Emergence of community-associated cases and distinct hospital strains suggests extra-hospital sources of C. difficile transmission.
• Community reservoirs, including food and the environment, are likely sources for C. difficile colonization in both humans and animals.

Purpose of the Study:

• To review the 'One Health' aspects of Clostridium difficile infection (CDI).
• To explore how community sources act as conduits for C. difficile transfer between animals and humans.
• To discuss the importance of a One Health approach in managing CDI.

Main Methods:

• Literature search conducted on PubMed and Web of Science.
• Included papers published from January 1, 2000, to July 10, 2019.
• Review focused on 'One Health' perspectives of CDI transmission.

Main Results:

• Evidence demonstrates C. difficile transmission from asymptomatic carriers to patients within hospitals.
• High-resolution genomic sequencing reveals animal-to-human C. difficile transmission, even without clear epidemiological links.
• An interconnected transmission pathway involving food animals, humans, and the environment for C. difficile is presented.

Conclusions:

• Clostridium difficile is a pathogen common to humans and animals, contaminating food and environmental sources.
• Managing CDI requires a collaborative 'One Health' approach.
• Collaboration among clinicians, veterinarians, environmentalists, and policymakers is paramount for effective CDI management.