FRI FOOD SAFETY REVIEWS Clostridium difficile as a Risk Associated with Animal Sources

Introduction....................................................................................................................................2 Clostridium difficile — Biology and Pathogenesis.........................................................................2 Biology...................................................................................................................................2 Virulence ................................................................................................................................2 Antibiotic resistance ...............................................................................................................3 Infection and carriage in humans............................................................................................3 Disease and carriage in animals..............................................................................................4 Epidemiology of C. difficile .......................................................................................................... 4 Incidence of infection worldwide .......................................................................................... 4 Healthcare-associated (HA) vs. community-associated (CA) infections................................5 Predisposing (risk) factors for infection .................................................................................6 Potential routes of infection....................................................................................................6 Person to person contact .................................................................................................6 Animal to person contact................................................................................................7 Airborne transmission ....................................................................................................7 Contact with contaminated equipment and surfaces.......................................................8 Consumption of contaminated food or water................................................................. 8 Control and Prevention of CDI.......................................................................................................8 Hospital and healthcare programs ..........................................................................................8 Sanitizers and surface treatments ...........................................................................................9 Prevention of animal disease ..................................................................................................9 Prevention of foodborne intoxication or infection..................................................................9 Data Gaps and Research Needed .................................................................................................10 Summary and Perspective ........................................................................................................... 10 Table 1: Surveys reporting C. difficile in animals ....................................................................... 11 Table 2: Reports of C. difficile detected in foods ........................................................................ 12 References................................................................................................................................... 13