C. Diff Claims the Lives of Two Elderly Scottish Patients

The BBC is reporting that two elderly patients suffering from Clostridium difficile  have died at Dr. Grey's hospital in Moray, Scotland.

Six other patients at the hospital have contracted Clostridium difficile.  Additionally, a higher than usual number of patients are suffering from gastrointestinal illnesses.

An outbreak control team has been set up.

The health board said the deaths happened in April and that both the patients had been frail.

A spokesman said the infection was the main cause of death in one of the patients and was a contributory factor in the second death. 

More information is in the BBC article.

 

Clostridium difficile in Food -Is This the Next Thing to Keep us Up at Night?

You would think we'd have enough pathogens to lose sleep over, but it seems that there is at least one more to add to the midnight pantheon.  Over the last several years we have seen multiple instances where Clostridium difficile and foodborne illness have been related. However, the Clostridium difficile infection has generally been associated with the foodborne illness after treatment for the infection by antibiotics, not as a result of actual ingestion of the Clostridium difficile bacteria. However, in the recent Salmonella Typhimurium Peanut Butter outbreak, we have two cases where children seem to be co-infected with both Clostridium difficile and Salmonella Typhimurium. Which brings us to the the important question – Is Clostridium difficile foodborne?

For background, Wikipedia reports that Clostridium difficile is a species of Gram-positive bacteria of the genus Clostridium. Clostridia are anaerobic, spore-forming rods (bacillus). C. difficile is the most serious cause of antibiotic-associated diarrhea (AAD) and can lead to pseudomembranous colitis, a severe infection of the colon, often resulting from eradication of the normal gut flora by antibiotics. The C. difficile bacteria, which naturally reside in the body, become overgrown: The overgrowth is harmful because the bacterium releases toxins that can cause bloating, constipation, and diarrhea with abdominal pain, which may become severe.

The CDC reports that mortality rates from Clostridium difficile disease in the United States increased from 5.7 per million population in 1999 to 23.7 per million in 2004. Increased rates may be due to emergence of a highly virulent strain of C. difficile.

Here are a few articles that I have found or have been sent on the topic. Clearly more research needs to be done.

Possible Seasonality of Clostridium difficile in Retail Meat, Canada
(pdf)

Rodriguez-Palacios A, Reid-Smith RJ, Staempfli HR, Diagnault D, Janecko N, Avery BP et al. Possible seasonality of Clostridium difficle in retail meat, Canada. Emerg Infect Dis. 2009 May

We previously reported Clostridium difficile in 20% of retail meat in Canada, which raised concerns about potential foodborne transmissibility. Here, we studied the genetic diversity of C. difficile in retail meats, using a broad Canadian sampling infrastructure and 3 culture methods. We found 6.1% prevalence and indications of possible seasonality (highest prevalence in winter).

Clostridium difficile
in Retail Meat Products, USA, 2007 (pdf)

Songer JG, Trinh HT, Killgore GE, Thompson AD, McDonald LC, Limbago BM. Clostridium difficile in retail meat products, USA, 2007. Emerg Infect Dis. 2009 May

To determine the presence of Clostridium difficile, we sampled cooked and uncooked meat products sold in Tucson, Arizona. Forty-two percent contained toxigenic C. difficile strains (either ribotype 078/toxinotype V [73%] or 027/toxinotype III [NAP1 or NAP1-related; 27%]). These findings indicate that food products may play a role in interspecies C. difficile transmission.

Clostridium difficile in Ready-to-Eat Salads, Scotland (pdf)


Bakri MM, Brown DJ, Butcher JP, Sutherland AD. Clostridium difficile in ready-to-eat salads, Scotland. Emerg Infect Dis. 2009 May

Of 40 ready-to-eat salads, 3 (7.5%) were positive for Clostridium difficile by PCR. Two isolates were PCR ribotype 017 (toxin A–, B+), and 1 was PCR ribotype 001. Isolates were susceptible to vancomycin and metronidazole but variably resistant to other antimicrobial drugs. Ready-to-eat salads may be potential sources for virulent C. difficile.

40 Percent of Grocery Store Meat Sampled has Superbug Clostridium difficile (C. diff)

A potentially deadly intestinal germ increasingly found n hospitals is also showing up in a more unsavory setting: grocery store meats.  According to press reports this morning, an Arizona researcher found that a shocking forty percent of tested meat products were contaminated with Clostridium difficile, a bacteria normally associated with severe hospital infections. The test was conducted on meat from three national chain stores.  Federal health officials, however, say more study is needed to determine whether C. diff is transmitted through food.

 More than 40 percent of packaged meats sampled from three Arizona chain stores tested positive for C. diff., according to newly complete analysis of 2006 data collected by a University of Arizona scientist. Nearly 30 percent of the contaminated samples of ground beef, pork and turkey and ready-to-eat meats like summer sausage were identical or closely related to a super-toxic strain of C. diff blamed for growing rates of illness and death in the U.S. — raising the possibility that the bacterial infections may be transmitted through food.

 

Outbreak of C. difficile claims 10 lives in Canada

An outbreak of C. difficile at a Quebec hospital in St-Hyacinthe has killed another person, bringing the death toll to 10 since the bacteria emerged at the health centre in July.

A total of 25 people have been infected with C. difficile, which causes severe diarrhea, at the Centre hospitalier Honoré-Mercier in St-Hyacinthe, an agricultural town southeast of Montreal.

The hospital announced in late October that it had introduced several measures to contain the infection, including restricted visiting rules and a massive disinfection campaign.

More information can be found in this article.