Equis ISSN 2398-2977

Clostridium difficile

Synonym(s): C. difficile

Contributor(s): Sarah Binns

Introduction

Classification

Taxonomy

  • Genus:Clostridium.
  • Species:difficile.

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Clinical Effects

Epidemiology

Habitat

  • Isolated from soil, hay, and sand.
  • Found in feces from cows, horses, dogs, cats, rodents, and human beings.

Lifecycle

  • Sporangia (vegetative cells) produce endospores.
  • Endospores may be released by heat or alcohol treatment   →   germinate anaerobially.

Transmission

  • Feco-oral transmission of spores or sporangia.

Pathological effects

  • Antibody production against toxins may occur.
  • Causes enterocolitis   Intestine: enteritis  in foals and adult horses.
  • C. difficileproduces at least 3 potential virulence factors:
    • An enterotoxin (toxin A) that induces fluid secretion into the intestines.
    • A cytotoxin (toxin B) that kills cells.
    • A substance that inhibits intestinal motility.
  • Toxins A and B are thought to be important in pathogenesis.
  • Not all equine cases are associated with antibiotic use.

Other Host Effects

  • Carried asymptomatically in the gastrotintestinal flora of human and equine neonates.
  • Carriage rates are much lower in adults.

Control

Control via animal

  • Good hygiene practices to avoid fecal contamination.

Control via chemotherapies

  • Treatment with vancomycin or metronidazole is successful in human cases of pseudomembranous colitis.
  • Metronidazole   Metronidazole  may be used in equine cases.
  • Resistance to other antibiotics is common, and use of antimicrobials may induceC. difficile-associated disease.

Control via environment

  • Avoid fecal contamination of feed and water.
  • Avoid accidental ingestion of antibiotics.
  • Use antibiotics judiciously.

Vaccination

  • None available.

Diagnosis

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Silva R O S et al (2013) Detection of A/B toxin and isolation of Clostridium difficile and Clostridium perfringens from foals. Equine Vet J 45 (6), 671-675 PubMed.
  • Magdesian K G et al (2006) Molecular characterization of Clostridium difficile isolates from horses in an intensive care unit and association of disease severity with strain type. JAVMA 228 (5), 751-755 PubMed.
  • Gustafsson A et al (2004) Study of faecal shedding of Clostridium difficile in horses treated with penicillin. Equine Vet J 36 (2), 180-182 PubMed.
  • Weese J S, Parsons D A & Stempfli H R (1999) Association of Clostridium difficile with enterocolitis and lactose intolerance in a foal. JAVMA 214 (2), 229-232 PubMed.
  • Baverud V, Franklin A, Gunnarsson A et al (1998) Clostridium difficile associated with acute colitis in mares when their foals are treated with erythromycin and rifampicin for Rhodococcus equi pneumonia. Equine Vet J 30 (6), 482-488 PubMed.
  • Madewell B R, Tang Y J, Jang S et al (1995) Apparent outbreaks of Clostridium difficile-associated diarrhea in horses in a veterinary medical teaching hospital. J Vet Diagn Invest (3), 343-346 PubMed.
  • Traub-Dargatz J L & Jones R L (1993) Clostridia-associated enterocolitis in adult horses and foals. Vet Clin North Am Equine Pract (2), 411-421 PubMed.

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