Clostridium difficile: an emerging zoonoses in Northern Ireland?

Clostridium difficile infection (CDI) is the main cause of infectious diarrhoea in hospitalised patients. Over 700 CDI cases are reported in N. Ireland every year (2008-2012 average) with ~10% mortality. C. difficile produces highly resistant and infectious spores which promote nosocomial spread in healthcare settings. However, CDI is increasingly reported in community patients with no history of healthcare contact. Recent studies have confirmed transmission of C. difficile “ribotype 078” between pigs and humans in the Netherlands. Unlike other regions, ribotype 078 is the most common strain associated with human disease in N. Ireland, causing 20-30% of cases.

Knowledge of reservoirs of C. difficile in general – and ribotype 078 in particular – is currently lacking, especially from the agri-food sector. Only limited studies of C. difficile in the Northern Irish agri-food industry have been undertaken. Coupled to this is the need to develop better tools for detecting C. difficile toxins. Current tests are insensitive, and the gold standard method (cell culture cytotoxin testing) is too cumbersome for routine diagnostic use.