National Laboratory for Health, Environment and Food, Maribor, Slovenia.
Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Zoonoses Public Health. 2018 Sep;65(6):669-674. doi: 10.1111/zph.12475. Epub 2018 Apr 23.
Clostridium difficile is an anaerobic, spore-forming bacterium that causes intestinal infections. Although C. difficile is still predominantly considered as a nosocomial pathogen, there has been an increase in the number of community-associated infections. Since C. difficile is ubiquitous and can be isolated from nearly any environment, one of the possibilities for community acquisition could be exposure to spores in the domestic environment. The aim of this study was to evaluate the presence of C. difficile spores on shoes, slippers and on dog paws and to explore the importance of these surfaces as vectors for the dissemination of C. difficile in a domestic environment. Overall, C. difficile was present in 14 (70%) of 20 households and in 31 of 90 (34%) collected samples. Shoes and slippers had the highest positivity rates, 19 of 44 (43%) and 6 of 21 (28%), respectively, followed by dog paws 6 of 25 (24%). Thirteen C. difficilePCR ribotypes were identified with half of the isolates belonging to ribotype 014/020, which is the predominant type circulating in human population and is also commonly found in the environment (e.g. soil and water) in Slovenia. In three households, identical PCR ribotypes were found on dog paws, shoes and slippers. To understand the fine-scale genetic relatedness of these isolates, we sequenced the genomes. Low level of single nucleotide variant (SNV) differences between isolates from the same households, consistent with a recent transmission from a common source, were seen for isolates of PCR ribotype 014/020 but not for PCR ribotype 010. Our results suggest that shoe soles and dog paws could serve for the dissemination of C. difficile spores between households and environment and could contribute to community-relevant sources for C. difficile infection in humans.
艰难梭菌是一种厌氧、产芽孢的细菌，可引起肠道感染。虽然艰难梭菌仍然主要被认为是医院获得性病原体，但社区获得性感染的数量有所增加。由于艰难梭菌无处不在，几乎可以从任何环境中分离出来，因此社区获得的可能性之一可能是暴露于家庭环境中的孢子。本研究旨在评估鞋底、拖鞋和狗爪上是否存在艰难梭菌孢子，并探讨这些表面作为艰难梭菌在家庭环境中传播的媒介的重要性。总的来说，在 20 个家庭中的 14 个（70%）和 90 个收集样本中的 31 个（34%）中发现了艰难梭菌。鞋子和拖鞋的阳性率最高，分别为 44 个中的 19 个（43%）和 21 个中的 6 个（28%），其次是狗爪的 25 个中的 6 个（24%）。共鉴定出 13 种艰难梭菌 PCR 核糖体分型，其中一半分离株属于核糖体分型 014/020，这是在人类人群中流行的主要类型，也是在斯洛文尼亚的环境（如土壤和水）中常见的类型。在三个家庭中，在狗爪、鞋子和拖鞋上发现了相同的 PCR 核糖体型。为了了解这些分离株的精细遗传相关性，我们对其基因组进行了测序。对于来自同一家庭的 014/020 型 PCR 核糖体型分离株，观察到相同水平的单核苷酸变异（SNV）差异，表明它们是从共同来源的近期传播而来，但对于 010 型 PCR 核糖体型分离株则没有。我们的研究结果表明，鞋底和狗爪可能有助于艰难梭菌孢子在家庭之间和环境之间的传播，并可能有助于人类社区相关的艰难梭菌感染源。
