Category Archives: Clostridium difficile

USA – Michigan consumers warned of produce contaminated with human waste

Food Safety News

The Michigan Department of Agriculture and Rural Development (MDARD) is advising consumers not to eat any Kuntry Gardens produce or products containing produce from Kuntry Gardens of Homer, MI, because it may be contaminated with raw, untreated human waste.

All of the implicated products are expected to be labeled under the name Kuntry Gardens.

During a routine produce safety inspection, MDARD staff identified that Kuntry Gardens was using raw, untreated human waste on the fields where produce was grown for sale to local grocery stores and direct sale. The use of raw, untreated, human waste for growing commodities intended for human food is a violation of state and federal laws and regulations.

If not treated professionally, human waste and other body fluids can spread dangerous infectious diseases such as hepatitis A, Clostridium difficile, E. coli, rotavirus and norovirus.

The state health department has placed impacted product still on the farm under seizure and is working with the farm to oversee disposition and corrective action.

USA – Mystery 2021 Pennsylvania Pool E. coli and C. difficile Outbreak Finally Explained – 15 Sickened

Food Poison Journal

On June 7, 2021, the Pennsylvania Department of Health (PADOH) received multiple complaints of gastrointestinal illness from patrons of a community swimming pool. Two patrons reported positive Shiga toxin-producing Escherichia coli (STEC) and Clostridioides difficile from stool specimens. PADOH issued pool closure orders and initiated an outbreak response to identify a source and prevent additional illnesses.

Confirmed cases were defined as isolation of E. coli O157:H7 or detection of Shiga toxin or Shiga toxin genes from stool specimens of persons who visited the pool during May 31–June 7, 2021. Probable cases were defined as three or more loose stools in 24 hours with nausea, vomiting, fever, or cramps in persons who visited the pool during the same time frame. C. difficile results were deemed incidental upon consultation with experts (LC McDonald, MD, CDC, personal communication, June 2021) and were not included in the case definition.

Fifteen cases (nine confirmed, six probable) in persons aged 4–14 years were identified; 10 patients were male. All persons reported swimming at the pool on May 31, 2021, the seasonal opening date, and had no other common exposures. The total number of pool visitors on this date is unknown. Symptom onsets occurred during June 2–June 4, 2021. Thirteen patients sought medical evaluation, and six were hospitalized. Four received antibiotics for C. difficile. None developed hemolytic uremic syndrome.

Early findings suggested an unusual association between exposure to a chlorinated swimming pool and infections caused by two pathogens susceptible to chlorine. Pool inspection revealed an automatic chlorinator malfunction. Record-keeping was inconsistent with local requirements, and the few available records demonstrated at least one instance of no detectable chlorine. The pool reopened following chlorinator repair, after which no additional cases were identified.

Research – Clostridioides difficile positivity rate and PCR ribotype distribution on retail potatoes in 12 European countries, January to June 2018 separator


 infection (CDI) is a notable cause of infectious diarrhoea worldwide. In Europe, the estimated number of CDI cases in 2011–12 was 123,997 (95% confidence interval (CI): 61,018–284,857), based on a survey of healthcare-associated infections performed by the European Centre for Disease Prevention and Control (ECDC) [1]. In 2016, as part of  surveillance performed by ECDC, 556 hospitals from 20 countries covering 24 million patient-days reported 7,711 CDI cases [2]. The symptoms can range from mild diarrhoea to potentially fatal pseudomembranous colitis. While historically regarded as a typical healthcare infection, community CDI is increasingly recognised [3].

In CDI, human-to-human transmission plays a major role, but other infection sources and transmission routes are under investigation.  has been repeatedly isolated from various foods worldwide, and it is feasible that some foods could be important vectors for its widespread dissemination [3]. Some important healthcare-associated  PCR ribotypes (RT) such as RT 027 and RT 001/072 tend to spread clonally within a single hospital, region or country, while others such as RT 014, RT 002 and RT 015 do not exhibit country-based clustering and are most likely disseminated across Europe by other sources possibly including the food chain [4]. Confirmed cases of food-associated CDI have so far not been described [3].

Existing evidence suggests that potatoes, which represent a major staple food consumed worldwide, could contribute to the spread of . Potatoes have the highest  contamination rates among all vegetables tested to date; the proportion of -positive retail potato samples ranges from 25.7% (18/70) to 53.3% (24/45) [5,6]. By contrast, the highest positivity rate in other types of vegetables such as leaf vegetables, ginger, sprouts and ready-to-eat salads is 9.4% [58] and in meats and meat products, reported positivity rates are typically below 20% [8,9]. Additionally, diverse and clinically relevant  PCR ribotypes have been previously recovered from potatoes. Certain PCR ribotypes such as RT 014/020, which are suggested to spread by non-clonal transmission networks [4], are among those often detected on potatoes [5,6]. Furthermore, potatoes are frequently imported and exported between countries. A previous study from Slovenia reported that 78.9% (15/19) of -positive retail potatoes were imported from more than 10 countries on three different continents [6].

Here we present the results of a European-wide study on  contamination of retail potatoes. Identical protocols for sampling and isolation were used for all 12 studied countries, enabling a direct comparison of the positivity rates of  on potatoes.

Slovakia – Report on zoonoses, foodborne diseases and waterborne diseases in the Slovak Republic in 2020



The protection of human and animal health can only be achieved through the active cooperation of experts in the field of control and research in the human and veterinary field. The report on zoonoses, foodborne diseases and waterborne diseases in the Slovak Republic for 2020 contains data from official inspections carried out in the field of agriculture and health care, as well as from research institutes and universities. The preparation of the report was coordinated by the National Contact Point for Scientific and Technical Cooperation with the European Food Safety Authority (EFSA EFSA), which is established at the Department of Food Safety and Nutrition of the Ministry of Agriculture and Rural Development of the Slovak Republic (MPRV SR).

The report serves as a basis for the EFSA NCB and scientific experts to set priorities and own national food safety risk assessments. At the same time, the report serves as one of the bases for the Community risk assessment carried out by the European Food Safety Authority (EFSA). Scientific risk assessment is the basis for risk management. The report describes the situation in  35 zoonotic agents, 5 foodborne diseases (ie foodborne diseases) without zoonotic potential and 4 waterborne pathogens. Of the 44 agents monitored, 23 are bacterial, 10 parasitic, 10 viral and prion.

It presents the summary results of examinations and tests performed in 2020 in the Slovak Republic and the evaluation of the national epidemiological situation in humans and animals with a focus on trends and sources of zoonotic and foodborne diseases.

The report presents the summary results of examinations and tests carried out in 2020 and an assessment of the national epidemiological situation in humans and animals , focusing on trends and sources of zoonotic and foodborne diseases . The number of monitored authors, cooperating organizations and experts is growing every year. A wide team of more than 70 experts from 24 scientific and control organizations in the Slovak Republic took part in its elaboration .

In 2020, 17,067 human diseases caused by the study agents were reported, with 29.1% related to campylobacteriosis, 20.9% to Clostridium dificille and 20.4% to salmonellosis. Rotavirus 11.6%, Norwalk virus 5.1%, Borrelia burgdorferi sl 5.6% and  Escherichia coli 1.2% also contributed to a higher percentage of diseases.

Seven of the study agents caused 380 human epidemics, of which 56.6% were salmonellosis, 23.2% were campylobacteriosis and 12.6% of epidemics were caused by rotavirus. Norwalk virus accounted for 5.5%, tick-borne encephalitis virus 1.3%, shigella and 0.5% and yersinia 0.3%.  

35,957 food samples were examined for the presence of 15 pathogens with a positive finding in 2.2% of samples. Higher percentages of positive findings were in  Yersinia spp. 48.1%, Enterococcus spp. 46.3% and  Vibrio spp. 31.8%.

The presence of 30 pathogens was monitored in 2,483,239 samples originating from livestock and wild animals, pets and zoos taken as part of official control, preventive monitoring, research, as well as from sick or dead animals. Positive findings accounted for 0.1% of samples. Higher percentages of positive findings were recorded for  Aeromonas spp. 59.3%, Clostridium spp. 55.4%, Francisella tularensis 50.4%, Babesia spp. 41.1%, Dirofilaria spp. 34.8%, Campylobacter spp. 18.3%, Yersinia spp. 18.3%, Staphylococcus aureus 18.1%, hepatitis E virus 14.1%, Listeria monocytogenes  11.8%, Toxocara spp. 10.5%.

Feed – 385 samples were examined for the presence of Salmonella spp. (1.5% positive samples), Escherichia coli (60.0% positive samples) and Clostridium spp.

(1.7% positive samples).

35,746 water samples were examined for the presence of 9 agents, of which 7.4% were positive, of which Legionella spp. 47.1% and Vibrio spp. 39.5%.

44,633 samples from the environment were examined for the presence of 8 pathogens, of which 2.3% were positive, of which Legionella spp. 36.0%, Vibrio spp. 6.8%,  E.coli 3.6% and  Enterococcus spp. 2.6%.

The report also includes the results of examinations for the resistance of microorganisms to antimicrobials, which has a growing trend worldwide and poses a real danger in the treatment of infections. Microbial resistance was monitored in Salmonella spp., E. coli , Campylobacter spp., Staphylococcus aureus and  Enterococcus spp.

The comprehensive report, which will be published as a publication, has a length of more than 130 pages, will be published in printed form, as a publication with an assigned ISBN. Summaries of individual chapters will be translated into English and published in an electronic version as a publication with an assigned ISBN.

See the appendices for more information.

Attachments (downloadable documents)


Research – Clostridial Neurotoxins: Structure, Function and Implications to Other Bacterial Toxins


Gram-positive bacteria are ancient organisms. Many bacteria, including Gram-positive bacteria, produce toxins to manipulate the host, leading to various diseases. While the targets of Gram-positive bacterial toxins are diverse, many of those toxins use a similar mechanism to invade host cells and exert their functions. Clostridial neurotoxins produced by Clostridial tetani and Clostridial botulinum provide a classical example to illustrate the structure–function relationship of bacterial toxins. Here, we critically review the recent progress of the structure–function relationship of clostridial neurotoxins, including the diversity of the clostridial neurotoxins, the mode of actions, and the flexible structures required for the activation of toxins. The mechanism clostridial neurotoxins use for triggering their activity is shared with many other Gram-positive bacterial toxins, especially molten globule-type structures. This review also summarizes the implications of the molten globule-type flexible structures to other Gram-positive bacterial toxins. Understanding these highly dynamic flexible structures in solution and their role in the function of bacterial toxins not only fills in the missing link of the high-resolution structures from X-ray crystallography but also provides vital information for better designing antidotes against those toxins. View Full-Text

Research – Slovenian study reveals low levels of C. difficile in food

Food Safety News Clost

Researchers in Slovenia have described results from a long-term, national Clostridioides difficile food surveillance project. Positive results were found in meat, fresh produce and poultry.

The three-year period of testing revealed a low proportion of Clostridioides — formerly Clostridium — difficile contaminated food and high genotype variability. As the risk of infection associated with Clostridioides difficile contaminated food is unknown, no measures were recommended for positive results.

Because of an increasing association between Clostridioides difficile and food, in 2015, the Administration of the Republic of Slovenia for Food Safety, Veterinary Sector and Plant Protection (UVHVVR) included it in national food surveillance. In Slovenia, the number of cases increased from 316 in 2013 to 665 in 2017.

Retail minced meat and meat preparations such as beef, pork and poultry were sampled from 2015 to 2017. They were collected at food markets and grocery stores in all Slovenian regions. Selected raw retail vegetables, leaf salads and root vegetables, and ready-to-eat salads were sampled during 2016 and 2017 and seafood only in 2017.

Research – Bacteria killed by new light-activated coating

Science Daily

To stop the spread of disease, it could be used to coat phone screens and keyboards, as well as the inside of catheters and breathing tubes, which are a major source of healthcare-associated infections (HCAIs).

The most well known HCAIs are caused by Clostridioides difficile (C. difficile), methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli). They commonly occur during in-patient medical or surgical treatment, or from visiting a healthcare setting and pose a serious health threat, making them a key priority for the NHS to address*.

The research, published today in Nature Communications, is the first to show a light activated antimicrobial coating successfully killing bacteria in low intensity, ambient light (300 Lux), such as that found in wards and waiting rooms. Previously, similar coatings needed intense light (3,000 Lux), like that found in operating theatres, to activate their killing properties.

The new bactericidal coating is made of tiny clusters of chemically modified gold embedded in a polymer with crystal violet — a dye with antibacterial and antifungal properties.


Research – New approach to unraveling Clostridium difficile

Science Daily Clostridium_difficile_01

The Clostridium difficile pathogen takes its name from the French word for “difficult.” A bacterium that is known to cause symptoms ranging from diarrhea to life-threatening colon damage, C. difficile is part of a growing epidemic of concern for the elderly and patients on antibiotics.

Outbreaks of C. difficile-infected cases have progressively increased in Western countries, with 29,000 reported deaths per year in the United States alone.

Now, biologists at the University of California San Diego are drawing parallels from newly developed models of the common fruit fly to help lay the foundation for novel therapies to fight the pathogen’s spread. Their report is published in the journal iScience.

Research – Detection of Psychrophilic Clostridium spp. Causing “Blown Pack” Spoilage in Meat Juice Samples from Chilled Vacuum-Packed Beef and Lamb Meat Imported from Different Countries to Switzerland

Journal of Food Protection


“Blown pack” spoilage (BPS) of chilled vacuum-packed meat is mainly caused by anaerobic and psychrophilic Clostridium spp., including C. estertheticum, C. gasigenes, C. frigoriphilum, and C. frigidicarnis. Recently, its occurrence has been reported in several countries, especially in internationally traded meat. Therefore, this study aimed at detecting the occurrence of psychrophilic Clostridium spp. causing BPS in meat juice samples (MJS) from chilled vacuum-packed beef and lamb meat imported from other countries to Switzerland. One hundred fifty-four MJS (n = 78 from beef; n = 76 from lamb meat) were screened for psychrophilic Clostridium spp. by quantitative PCR, whereby MJS with a crossing point PCR cycle value <35 and >35 were considered positive and negative, respectively. Psychrophilic Clostridium spp. were detected in 10 MJS, of which 2 were from beef and 8 were from lamb meat. The two beef MJS originated from Spain and Lithuania, whereas the lamb MJS originated from New Zealand (six) and Australia (two). This is the first report of psychrophilic Clostridium spp. in MJS from chilled vacuum-packed beef and lamb meat imported from other countries to Switzerland and provides further evidence that the risk of BPS in lamb meat is higher than in beef.

  • Psychrophilic Clostridium spp. were detected in 10 of 154 meat juice samples.

  • Prevalence of psychrophilic Clostridium spp. in lamb meat was higher than in beef.

  • Prevalence of psychrophilic Clostridium spp. was highest in meat imported from New Zealand and Australia.

UK – Scotland – Annual summary of Salmonella infections, 2018

HPS Scotland 

During 2018, the Scottish SalmonellaShigella and Clostridium difficile Reference Laboratory (SSSCDRL) reported 751 cases of human non-typhoidal Salmonella to Health Protection Scotland. This represented a 10% decrease on the 840 cases reported in 2017, and the 839 cases reported in 2016.