title: Prevalence of Clostridium difficile in the environment in a rural community in Zimbabwe.
abstract: Clostridium difficile has been shown to be a nosocomial pathogen associated with diarrhoea and pseudomembranous colitis in hospitalised patients, but very little is known about its prevalence outside the hospital environment. The aim of this study was to determine the prevalence of C. difficile in faeces of domestic animals, soil and drinking water in a rural community. Water, animal faeces and soil were collected from homesteads in a rural community and the samples were cultured for C. difficile. Clostridium difficile isolates that produced toxins A or B were tested for their susceptibility to antimicrobial drugs. Clostridium difficile was isolated from 37.0% of 146 soil samples, 17.4% of 115 chicken faeces samples, 6.0% of 234 water samples and 4.3% of 161 faecal samples of other animals. Some of the C. difficile isolates from chickens (55.0%), soil (66.7%) and water (14.3%) were toxigenic. All toxigenic isolates were susceptible to metronidazole, vancomycin, doxycycline, chloramphenicol and tetracycline and all were resistant to cefotaxime, gentamicin, ciprofloxacin, norfloxacin and nalidixic acid. The results of the present study suggest that chickens kept by villagers are an important reservoir of C. difficile, which may act as a source of human infection.
authors.affiliation: Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Harare, Zimbabwe. cmdsimango@yahoo.com
authors.forename: Clifford
authors.initials: C
authors.lastname: Simango
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000032:analysis; D016360:Clostridioides difficile / Q000187:drug effects / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000188:drug therapy / Q000453:epidemiology*; D005243:Feces / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D012423:Rural Health; D012988:Soil Microbiology; D014871:Water Microbiology; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins