title: Prevalence and Characterization of Clostridium difficile in Beef and Mutton Meats of Isfahan Region, Iran.
abstract: BACKGROUND
  Clostridium difficile (C. difficile) is a frequent cause of nosocomial infections. During last few years, the mortality rate of C. difficile infection (CDI) increased in healthcare facilities. This organism has become a major public health concern in developed nations. Because of the increasing incidence of acquired-CDI (CA-CDI) and notable genetic overlap between C. difficile isolates from animals and humans, meat has defined as one of the probable transmission route of C. diffiicle to humans.
  
  
  OBJECTIVE
  This study was performed to determine the prevalence of toxigenic C. difficile in beef and mutton meats consumed as human food in Isfahan, central part of Iran. Furthermore the polymerase chain reaction (PCR)-ribotyping employed to compare the genetic pattern of positive isolates in meat with clinical ones.
  
  
  METHODS
  A total of 200 raw meat samples (81 beef and 119 mutton) were purchased from meat packaging plants. The samples were anaerobically cultured in C. difficile moxalactam norfloxacin (CDMN) broth and plated on selective enrichment medium. The suspicious colonies were recultured on blood agar anaerobically. All C. difficile isolates identified by morphological and biochemical testing were screened by PCR for the presence of genes encoding the triose phosphate isomerase (tpi), toxin A (tcdA), toxin B (tcdB) and binary toxin (cdtB). The genomes of extracted isolates were analyzed by 16S-23S rRNA-based PCR ribotyping.
  
  
  RESULTS
  The overall prevalence of C. difficile with two toxigenic genes including tcdA and tcdB was estimated at 4.0%. C. difficile was detected in 2.8%, 2.1%, 3.6% and 6.2% of chopped beef, ground beef, chopped mutton and ground mutton, respectively. The cdtB gene was not found in positive isolates. Eight different ribotypes were found in isolated strains that were not identical with those belonging to patients with CDI.
  
  
  CONCLUSIONS
  The results of PCR-ribotyping indicate that no relationship exists between clinical and meat isolates. We therefore conclude that other sources than meat may function as a vector for CA-CDI.
authors.affiliation: Department of Food Science and Technology, College of Food Science and Technology, Tehran Science and Research Branch, Islamic Azad University, Tehran, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Esfandiari
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, School of Food Sciences and Nutrition, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jalali
authors.affiliation: Department of Food Science and Technology, College of Food Science and Technology, Tehran Science and Research Branch, Islamic Azad University, Tehran, IR Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Ezzatpanah
authors.affiliation: Department of Pathobiology, University of Guelph, Guelph, Ontario, N1G 2W1, Canada.
authors.forename: J Scott
authors.initials: JS
authors.lastname: Weese
authors.affiliation: Department of Animal Science, Faculty of Agriculture and Natural Resources, Tehran Science and Research Branch, Islamic Azad University, Tehran, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Chamani
keywords: Clostridium difficile; Iran; Meat; PCR