Clostridioides difficile infection in animals: a literature review.

Overview

• This literature review examines the occurrence and characteristics of Clostridioides difficile infection (CDI) in various animal species, detailing differences in disease associations, prevalence, and potential zoonotic implications.

Introduction to Clostridioides difficile in Animals

• Clostridioides difficile (C. difficile) is a microorganism known to affect humans and multiple animal species.
• Species commonly affected include horses, pigs, gerbils, guinea pigs, hamsters, and rabbits.
• C. difficile has also been found in the gastrointestinal tracts of healthy animals where its link to disease is unclear.

Infection Characteristics Across Species

• Traditionally, CDI in domestic animals has been associated with antibiotic use, reflecting similar patterns seen in humans.
• Recent cases have been reported where CDI occurred without prior antibiotic treatment, particularly noteworthy in pigs where no antibiotic association is observed.
• Age association with CDI varies by species:
  • In most animals, CDI is not linked to a specific age group.
  • In pigs, CDI primarily affects neonatal animals, suggesting age-specific vulnerability.

Prevalence and Risk Factors in Horses

• Horses show a high prevalence of CDI compared to other animal species.
• Predisposing factors beyond antibiotic use and hospitalization include:
  • Co-infections with other bacteria or parasites
  • Intestinal displacements
  • Transportation stress
  • Surgical or medical interventions
  • Nasogastric intubation

Zoonotic Potential of CDI

• Recent research provides substantial evidence suggesting that CDI may be zoonotic, meaning it could be transmitted from animals to humans.
• Despite these indications, definitive proof confirming zoonotic transmission pathways remains lacking.

Summary

• The review highlights:
  • Species-specific differences in CDI epidemiology and pathogenesis
  • The evolving understanding of CDI beyond antibiotic-associated cases
  • The complex interplay of risk factors, especially in horses
  • The ongoing investigation into CDI’s zoonotic role