Equine veterinary journal2003; 35(5); 465-471; doi: 10.2746/042516403775600505

Clostridium difficile: prevalence in horses and environment, and antimicrobial susceptibility.

Abstract: Clostridium difficile has been associated with acute colitis in mature horses. Objective: To survey C. difficile colonisation of the alimentary tract with age, occurrence of diarrhoea and history of antibiotic therapy; and to study the occurrence and survival of C. difficile in the environment and antimicrobial susceptibility of isolated strains. Methods: A total of 777 horses of different breeds, age and sex were studied. Further, 598 soil samples and 434 indoor surface samples were examined. Antimicrobial susceptibility of 52 strains was investigated by Etest for 10 antibiotics. Results: In horses that developed acute colitis during antibiotic treatment, 18 of 43 (42%) were positive to C. difficile culture and 12 of these (28%) were positive in the cytotoxin B test. Furthermore, C. difficile was isolated from a small number of diarrhoeic mature horses (4 of 72 [6%]) with no history of antibiotic treatment, but not from 273 healthy mature horses examined or 65 horses with colic. An interesting new finding was that, in normal healthy foals age < 14 days, C. difficile was isolated from 1/3 of foals (16 of 56 [29%]). All older foals (170) except one were negative. Seven of 16 (44%) nondiarrhoeic foals treated with erythromycin or gentamicin in combination with rifampicin were also excretors of C. difficile. On studfarms, 14 of 132 (11%) outdoor soil samples were positive for C. difficile in culture, whereas only 2 of 220 (1%) soil samples from farms with mature horses were positive for C. difficile (P = < 0.001). By PCR, it was demonstrated that strains from the environment and healthy foals can serve as a potential reservoir of toxigenic C. difficile. The experimental study conducted here found that C. difficile survived in nature and indoors for at least 4 years in inoculated equine faeces. The susceptibility of 52 strains was investigated for 10 antibiotics and all were susceptible to metronidazole (MIC < or = 4 mg/l) and vancomycin (MIC < or = 2 mg/l). Conclusions: C. difficile is associated with acute colitis in mature horses, following antibiotic treatment. Furthermore, C. difficile was isolated from 1 in 3 normal healthy foals age < 14 days. Conclusions: Strains from healthy foals and the environment can serve as a potential reservoir of toxigenic C. difficile.
Publication Date: 2003-07-24 PubMed ID: 12875324DOI: 10.2746/042516403775600505Google Scholar: Lookup
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This research article explores the prevalence of the bacterium Clostridium difficile in horses, its presence in the environment, and how antibiotic treatment influences the bacteria. The study also evaluates the effect of age on C. difficile’s colonization of a horse’s gut, and investigates the bacterium’s survival time and antimicrobial susceptibility.

Research Methods

  • The researchers studied a wide sample size, involving a total of 777 horses of varying breeds, age, and sex. This provided a broad demographic to draw from for the research.
  • They examined 598 soil samples and 434 indoor sample surfaces. This allowed them to investigate the occurrence and survival of C. difficile in the environment.
  • They checked the antimicrobial susceptibility of 52 isolated strains of C. difficile utilizing the Etest for 10 antibiotics. This allowed them to examine how easily the bacteria could be killed by different types of antibiotics.

Research Results

  • Among horses that developed acute colitis while on antibiotic treatment, 42% were found to be positive for C. difficile culture and 28% were positive in the cytotoxin B test.
  • Interestingly, they found C. difficile in a small percentage (6%) of diarrhoeic mature horses without a history of antibiotic treatment, but none in healthy mature horses or horses with colic.
  • They managed to isolate C. difficile from 29% of normal healthy foals less than 14 days old. This is a significant new finding, showing that very young horses may carry C. difficile.
  • They also found that 44% of foals that were treated with antibiotics also contained C. difficile.
  • The researchers discovered that environmental factors such as soil carried an 11% prevalence of C. difficile in stud farms but only a 1% positive rate in farms with mature horses.
  • Strains from the environment and young, healthy foals could potentially serve as a reservoir of toxigenic C. difficile, as demonstrated by PCR tests.
  • In their experimental study, they found that C. difficile can survive both in nature and indoors for at least 4 years in contaminated horse faeces.
  • All 52 strains of C. difficile studied were found to be susceptible to antibiotics metronidazole and vancomycin.


  • C. difficile is associated with acute colitis in mature horses following antibiotic treatment.
  • They isolated the bacteria from 1 in 3 normal healthy foals aged less than 14 days.
  • Strains of the bacteria from healthy foals and the environment can potentially serve as a reservoir for toxigenic C. difficile, thereby possibly spreading the bacteria among the horse population.

Cite This Article

Bu00e5verud V, Gustafsson A, Franklin A, Aspu00e1n A, Gunnarsson A. (2003). Clostridium difficile: prevalence in horses and environment, and antimicrobial susceptibility. Equine Vet J, 35(5), 465-471. https://doi.org/10.2746/042516403775600505


ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 35
Issue: 5
Pages: 465-471

Researcher Affiliations

Bu00e5verud, V
  • Department of Bacteriology, National Veterinary Institute, SE-751 89 Uppsala, Sweden.
Gustafsson, A
    Franklin, A
      Aspu00e1n, A
        Gunnarsson, A

          MeSH Terms

          • Acute Disease
          • Age Factors
          • Animals
          • Anti-Bacterial Agents / pharmacology
          • Anti-Bacterial Agents / therapeutic use
          • Bacterial Proteins
          • Bacterial Toxins / analysis
          • Clostridioides difficile / drug effects
          • Clostridioides difficile / growth & development
          • Clostridioides difficile / isolation & purification
          • Colitis / drug therapy
          • Colitis / epidemiology
          • Colitis / microbiology
          • Colitis / veterinary
          • Colony Count, Microbial
          • Diarrhea / drug therapy
          • Diarrhea / epidemiology
          • Diarrhea / microbiology
          • Diarrhea / veterinary
          • Disease Reservoirs / veterinary
          • Drug Resistance, Bacterial
          • Enterocolitis, Pseudomembranous / drug therapy
          • Enterocolitis, Pseudomembranous / epidemiology
          • Enterocolitis, Pseudomembranous / microbiology
          • Enterocolitis, Pseudomembranous / veterinary
          • Feces / chemistry
          • Feces / microbiology
          • Female
          • Horse Diseases / drug therapy
          • Horse Diseases / epidemiology
          • Horse Diseases / microbiology
          • Horses
          • Male
          • Microbial Sensitivity Tests / veterinary
          • Prevalence
          • Soil Microbiology


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