Escherichia fergusonii.

Escherichia fergusonii was introduced in the genus Escherichia almost 65 years later than Escherichia coli after which the genus was named. From then (1985) onwards mainly case reports on E. fergusonii associated with disease in individuals of veterinary or human origin have been reported and only very few more extensive studies became available. This has resulted in very fragmented knowledge on this organism. The aim of this manuscript is to give an overview of what is known on E. fergusonii today and to stimulate more research on this organism so that better insight can be obtained in the role that E. fergusonii plays in human and animal infections.

Vermin on pig farms are vectors for Clostridium difficile PCR ribotypes 078 and 045.

Clostridium difficile is a gram positive, spore forming, toxin producing, anaerobic bacteria and an opportunistic pathogen for Man and many animal species, causing diarrhea in young piglets. Piglets probably become colonized from the environment. To investigate the possible spread and transmission of C. difficile by vermin, vermin samples were collected on a pig farm in the Netherlands and investigated for the presence of C. difficile. Samples of house mice (n=53), drain flies (n=39), lesser houseflies (n=95), and yellow mealworms (n=11) were found positive for C. difficile in 66%, 97%, 56% and 100% of cases respectively. C. difficile PCR ribotype 078 was found in all categories of vermin and ribotype 045 was found in two samples from the skeletal muscle of mice. House sparrows found dead on the premises (n=35) and bird droppings (n=26) were also investigated and carried C. difficile in 66% and 4% of cases respectively. PCR ribotype 078 was identified in bird and droppings samples but ribotype 045 was not. We conclude that vermin can play a role in the spread and transmission of C. difficile types 078 and 045 within pig farms and to other locations.

Clostridium difficile infection in the community: a zoonotic disease?

Clostridium difficile infections (CDIs) are traditionally seen in elderly and hospitalized patients who have used antibiotic therapy. In the community, CDIs requiring a visit to a general practitioner are increasingly occurring among young and relatively healthy individuals without known predisposing factors. C. difficile is also found as a commensal or pathogen in the intestinal tracts of most mammals, and various birds and reptiles. In the environment, including soil and water, C. difficile may be ubiquitous; however, this is based on limited evidence. Food products such as (processed) meat, fish and vegetables can also contain C. difficile, but studies conducted in Europe report lower prevalence rates than in North America. Absolute counts of toxigenic C. difficile in the environment and food are low, however the exact infectious dose is unknown. To date, direct transmission of C. difficile from animals, food or the environment to humans has not been proven, although similar PCR ribotypes are found. We therefore believe that the overall epidemiology of human CDI is not driven by amplification in animals or other sources. As no outbreaks of CDI have been reported among humans in the community, host factors that increase vulnerability to CDI might be of more importance than increased exposure to C. difficile. Conversely, emerging C. difficile ribotype 078 is found in high numbers in piglets, calves, and their immediate environment. Although there is no direct evidence proving transmission to humans, circumstantial evidence points towards a zoonotic potential of this type. In future emerging PCR ribotypes, zoonotic potential needs to be considered.

The use of digital games and simulators in veterinary education: an overview with examples.

In view of current technological possibilities and the popularity of games, the interest in games for educational purposes is remarkably on the rise. This article outlines the (future) use of (digital) games and simulators in several disciplines, especially in the veterinary curriculum. The different types of game-based learning (GBL)-varying from simple interactive computer board games to more complex virtual simulation strategies-will be discussed as well as the benefits, possibilities, and limitations of the educational use of games. The real breakthrough seems to be a few years away. Technological developments in the future might diminish the limitations and stumbling blocks that currently exist. Consequently, educational games will play a new and increasingly important role in the future veterinary curriculum, providing an attractive and useful way of learning.

Aerial dissemination of Clostridium difficile on a pig farm and its environment.

Clostridium difficile is increasingly recognized as an important enteropathogen in both humans and animals. The finding of C. difficile in air samples in hospitals suggests a role for aerial dissemination in the transmission of human C. difficile infection. The present study was designed to investigate the occurrence of airborne C. difficile in, and nearby a pig farm with a high prevalence of C. difficile. Airborne colony counts in the farrowing pens peaked on the moments shortly after or during personnel activity in the pens (P=0.043 (farrowing pens 1, 2), P=0.034 (farrowing pen 2)). A decrease in airborne C. difficile colony counts was observed parallel to aging of the piglets. Airborne C. difficile was detected up to 20 m distant from the farm. This study showed widespread aerial dissemination of C. difficile on a pig farm that was positively associated with personnel activity.

The relation between farm specific factors and prevalence of Clostridium difficile in slaughter pigs.

Foodborne ingestion through pork products of Clostridium difficile has been suggested a possible route of transmission of C difficile from pigs to humans. To determine whether C. difficile bacteria are present in the intestines of slaughter pigs, rectum contents of 677 slaughter pigs from 52 farms were collected at the slaughterhouse. Data on farm specific factors were collected and the association of these factors with the presence of C. difficile in pig herds from 39 farms was assessed. The prevalence of C. difficile and the ribotypical diversity that were found in this study were much higher than previously reported in literature, with an overall C. difficile prevalence of 8.6% (58/677). Sixteen distinct C. difficile ribotypes were identified, predominantly type 078 (31.0%, 18/58). This type is also commonly found in humans with C. difficile infection (CDI). Both on individual pig level and on herd level, no significant difference between the prevalence of C. difficile in pigs derived from conventional or organic farming types was detected. Farm system, size, and presence of other animal species on the farm did not result in significant different prevalences of C. difficile.

Clostridium difficile infection in humans and animals, differences and similarities.

Clostridium difficile is well known as the most common cause of nosocomial infections in human patients. In recent years a change in epidemiology towards an increase in incidence and severity of disease, not only inside the hospital, but also in the community, is reported. C. difficile is increasingly recognized in veterinary medicine as well and is now considered the most important cause of neonatal diarrhea in swine in North America. Research on the presence of C. difficile in production and companion animals revealed a huge overlap with strains implicated in human C. difficile infection (CDI). This has lead to the concern that interspecies transmission of this bacterium occurs. In this review C. difficile infections in humans and animals are compared. The pathogenesis, clinical signs, diagnosis and prevalence of CDI are described and similarities and differences of CDI between humans and animals are discussed.

Reduction of Clostridium sporogenes spore outgrowth in natural sausage casings using nisin.

Preservation of natural sausage casings using dry salt or saturated brine is regarded as sufficient to inactivate vegetative pathogenic non-spore-forming bacteria present on the casings. Although the outgrowth of bacterial spores is prevented by salt or saturated brine preservation, these spores will remain present and develop into vegetative cells when conditions are more favourable. To prevent subsequent outgrowth additional preservation measures should be implemented. In the experiments described the use of nisin was evaluated to reduce outgrowth of spores in desalinated casings. The bacteriocin nisin was chosen because of its known efficacy against spore-forming bacteria and their spores in various foodstuffs. Clostridium spore suspensions (Clostridium sporogenes, ATCC 3584) were used in two concentrations to inoculate three nisin concentrations (10, 50, 100 µg/mL) in water containing gamma-irradiated casings. Additionally, the binding of nisin to casings, using (14)C-labeled nisin Z and subsequent availability of nisin were evaluated. Results demonstrate that nisin is partly reversibly bound to casings and can reduce the outgrowth of Clostridium spores in the model used by approximately 1 log(10) (90%). However, the biological relevance of these results needs to be determined further by conducting industrial trials before any recommendation can be made on the practical implementation of nisin in the preservation of natural sausage casings.

Evaluation of four different diagnostic tests to detect Clostridium difficile in piglets.

Clostridium difficile is emerging as pathogen in both humans and animals. In 2000 it was described as one of the causes of neonatal enteritis in piglets, and it is now the most common cause of neonatal diarrhea in the United States. In Europe, C. difficile infection (CDI) in both neonatal piglets and adult sows has also been reported. Diagnosis of this infection is based on detection of the bacterium C. difficile or its toxins A and B. Most detection methods, however, are only validated for diagnosing human infections. In this study three commercially available enzyme immunoassays (EIAs) and a commercial real-time-PCR (Becton, Dickinson, and Company) were evaluated by testing 172 pig fecal specimens (139 diarrheic and 33 nondiarrheic piglets). The results of each test were compared to those of cytotoxicity assays (CTAs) and toxigenic culture as the "gold standards." Compared to CTAs, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were, respectively, as follows: for real-time PCR, 91.6, 37.1, 57.6, and 82.5%; for Premier Toxins A&B (Meridian), 83.1, 31.5, 53.1, and 66.7%; for ImmunoCard Toxins A&B kit (ICTAB; Meridian), 86.6, 56.8, 66.9, and 80.7%; and for VIDAS (bioMérieux), 54.8, 92.6, 85.0, and 72.8%. Compared to toxigenic culture, the sensitivity, specificity, PPV, and NPV were, respectively, as follows: for real-time PCR, 93.0, 34.7, 50.0, and 87.5%; for Premier Toxins A&B, 80.3, 27.7, 43.8, and 66.7%; and for ICTAB, 80.0, 46.2, 52.8, and 75.4%; and for VIDAS, 56.4, 89.8, 77.5, and 76.7%. We conclude that all tests had an unacceptably low performance as a single test for the detection of C. difficile in pig herds and that a two-step algorithm is necessary, similar to that in cases of human CDI. Of all of the assays, the real-time PCR had the highest NPV compared to both reference methods and is therefore the most appropriate test to screen for the absence of C. difficile in pigs as a first step in the algorithm. The second step would be a confirmation of the positive results by toxigenic culture.

Acquisition of Clostridium difficile by piglets.

Clostridium difficile is recognized as an important cause of nosocomial diarrhoea in humans especially in association with administration of antibiotics. In pigs, C. difficile can cause neonatal enteritis and can be isolated from faeces from both diseased and healthy animals. The presented prospective study describes how soon C. difficile can be isolated from newborn piglets after normal parturition and how C. difficile spreads within a pig farm. Six sows, their farrowing crates and their litters at one farm were sampled until C. difficile was found in all piglets. Within 48 h after birth, all 71 piglets became positive for C. difficile (two piglets were already positive within 1h post partum), all sows became positive within 113 h after parturition and the farrowing crates were found intermittently positive. C. difficile could also be detected in air samples and in samples of teats of the sows. All isolates belonged to PCR ribotype 078. Twenty-one C. difficile ribotype 078 isolates, found at the farm, were further analyzed by MLVA (multiple-locus variable-number tandem repeat analysis) and belonged to one clonal complex, except one isolate. To be sure that piglets were not born already infected with C. difficile ribotype 078, 38 caesarean derived piglets were sampled immediately after surgery. All piglets tested negative at delivery and stayed negative for C. difficile ribotype 078 during the 21 days in which they were kept in sterile incubators. This study shows that C. difficile ribotype 078 spreads easily between sows, piglets and the environment. Vertical transmission of C. difficile ribotype 078 was not found and is very unlikely to occur.

High occurrence of various Clostridium difficile PCR ribotypes in pigs arriving at the slaughterhouse.

BACKGROUND: Clostridium difficile is recognized as an important cause of nosocomial diarrhoea in humans, especially in association with the administration of antibiotics. Furthermore, C. difficile can not only cause neonatal enteritis in pigs but can also be found in pigs without any clinical disease symptoms. Clostridium difficile had been found on pork samples destined for human consumption. However, little is known about the risk of food-borne transmission. OBJECTIVE: To elaborate the risk of food-borne transmission of C. difficile via pigs. ANIMALS AND METHODS: The occurrence of C. difficile was assessed in pigs arriving at a slaughterhouse in the Netherlands. Rectal faecal samples from 50 pigs originating from 10 different farms were taken just after the pigs were stunned and bled. These samples were examined using a real-time PCR (BD GeneOhm™ Cdiff Assay) combined with culturing following enrichment. RESULTS: Using real-time PCR, none of the faecal samples were found positive for C. difficile while after culturing following enrichment, 14 out of 50 samples (28%) contained C. difficile. The positive samples were derived from nine different farms and encompassed seven different PCR ribotypes (015 predominant). All isolated C. difficile strains were positive for the toxin A and B genes. CONCLUSION: These results indicate that C. difficile can be found in faecal samples obtained from pigs after they were stunned and bled in a slaughterhouse. CLINICAL IMPORTANCE: The potential risk of these findings on food-borne transmission via pigs and associated impact on human health cannot be excluded and needs further study.

Short communication: Repeatability of differential goat bulk milk culture and associations with somatic cell count, total bacterial count, and standard plate count.

The aims of this study were to assess how different bacterial groups in bulk milk are related to bulk milk somatic cell count (SCC), bulk milk total bacterial count (TBC), and bulk milk standard plate count (SPC) and to measure the repeatability of bulk milk culturing. On 53 Dutch dairy goat farms, 3 bulk milk samples were collected at intervals of 2 wk. The samples were cultured for SPC, coliform count, and staphylococcal count and for the presence of Staphylococcus aureus. Furthermore, SCC (Fossomatic 5000, Foss, Hillerød, Denmark) and TBC (BactoScan FC 150, Foss) were measured. Staphylococcal count was correlated to SCC (r=0.40), TBC (r=0.51), and SPC (r=0.53). Coliform count was correlated to TBC (r=0.33), but not to any of the other variables. Staphylococcus aureus did not correlate to SCC. The contribution of the staphylococcal count to the SPC was 31%, whereas the coliform count comprised only 1% of the SPC. The agreement of the repeated measurements was low. This study indicates that staphylococci in goat bulk milk are related to SCC and make a significant contribution to SPC. Because of the high variation in bacterial counts, repeated sampling is necessary to draw valid conclusions from bulk milk culturing.

Integrating the issues of global and public health into the veterinary education curriculum: a European perspective.

Veterinary public health is an essential field in public health activities, based upon veterinary skills, knowledge and resources and which aims to protect and improve human health and welfare. This discipline has evolved through three stages, beginning with the fight against animal diseases, moving on to include meat inspection and control of zoonoses and now encompassing a much broader health sciences education, with the goal of guaranteeing a safe and wholesome food supply, protecting human wellbeing and conserving the environment. Within the veterinary medicine curriculum, veterinary public health has undergone a similar development. At first, it was mainly concerned with slaughterhouse-based courses but in time it included the teaching of such subjects as epidemiology, the control of communicable (zoonotic) diseases and emergency preparedness. Veterinary medical faculties in Europe have adjusted their curricula over the past few years to reflect these changes in the subject and to meet the need for specialisation. It could be said that veterinary public health education has literally moved from the local abattoir to the global community. In this paper, the authors briefly discuss examples of veterinary medicine curricula at different universities. The veterinary public health curriculum of the Faculty of Veterinary Medicine, Utrecht, is then discussed in detail, as an example of the European perspective on integrating global and public health issues into the veterinary curriculum.

Application of HACCP principles to control visitor health threats on dairy farms open to the general public.

An increasing number of Dutch dairy farmers have diversified their activities, often opening their farm up to visitors (tourist accommodation, farm shop, contact with livestock, etc). It is essential to prevent these visitors from having accidents or becoming ill, which could result in financial claims and might harm the reputation of the agricultural sector. This article describes how the hazard analysis critical control points concept and principles (HACCP) can be applied to these activities and integrated with on-farm operational herd health and production management programmes.