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Open AccessReview

Clostridium difficile in Asia: Opportunities for One Health Management

School of Medical & Health Sciences, Edith Cowan University, Joondalup 6027, Australia
Department of Microbiology, PathWest Laboratory Medicine, Nedlands 6009, Australia
School of Veterinary & Life Sciences, Murdoch University, Murdoch 6150, Australia
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2019, 4(1), 7;
Received: 4 December 2018 / Revised: 22 December 2018 / Accepted: 23 December 2018 / Published: 28 December 2018
(This article belongs to the Special Issue One Health and Zoonoses)
Clostridium difficile is a ubiquitous spore-forming bacterium which causes toxin-mediated diarrhoea and colitis in people whose gut microflora has been depleted by antimicrobial use, so it is a predominantly healthcare-associated disease. However, there are many One Health implications to C. difficile, given high colonisation rates in food production animals, contamination of outdoor environments by use of contaminated animal manure, increasing incidence of community-associated C. difficile infection (CDI), and demonstration of clonal groups of C. difficile shared between human clinical cases and food animals. In Asia, the epidemiology of CDI is not well understood given poor testing practices in many countries. The growing middle-class populations of Asia are presenting increasing demands for meat, thus production farming, particularly of pigs, chicken and cattle, is rapidly expanding in Asian countries. Few reports on C. difficile colonisation among production animals in Asia exist, but those that do show high prevalence rates, and possible importation of European strains of C. difficile like ribotype 078. This review summarises our current understanding of the One Health aspects of the epidemiology of CDI in Asia. View Full-Text
Keywords: Clostridium difficile; Asia; epidemiology; One Health Clostridium difficile; Asia; epidemiology; One Health
MDPI and ACS Style

Collins, D.A.; Riley, T.V. Clostridium difficile in Asia: Opportunities for One Health Management. Trop. Med. Infect. Dis. 2019, 4, 7.

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