Clostridium difficile in Ready-to-Eat Salads, Scotland.

Of 40 ready-to-eat salads, 3 (7.5%) were positive for Clostridium difficile by PCR. Two isolates were PCR ribotype 017 (toxin A–, B+), and 1 was PCR ribotype 001. Isolates were susceptible to vancomycin and metronidazole but variably resistant to other antimicrobial drugs. Ready-to-eat salads may be potential sources for virulent C. difficile. Over the past decade, C. difficile infection has become a prominent cause of healthcare-associated infection. Although C. difficile has been thought of traditionally as a predominantly nosocomial infection, the incidence of community-acquired cases has increased recently, as has the incidence of cases from other healthcare settings such as nursing homes. Notably, some evidence has shown that C. difficile may be brought into the healthcare environment by asymptomatic carriers. The reported carriage rates of C. difficile in healthy adults have varied from 0% to 3% in Europe to up to 15% in Japan. Little is known, however, about the prevalence of C. difficile in the environment and how it may be transmitted to humans. C. difficile has been found in a variety of environments, including water, soil, animal faeces, and foods; these findings suggest that C. difficile may be transmitted to humans through food, although no foodborne cases have been reported. Because ready-to-eat foods have been implicated in foodborne disease outbreaks associated with Salmonella species and Escherichia coli O157, the researchers examined ready-to-eat salads for the presence of C. difficile. Emerg Infect Dis. May 2009. Accessed 14 July 2009. Available from: http://www.cdc.gov/EID/content/15/5/817.htm DOI: 10.3201/eid1505.081186