Clostridium difficile is a bacterial species found in the intestinal tract of humans and various animal species, including pets, farm animals, and wildlife. It is an important cause of disease in both humans and animals. Some strains of C. difficile produce toxins that lead to illness, while others can form spores that survive in the environment and are resistant to many disinfectants. The prevalence of C. difficile is increasing in North America, and dog owners should be aware of how it can affect their canine companions.
Prevalence in Humans
C. difficile is the leading cause of infectious hospital-associated diarrhea in adults in developed countries, accounting for 15-25% of antibiotic-associated diarrhea cases. The risk of C. difficile infection (CDI) increases with antibiotic treatment, which can disrupt the balance of gut bacteria and allow C. difficile to grow rapidly. Other risk factors include old age, certain cancer treatments, acid-suppressants used for stomach ulcers, long hospitalization, and certain medical procedures. A hyper-virulent strain of C. difficile (ribotype 027/NAP1) has emerged and caused severe illness in hospitalized patients.
Prevalence in Animals
C. difficile can be found in the intestines of healthy dogs, with higher percentages in puppies, kittens, breeding colonies, and dogs visiting hospitals (up to 30%). The bacteria can also be present in other types of pets, but its overall prevalence is unknown. Most animals carrying C. difficile do not become ill, but a link between C. difficile and diarrhea in dogs has been observed in some cases.
Transmission between Humans and Animals
It is uncertain whether C. difficile can be transmitted from pets to humans. The strains found in pets are often the same as those found in humans, including the hyper-virulent ribotype 027/NAP1. While transmission between species is plausible, conclusive proof is still lacking. As a precaution, it is best to consider C. difficile as potentially transmissible between pets and people until further evidence is available.
Diagnosis and Treatment
CDI is diagnosed by testing for the toxins produced by C. difficile in the stool. Treatment for mild cases may not be necessary, but severe cases may require antibiotics to control the infection. Probiotics are not considered effective for treating CDI in humans, and cases in dogs often resolve without additional antibiotics.
Preventive Measures for Dog Owners
- Wash hands thoroughly with soap and water after handling your dog, especially before touching food or items in the kitchen.
- Avoid direct contact with dog stool, and promptly clean up any accidents, disinfecting the area with diluted household bleach (1 part bleach to 10 parts water) for surfaces that won't be damaged.
- Prevent dogs from drinking from toilets in human hospitals or nursing homes.
- Follow all treatment instructions given by your veterinarian.
- Keep dogs diagnosed with C. difficile away from other animals until their diarrhea has resolved.
Therapy Animals
Visiting healthcare facilities is a risk factor for C. difficile shedding in dogs, but the risk to therapy dogs is uncertain. There are guidelines available to reduce the risk of dogs acquiring infectious diseases in hospitals, and therapy dogs should not be tested or treated for C. difficile unless symptoms are present.
Zoonotic Risk
Healthy adults and older children who thoroughly wash their hands after handling dogs and avoid contact with animal feces have a low zoonotic risk of C. difficile transmission. Infants under 12 months are not affected by C. difficile, but young children should be supervised when playing with dogs and taught to wash their hands afterward, especially before handling food.
Clostridium difficile is a concerning bacterial species present in humans and animals, including dogs. The prevalence is increasing in North America, and while transmission between pets and people is plausible, further research is needed to confirm it. Dog owners should take preventive measures to reduce the risk of infection and be cautious with therapy pets visiting healthcare facilities. Washing hands thoroughly and avoiding direct contact with dog stool are essential practices to minimize the risk of transmission.
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