First isolation of Clostrioides difficile from smoked and dried freshwater fish in Cambodia

In Cambodia, freshwater aquaculture is the most important source of food production. Fresh fish meat is considered a highly perishable food that requires the use of different manipulations and preservation techniques to inhibit the proliferation of undesirable bacteria. These bacteria are naturally present in the raw product or could be acquired during manipulation by cross-contamination. Many studies worldwide have investigated the epidemiology of Clostridioides difficile (C. difficile) in food, but to date, there are no publications about the bacterium in ready-to-eat fish or descriptions in Cambodia. The objective of this study was to assess the presence of C. difficile in one of the main food supplies of this country, smoked freshwater fish, originating from different provinces. A total of 25 samples were collected directly from local markets, yielding 4 C. difficile isolates and an overall recovery rate of 16%. Most of the isolates were toxigenic and classified as rare PCR profiles, and they were resistant to clindamycin. These findings indicate contamination during handling and/or contamination of the raw fish, followed by insufficient heat treatment to kill the spores. The presence of C. difficile in smoked and dried fish implies a potential risk of human exposure, contamination and infection

Standardised surveillance of Clostridium Difficile Infection in European acute care hospitals: A pilot study, 2013

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a ‘minimal’ option (aggregated hospital data), a ‘light’ option (including patient data for CDI cases) and an ‘enhanced’ option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe

Nest-site competition between bumblebees (Bombidae), social wasps (Vespidae) and cavity-nesting birds in Britain and the Western Palearctic

Capsule: There is no evidence of widespread significant nest-site competition in Britain or the Western Palearctic between cavity-nesting birds and bumblebees or social wasps. Aims: To investigate competition between cavity-nesting birds and bumblebees and wasps, particularly the range-expanding Tree Bumblebee, Saxon Wasp and European Hornet in Britain, and review evidence throughout the Western Palearctic. Methods: We compared field data from English and Polish studies of tits and woodpeckers breeding in nest-boxes and/or tree holes to assess nest-site competition with bumblebees and wasps. We reviewed the literature quantifying nest-site competition between birds and these insects in the Western Palearctic. Results: Bumblebees and wasps are capable of usurping small passerines from nests. In England, these insects commandeered a mean annual 4.1% of tit nests initiated in nest-boxes; occurrence of hornets showed a long-term increase, but not other wasps or bumblebees. Across the Western Palearctic, insect occupation of nest-boxes was generally low, and was lower in England than in Poland. No insects were discovered in tree cavities, including those created by woodpeckers (Picidae). Conclusion: Nest-site competition between cavity-nesting birds and bumblebees and wasps appears to be a ‘nest-box phenomenon’, which may occasionally interfere with nest-box studies, but appears negligible in natural nest-sites

Two Distinct Patterns of Clostridium Difficile Diversity Across Europe Indicates Contrasting Routes of Spread

Background Rates of Clostridium difficile infection vary widely across Europe, as do prevalent ribotypes. The extent of Europe-wide diversity within each ribotype is however unknown. Methods Inpatient diarrhoeal faecal samples submitted on one day in summer and winter (2012-2013) to laboratories in 482 European hospitals were cultured for C. difficile, and isolates ribotyped; those from the 10 most prevalent ribotypes were Illumina whole-genome sequenced. Pairwise single nucleotide differences (SNPs) were obtained from recombination-corrected maximum-likelihood phylogenies. Within each ribotype, country-based sequence clustering was assessed using the ratio of the median SNPs between isolates within versus across different countries using permutation tests. Time-scaled Bayesian phylogenies where used to reconstruct the historic location of each lineage. Results Sequenced isolates (n=624) were from 19 countries. Five ribotypes had within-country clustering: ribotype-356, only in Italy; ribotype-018, predominantly in Italy; ribotype-176, with distinct Czech and German clades; ribotype-001/072, including distinct German, Slovakian, and Spanish clades; and ribotype-027, with multiple predominantly country-specific clades including in Hungary, Italy, Germany, Romania and Poland. By contrast, we found no within-country clustering for ribotypes 078, 015, 002, 014, and 020, consistent with a Europe-wide distribution. Fluoroquinolone-resistance was significantly more common in within-country clustered ribotypes (p=0.009). Fluoroquinolone-resistant isolates were also more tightly geographically clustered, median (IQR) 43 (0-213) miles between each isolate and the most closely genetically-related isolate vs. 421 (204-680) in non-resistant pairs (p<0.001). Conclusions Two distinct patterns of C. difficile ribotype spread were observed, consistent with either predominantly healthcare-associated acquisition or Europe-wide dissemination via other routes/sources, e.g. the food chain