Clostridium difficile: Is it a new food-borne pathogen?

Clostridium difficile, commonly found in nature, is a nosocomial opportunistic pathogen which causes formation of various clinical disorders including antibiotic associated diarrhea, fulminant colitis and pseudomembranous colitis. C. difficile is thought to be responsible for almost all of the pseudomembranous colitis and 15-25% of the antibiotics related diarrhea. Also it is known that hypervirulent strains generally have high recurrence rate and cause severe infections or even death. Although there is not enough data that C.difficile infects people by transmition via food, there is a significant increase in infections caused by C. difficile in recent studies. In addition to this knowledge bacteria have been isolated from various samples which animal foods, raw or ready to eat foods, vegetables, salads, the waters of sea, lake and river, seafood, soil and environmental samples. All of these bring to mind a question that C. difficile is whether or not a food-borne pathogen. Toxigenic characteristics of some strains of C. difficile detected in foods, resistance to antibiotics in various ratios and their spreading easily properties due to endospores resistant to difficult conditions have further increased the importance of this bacterium. In this review, the information about general characteristics, pathogenesis, infection sources, risk factors, presence in food, isolation from food and idendification of C. difficile have been given.