Clostridium difficile in food and domestic animals: a new foodborne pathogen?

Clostridium difficile infection is increasingly recognized as a cause of diarrhea in outpatients and persons with no apparent health care facility contacts. In contrast to C. difficile infection acquired in health care settings, few risk factors for development of community-associated C. difficile infection are known. Foodborne transmission of C. difficile has been hypothesized as a possible source for community-associated infections; however, the evidence to confirm or refute this hypothesis is incomplete. Recent studies have demonstrated isolation of C. difficile from foods in the United States, Canada, and Europe and from meat products intended for consumption by pets. This raises questions about foodborne transmission of this pathogen to humans through consumption of contaminated products. This review summarizes the available data on C. difficile in animals and food and discusses the potential for foodborne transmission of this pathogen.