The Clostridium difficile Epidemic and its Prevalence in Two New Urban, International Environments

Background: Clostridium difficile is a disruptive pathogen of global concern, particular among children, elderly, and immunosuppressed patients. While many studies have been done in United States and Europe, we looked at areas with high population density in third world countries. This provides a preliminary step to understand the prevalence of this virulent pathogen in parts of the world which have not yet received attention. Methods: We collected non-hospital, environmental swabs from shoe bottoms and high-touch surfaces in Mumbai, India and Nuevo Laredo, Mexico. All positive samples for C. difficile were tested for toxins A and B, ribotyped, and compared with each other for further toxigenic analysis. Results: Fairly similar percentages were produced for C. difficile prevalence in both urban environments. Also, very close percentages of toxigenic C. difficile were produced when both locations had the same ribotypes and when the cities each had their own unique ribotypes. Conclusions: The toxigenic strains specific to both Mumbai and Nuevo Laredo and toxigenic strains unique to both environments had resembling prevalence indicating the ubiquity of the pathogen C. difficile in all environments regardless of population or size.