C. difficile: Follow the Faeces

In this episode of Infection Control Matters, Brett and Martin talk to Professor Tom Riley about why we need to look well beyond the hospital to understand where Clostridioides difficile comes from. Tom discusses the growing importance of C. difficile as a community-acquired infection and explains how antimicrobial use in agriculture, animals, animal faeces, food and the environment may all form part of the transmission pathway. We explore some findings from his research, including C. difficile contamination of potatoes and domestic kitchens. We also discuss the challenges of controlling highly persistent spores in the environment, the potential role of foodborne transmission, and Tom's recent involvement with the Food and Agriculture Organization of the United Nations, where genomic evidence from an onion-associated outbreak provided compelling evidence for foodborne transmission. From animal antibiotics and manure to potatoes, kitchen sinks and the wider environment, this conversation challenges us to rethink where C. difficile comes from—and where infection prevention needs to look next. Perhaps the most important message? To understand C. difficile, we need to follow the faeces. Access the UN FAO report on toxigenic Clostridia in food here: https://openknowledge.fao.org/items/cce3d2ab-e8d7-4ab2-a349-dacba4eda392