Clostridium difficile

The aim of this study is to determine the prevalence and diversity of C. difficile in Dutch animals using the MLVA method and an existing faeces collection.

Clostridium difficile is the most important bacterial cause of diarrhea in hospitalised humans. The occurrence is frequently associated with antibiotic and cytostatic treatments. Recent research showed that the frequency, seriousness and treatment failure of CDAD (Clostridium difficile acquired disease) or CDI (Clostridium difficile infection) is increasing in Europe, US and Canada. CDAD was originally associated with outbreaks in hospital acquired outbreaks, however recently community acquired outbreaks have been identified. These CDAD strains are regarded as more virulent and less sensitive for antibiotics.

C. difficile can also cause diarrhea in several animals, and appears to be an increasing problem in pigs and calves. Due to the prohibition of growth promoters in animal feed the number of C. difficile infections in animals has increased over the last years. A well recognised example is ribotype O27, a subtype which gives epidemic human outbreaks, but which is also found in calves and meat products, and therefore might be a source of infection for humans.

Despite the increasing prevalence of human and veterinary CDAD, epidemical research on C. difficile (relationship between human and veterinary isolates) in the Netherlands is limited. Several genotyping methods have been described, amongst them MLVA (multi locus variable number of tandem repeat analysis) which is regarded as a high discriminatory, robust and fast method.


Establish a well characterised collection of C. difficile isolates from animals which can be used for studying relationships between human and animal isolates.

Develop a C. difficile ribotype and MLVA database, which can be used for studying relationships between human and animal isolates.

Overview of the prevalence of C. difficile isolates from animals in the Netherlands.
Overview of the diversity / population structure of C. difficile isolates from animals in the Netherlands and the relationship with human isolates.