Occurrence of Clostridium difficile in two types of wastewater treatment plants

Abstract

Wastewater is a potential environmental source of Clostridium difficile, although a direct link with community-acquired C. difficile infection (CA-CDI) in humans has not yet been established. The present study was performed to determine the occurrence of C. difficile in two types of wastewater treatment plants (WWTPs) in Isfahan, Iran. A total of 95 samples were taken from a conventional activated sludge treatment plant and a waste stabilization ponds system, and analyzed for the presence of C. difficile. C. difficile was found in 13.6 (3/22) of digested sludge samples. However, no C. difficile was detected in inlet and outlet samples or in raw sludge of activated sludge. C. difficile was also detected in 5 (2/40) of the samples from waste stabilization ponds. Polymerase chain reaction (PCR) analysis showed that all strains of C. difficile detected were toxigenic (tcdB gene positive). This study shows that C. difficile was present in WWTPs, which might constitute a potential source of community-acquired C. difficile infection. Copyright (C) 2015, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.