A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Clostridium difficile contamination of public tap water distribution system during a waterborne outbreak in Finland
Tekijät: Kotila SM, Pitkänen T, Brazier J, Eerola E, Jalava J, Kuusi M, Könönen E, Laine J, Miettinen IT, Vuento R, Virolainen A
Kustantaja: SAGE PUBLICATIONS LTD
Julkaisuvuosi: 2013
Journal: Scandinavian Journal of Public Health
Tietokannassa oleva lehden nimi: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH
Lehden akronyymi: SCAND J PUBLIC HEALT
Numero sarjassa: 5
Vuosikerta: 41
Numero: 5
Aloitussivu: 541
Lopetussivu: 545
Sivujen määrä: 5
ISSN: 1403-4948
DOI: https://doi.org/10.1177/1403494813481648
Tiivistelmä
Aims: In November through December 2007, the drinking water distribution system in the town of Nokia, Finland, was contaminated with treated sewage effluent that resulted in a large gastroenteritis outbreak in the community. The aim of the present study was to investigate if the contaminated water in this outbreak was also a potential source of Clostridium difficile infections. Methods: Samples from the contaminated tap water and treated sewage effluent were collected. Stool samples from a portion of patients that fell ill during the outbreak were examined for C. difficile. PCR ribotyping was performed on toxin positive C. difficile isolates and the genetic profiles of the water and patient isolates were compared. Results: Twelve toxin-positive C. difficile isolates were found in water samples: five from contaminated tap water and seven from treated sewage effluent. Among these, four and five distinct PCR ribotype profiles were identified, respectively. Four PCR ribotype profiles were found among nine human faecal C. difficile isolates. Two isolates, one from tap water and one from a patient, had an indistinguishable PCR ribotype profile. Conclusions: Our findings demonstrate for the first time C. difficile contamination of a tap water distribution system and waterborne transmission of toxigenic C. difficile seems possible.
Aims: In November through December 2007, the drinking water distribution system in the town of Nokia, Finland, was contaminated with treated sewage effluent that resulted in a large gastroenteritis outbreak in the community. The aim of the present study was to investigate if the contaminated water in this outbreak was also a potential source of Clostridium difficile infections. Methods: Samples from the contaminated tap water and treated sewage effluent were collected. Stool samples from a portion of patients that fell ill during the outbreak were examined for C. difficile. PCR ribotyping was performed on toxin positive C. difficile isolates and the genetic profiles of the water and patient isolates were compared. Results: Twelve toxin-positive C. difficile isolates were found in water samples: five from contaminated tap water and seven from treated sewage effluent. Among these, four and five distinct PCR ribotype profiles were identified, respectively. Four PCR ribotype profiles were found among nine human faecal C. difficile isolates. Two isolates, one from tap water and one from a patient, had an indistinguishable PCR ribotype profile. Conclusions: Our findings demonstrate for the first time C. difficile contamination of a tap water distribution system and waterborne transmission of toxigenic C. difficile seems possible.
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