Approaching toxigenic Clostridia from a one health perspective

The anaerobic Clostridia include a number of toxigenic, disease-causing species, including Clostridium botulinum, Clostridioides difficile and Clostridium perfringens [1,2], in addition to other species such as Clostridium tetani, Paeniclostridium sordellii and Clostridium novyi [3,4]. A core feature among the Clostridia is their ability to sporulate, a stress-induced response that enables their survival through harsh conditions including extremes of temperature, pH, as well as exposures to antimicrobials and other sterilants [[5], [6], [7]]. Clostridial endospores are found ubiquitously in marine and freshwater ecosystems, soil, and food sources, in addition to their colonization of the gastrointestinal tracts of animals. Clostridial spores can further persist for extended periods of time and be actively spread through adherence to fomites such as walls, floors, soles of shoes, animal fur, as well as on surfaces and equipment [8,9]. In contrast to pathogenic strains from other phyla, toxigenic and spore-forming pathogens have greater capacity to spread and persist in diverse environments [[9], [10], [11], [12]], factors that provide unique challenges in detecting transmission chains, and in considering preventive and therapeutic approaches for infections, particularly in immunocompromised and other vulnerable populations such as infants and young animals [[13], [14], [15], [16]].

Globally, Clostridial pathogens incur billions of US dollars annually in costs associated with human and animal infections, as well as agricultural systems and components of the food supply that are impacted by associated outbreaks. The advent of methods to rapidly sequence bacterial genomes has provided a robust tool to enhance our monitoring and implementation of preventive programs [[17], [18], [19]], while also supporting mechanistic studies to define how toxigenic strains leverage these virulence factors with innate metabolic and cellular properties to promote their survival and spread among ecosystems [[20], [21], [22], [23], [24], [25]]. Investigating transmission chains among these settings under a One Health framework supports ongoing efforts in Public Health to define pathogen reservoirs, at-risk populations, and the development of preventive programs and improved measures to diagnose, treat, and prevent these infections.

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