Issue: August 2017
July 12, 2017
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Epidemic strains of C. difficile detected within playground sandboxes

Issue: August 2017
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Jose Blanco, MD
José L. Blanco

Sandboxes in playgrounds that are unprotected from dogs and other wild animals may harbor epidemic strains of Clostridium difficile, posing a significant health risk to children, according to a study published in Zoonoses and Public Health.

Perspective from Andi L. Shane, MD, MPH, MSc

“The soil of playgrounds is a reservoir of diverse parasites and infectious agents. Free access of domestic and wild animals to recreational areas can increase the burden of microbiological contamination,” José L. Blanco, PhD, DVM, from the department of animal health at the Complutense University of Madrid, and colleagues wrote. “Children are generally regarded as the main group at risk for environmental exposure to pathogens, not only because they are frequent users of playgrounds, but also due to the high prevalence of geophagia within this group, and the immaturity of their immunological, neurological and digestive systems.”

To determine the presence of C. difficile in sandboxes to which dogs and other animals may have been exposed, the researchers conducted an isolation process through enrichment and selective culture procedures. The diversity of ribotype and amplified fragment length polymorphism (AFLP) was determined for the bacteria found within sandboxes in playgrounds located in Madrid, Spain.

C. difficile was present in 21 of 40 samples taken (52.5%). Of the 20 available isolates, eight were classified as toxigenic ribotypes (014 [n = 5], 106 [n = 2] and CD047 (n = 1)]. Ribotypes 014 and 106 were considered epidemic in these samples. Other isolates detected in sandboxes were detected as nontoxigenic and included ribotypes 009 (n=5), 039 (n=4), 067,151 and CD048 (one each).

“The growing number of pets and other animals leaving excrement in the sandboxes of playgrounds and other recreational areas constitutes a serious epidemiological threat,” Blanco and colleagues wrote. “Current tests for assessing the sanitary conditions of sandboxes focus on detecting some select pathogenic parasites and bacterial indicators of fecal contamination, but mostly neglect the possible presence of other emerging pathogens such as C. difficile.” — by Katherine Bortz

Disclosure: The researcher provides no relevant financial disclosures.