Sources and potential transmission of Clostridium difficile in the community of Western Australia

The notion that Clostridium difficile infection (CDl) is a hospital-associated disease has been challenged following reports of global increases in community-associated CDl cases and the isolation of clinically-important C. difficile strains from animals. This thesis provides novel and important insights into the prevalence, genotypes, antimicrobial resistance and potential transmission of food and environmental C. difficile in Western Australia (WA ). This work has shown that both food and the general environment in WA are reservoirs for C. difficile that are genetically closely-related to clinical isolates, findings that support the theory of food borne and environmental transmission of CDl.