difficile has also emerged as a pathogen or commensal in different animals such as pigs, calves BMN 673 solubility dmso and chickens [5–7]. Studies on C. difficile in the environment are sparse and describe its presence in soil and water [8–11]. For both, environmental contamination and community-associated human infections, animals have been suggested as possible reservoir [5, 12, 13]. The most prevalent PCR C646 mouse ribotypes differ between humans and food animals. In bovine and porcine hosts PCR ribotype 078 (corresponding to NAP7 and NAP8 by PFGE) is most often detected [14–16]. In humans approximately 300 PCR ribotypes are recognized and the most prevalent in many European countries is PCR ribotype 014/020 (toxinotype

0) [17]. However, in both animals and humans, the distribution of ribotypes is different between countries URMC-099 cell line and from setting to setting, although the heterogeneity is much lower in animals compared to humans. Two large pan-European studies have shown these geographic differences for human-associated C. difficile [17, 18]. Commonly identified PCR ribotypes for which only regional spreading is suggested are 106, the predominant

strain in the UK, ribotype 053 in Austria and 018 which is predominant in Italy [19, 20]. In the United States and Canada NAP1, corresponding to PCR ribotype 027 is one of the predominant strains in humans, and in Japan and Korea PCR ribotype 017/toxinotype VIII (A-B+) strain is responsible for CDI outbreaks [21, 22]. Most of the comparative studies on C. difficile genotypes in humans and food animals have focused on

ribotype 078 strain comparisons [23–25]. In addition to being the most frequently isolated Thymidine kinase strain from pigs and calves in North America and the Netherlands [14–16] it is becoming prevalent in humans in hospitals [17, 26] and in the community [3]. It is also often the most prevalent ribotype isolated from food [13, 27]. Some other currently important human ribotypes (027, 017) are also reported from animals, [5] but they seem to be less well established in animal hosts. There is currently no published report comparing a large number of strains isolated in the same geographic region from different sources, including humans, animals and the environment. This study makes such a comparison of C. difficile strains isolated from three of the possible main reservoirs in a single country to show that ribotypes other than 078 are shared between host types and the environment. Results and discussion Distribution of PCR ribotypes in different hosts and the environment All 786 isolates that were isolated between 2008 and 2010 were grouped into 90 different PCR ribotypes; human isolates into 77 ribotypes, animal isolates into 23 ribotypes and the environmental isolates into 36 ribotypes (Figure 1, see also Additional file 1: Table S1). There was a considerable overlap between C. difficile ribotypes isolated from humans, animals and the environment. Eleven PCR ribotypes were common to all three reservoirs.