Clostridioides difficile as a Zoonotic and Foodborne Pathogen: Reviewing the Global Evidence and South African Data.

Clostridioides difficile infections (CDIs) are becoming increasingly problematic in developing countries, further burdening healthcare systems. In Southern Africa, limited information is available on the prevalence and diversity of C. difficile strains in animals, food, and the environment. This review aims to provide insight into global findings on strain diversity, antibiotic resistance, and the epidemiology of C. difficile associated with food-producing animals, wildlife, and food processing environments. The review further explores the zoonotic and foodborne risk potential of the pathogen and includes clinical trends of CDIs within South Africa. It is evident that farm environments and animals play a considerable role in the spread of C. difficile. A lack of broad surveillance, incomplete data on CDIs, and the prevalence of C. difficile within South Africa hinder an accurate representation of its zoonotic and foodborne potential.