This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Clostridium, Subject name: Microbiology
Clostridium difficile can be spread through all EXCEPT- 
Select and explain. 
A. Oral - fecal route, B. Direct, C. Hand to hand contact, D. Needles
D: Needles
Answer: D: Needles 
Explanation: Ans. (d) NeedlesRef: Microbiology by Ananthanarayan and Paniker 8th ed. /251, 263, 634* The organism is carried by about 3% of the general population and about 30% of the hospitalised patients in their gastrointestinal tract.* It is usually transmitted by the feco-oral route and direct contact and hand to hand transmission are important modes of transmission in the hospitalized patients.* Clostridium difficile causes pseudomembranous colitis.