<unk> is transmitted from person to person by the fecal-oral route, shed in faeces. Any surface, device, or material (e.g., toilets, bathing tubs, and electronic rectal thermometers) that becomes contaminated with faeces may serve as a reservoir for the C.<unk>  spores. C.<unk>  can live for long periods of time on surfaces. The organism forms heat-resistant spores that are not killed by alcohol-based hand cleansers or routine surface cleaning, thus, these spores survive in clinical environments for long periods. Because of this, the bacterium may be cultured from almost any surface. Once spores are ingested, their acid resistance allows them to pass through the stomach unscathed. They germinate and multiply into vegetative cells in the colon upon exposure to bile acids. Consequently, the World Health Organization advocates the use of soap in addition to alcohol solutions to limit the spread of the spores. Sporulation was shown to be significantly reduced after inactivation of C.<unk> s DNA methyltransferase CamA, raising the prospect of developing a drug that may inhibit this bacterium in a specific manner. Susceptibility to colonization appears to be triggered by diarrheal illnesses, such as food poisoning or laxative abuse; people without a history of diarrheal illnesses who are exposed to C.<unk>  spores will not necessarily become carriers. Once people are colonized by C.<unk> , they remain carriers for year-long time scales, but the day-to-day abundance of C.<unk>  fluctuates considerably - fluctuating from being below the limit of detection to high levels of shedding from one day to the next. GI disturbances in carriers appear to trigger periods of increased shedding which may be an important factor for transmission.
Clostridioides difficile 
Salmonella
Campylobacter upsaliensis
Campylobacter jejuni
Yersinia enterocolitica
Yersinia rohdei
Enteroaggregative Escherichia coli
Escherichia coli O157:H7