Clostridioides difficile, a New “Superbug”

Abstract

Clostridioides difficile is a Gram-positive, spore-forming, anaerobic bacterium. The clinical features of C. difficile infections (CDIs) can vary, ranging from the asymptomatic carriage and mild self-limiting diarrhoea to severe and sometimes fatal pseudomembranous colitis. C. difficile infections (CDIs) are associated with disruption of the gut microbiota caused by antimicrobial agents. The infections are predominantly hospital-acquired, but in the last decades, the CDI patterns have changed. Their prevalence increased, and the proportion of community-acquired CDIs has also increased. This can be associated with the appearance of hypervirulent epidemic isolates of ribotype 027. The COVID-19 pandemic and the associated antibiotic overuse could additionally change the patterns of infections. Treatment of CDIs is a challenge, with only three appropriate antibiotics for use. The wide distribution of C. difficile spores in hospital environments, chronic persistence in some individuals, especially children, and the recent detection of C. difficile in domestic pets can furthermore worsen the situation. “Superbugs” are microorganisms that are both highly virulent and resistant to antibiotics. The aim of this review article is to characterise C. difficile as a new member of the “superbug” family. Due to its worldwide spread, the lack of many treatment options and the high rates of both recurrence and mortality, C. difficile has emerged as a major concern for the healthcare system.

A Novel Antibiotic, Rhodomyrtone: Pharmacokinetic Studies in a Murine Model and Optimization and Validation of High-Performance Liquid Chromatographic Method for Plasma Analysis

“…The Tmax of vancomycin is not available due to being practically not absorbed via the oral route [31]. However, oral vancomycin is recommended for treating C. difficile infection [32] and rhodomyrtone also has potential [13]. The SwissADME [33] model predicted that rhodomyrtone had high lipophilicity, poor water solubility and good gastrointestinal absorption (Table 6).…”

Clustering Disease of Clostridioides Difficile Infection: Implication for the Management in Internal Medicine

“…Closely related to the production of the two toxins, there is also the regulatory activity of TcdC which should repress the production of TcdA and TcdB, but in conjunction with exposure to antibiotics or changes in the intestinal microflora, loses its function on the gene expression of the toxins. As a result, the expression of TcdA and TcdB is upregulated, leading to increased toxin production, which can cause more severe disease symptoms [172,173].…”

A peptide selectively recognizes Gram-negative bacteria and forms a bacterial extracellular trap (BET) through interfacial self-assembly

“…Superbug infection emerged as an underestimated global public health issue largely due to abuse of antibiotics. 1–4 Gram-negative strains are more readily becoming antibiotic-resistant primarily due to the existence of impermeable cell walls. 5–8 Thus, new therapeutics with novel mechanisms, broad-spectrum, and low risk to induce antimicrobial resistance are pursued continuously in this field.…”