Gastrointestinal dysbiosis and the use of fecal microbial transplantation inClostridium difficileinfection

Abstract

The impact of antibiotics on the human gut microbiota is a significant concern. Antibiotic-associated diarrhea has been on the rise for the past few decades with the increasing usage of antibiotics. Clostridium difficile infections (CDI) have become one of the most prominent types of infectious diarrheal disease, with dramatically increased incidence in both the hospital and community setting worldwide. Studies show that variability in the innate host response may in part impact upon CDI severity in patients. That being said, CDI is a disease that shows the most prominent links to alterations to the gut microbiota, in both cause and treatment. With recurrence rates still relatively high, it is important to explore alternative therapies to CDI. Fecal microbiota transplantation (FMT) and other types of bacteriotherapy have become exciting avenues of treatment for CDI. Recent clinical trials have generated excitement for the use of FMT as a therapeutic option for CDI; however, the exact components of the human gut microbiota needed for protection against CDI have remained elusive. Additional investigations on the effects of antibiotics on the human gut microbiota and subsequent CDI will help reduce the socioeconomic burden of CDI and potentially lead to new therapeutic modalities.

Composition and immunological significance of the upper respiratory tract microbiota

“…Exploring host–bacterial interactions that have been uncovered in the gut, including adaptive immune development and pathogen clearance, could greatly decrease respiratory disease morbidity. Fecal transplants, which have been used to combat recurrent Clostridium difficile infections and diarrhea, have been identified to boost colonization resistance against the pathogen by altering the microbial community . Colonization resistance can be caused by limiting nutrients essential for pathogen growth, disrupting the niche required by the pathogen, or enhancing the immune response by the body.…”

Protective Effect of Carvacrol against Gut Dysbiosis and Clostridium difficile Associated Disease in a Mouse Model

“…Strikingly, CR reduced antibiotic-induced increases in the abundance of unfavorable bacterial populations such as Proteobacteria, specifically pathogenic gamma proteobacteria, including Enterobacteriaceae and other bacterial populations such as Verrucobacteria (Figure 5 ). Surprisingly, this beneficial shift brought about by CR treatment in the gut microbiome of antibiotic-treated and C. difficile infected animals is very much similar to that of human patients who have undergone fecal microbiome transplantation (Weingarden et al, 2014 ), which is documented as one of the most effective strategies against severe C. difficile infection (Schenck et al, 2015 ; Ofosu, 2016 ). These results suggest that reduced or delayed clinical infection rate and less severe clinical presentation of CR-treated animals could attributed in part to the beneficial shift in the gut microbiome.…”

The Gut Microbiome and Its Role in Obesity

“…47 A randomized controlled trial in obese subjects was conducted to investigate the effects of fecal transplantation on insulin resistance . 48 Subjects underwent small intestinal biopsies and subsequent bowel lavage through a duodenal tube, followed by random assignment to receive either homogenates of their own feces (autologous) or from healthy, lean donors (allogenic).…”