Gut microbiome and Clostridioides difficile infection: a closer look at the microscopic interface

Abstract

The pathogenesis of Clostridioides difficile infection (CDI) was recognized with its link to the use of antimicrobials. Antimicrobials significantly alter gut microbiota structure and composition, which led to the discovery of the association of this gut perturbation with the development of CDI. A number of factors implicated in its pathogenesis, such as advancing age, proton-pump inhibitors, and gastrointestinal diseases, are linked to gut microbiota perturbations. In an effort to better understand CDI, a multitude of studies have tried to ascertain protective and predictive microbial footprints linked with CDI. It has further been realized that CDI in itself can alter the gut microbiome. Its spore-forming capability poses as an impediment in the management of the infection and contributes to its recurrence. Antibiotic therapies used for its management have also been linked to gut microbiota changes, making its treatment a little more challenging. In an effort to exploit and utilize this association, gut microbial restoration therapies, particularly in the form of fecal microbial transplant, are increasingly being put to use and are proving to be beneficial. In this review, we summarize the association of the gut microbiome and microbial perturbation with initial and recurrent CDI.

A Metatranscriptomics Survey of Microbial Diversity on Surfaces Post-Intervention of cleanSURFACES® Technology in an Intensive Care Unit

“…With respect to potential respiratory pathogenic genera ( Haemophilus and Streptococcus) , there were no significant reduction in transcripts observed after application of cleanSURFACES ® intervention ( Figure 7 ) ( LaRocque and Ryan, 2019 ). Transcripts for the fecal biomarker taxa, Faecalibacterium , were significantly (P = 0.03) depleted on OBT surfaces ( Sehgal and Khanna, 2021 ). While observed reductions from Baseline to Post-intervention are not statistically significant for Enterococcus and Clostridioides , transcripts were shown to be depleted on OBT surfaces ( Figure 8 ).…”

Gut community alterations associated with Clostridioides difficile colonization in hospitalized gastroenterological patients with or without inflammatory bowel disease

“…Gut microbiota perturbations can be a precondition as well as a consequence of both IBD and CDI ( Missaghi et al, 2014 ; Guan, 2019 ; Sehgal and Khanna, 2021 ; Qiu et al, 2022 ). While co-occurrence of IBD and CDI is common ( Khanna et al, 2017 ), this study demonstrated that these two medical conditions also share common gut community signatures.…”

Impact of Primary and Secondary Bile Acids on Clostridioides difficile Infection

“…Numerous studies have shown a reduction in gut microbiota richness in patients with CDI compared to healthy controls, and in the first CDI episode compared to recurrent CDI ( Theriot et al 2011 ; 2014 ; Buffie et al 2015 ). Lack of bacteria with 7α-dehydroxylation activity leads to decreased secondary BA production ( Sehgal and Khanna 2021 ). It results in a a cause-and-effect relationship in which dysbiosis and BA pool alterations intensify and aggravate each other, leading inexorably to worsening of the situation, which could be described as a “vicious circle”.…”