<i>Clostridium difficile:</i> A bad bug goes into defensive mode

Bremer, Erhard

doi:10.1111/1462-2920.13776

Cited by 1 publication

(1 citation statement)

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“…Due to strict anaerobic conditions required for the vegetative forms’ growth, spores are the main source of transmission and infection. Sporulation and further germination are essential for CDI establishment [ 4 , 5 ], whereas production of toxins is required to initiate symptomatology. Mechanisms and factors controlling C. difficile sporulation are not fully understood, but under certain stress conditions, the pathogen produces aerotolerant dormant spores to survive extreme environments [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Lactulose Administration Improves Dysbiosis Induced by Antibiotic and C. difficile in the PathoGutTM SHIME Model

et al. 2022

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Clostridioides difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea and an important nosocomial infection with different severity degrees. Disruption of the gut microbiota by broad-spectrum antibiotics creates a proper environment for C. difficile colonization, proliferation, and clinical disease onset. Restoration of the gut microbial ecosystem through prebiotic interventions can constitute an effective complementary treatment of CDI. Using an adapted simulator of the human gut microbial ecosystem, the PathoGutTM SHIME, the effect of different long-term and repeated dose lactulose treatments was tested on C. difficile germination and growth in antibiotic-induced dysbiotic gut microbiota environments. The results showed that lactulose reduced the growth of viable C. difficile cells following clindamycin treatment, shifted the antibiotic-induced dysbiotic microbial community, and stimulated the production of health-promoting metabolites (especially butyrate). Recovery of the gut microenvironment by long-term lactulose administration following CDI was also linked to lactate production, decrease in pH and modulation of bile salt metabolism. At a structural level, lactulose showed a significant bifidogenic potential and restored key commensal members of the gut ecosystem such as Lactobacillaceae, Veillonellaceae and Lachnospiraceae. These results support further human intervention studies aiming to validate the in vitro beneficial effects of lactulose on gut microbiome recovery during antibiotic exposure and CDI.

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