Insight into alteration of gut microbiota in Clostridium difficile infection and asymptomatic C. difficile colonization

Zhang, Lihua; Dong, Danfeng; Jiang, Cen; Li, Zhen; Wang, Xuefeng; Peng, Yibing

doi:10.1016/j.anaerobe.2015.03.008

Cited by 115 publications

(152 citation statements)

References 30 publications

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“…Human studies have also implicated particular microbial taxa in modulating susceptibility to CDI. In general, high levels of members of the phylum Bacteroidetes, consisting of strictly Gram-negative anaerobes, are thought to be protective against CDI, whereas increased numbers of Proteobacteria are thought to increase susceptibility (58,59,99,114,115). These correlations are also consistent with observations that FMT recipients have increased levels of Bacteroidetes and decreased levels of Proteobacteria following recovery from CDI (92,93,95,116).…”

Section: Microbial Taxa Associated With Colonization Resistance Againsupporting

confidence: 79%

“…Antibiotic treatment depletes members of the two dominant bacterial phyla in the gut, the Bacteroidetes and Firmicutes (56,57). Antibiotics also lead to increases in the numbers of Proteobacteria, which are associated with susceptibility to CDI in humans (56)(57)(58)(59). Studies in both humans and animals have indicated that changes in the microbiota brought on by antibiotic treatment can be long lasting, although this depends on the antibiotic used (56,57,60,61).…”

Section: Risk Factors For Developing CDImentioning

confidence: 99%

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Gleaning Insights from Fecal Microbiota Transplantation and Probiotic Studies for the Rational Design of Combination Microbial Therapies

et al. 2017

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SUMMARY Beneficial microorganisms hold promise for the treatment of numerous gastrointestinal diseases. The transfer of whole microbiota via fecal transplantation has already been shown to ameliorate the severity of diseases such as Clostridium difficile infection, inflammatory bowel disease, and others. However, the exact mechanisms of fecal microbiota transplant efficacy and the particular strains conferring this benefit are still unclear. Rationally designed combinations of microbial preparations may enable more efficient and effective treatment approaches tailored to particular diseases. Here we use an infectious disease, C. difficile infection, and an inflammatory disorder, the inflammatory bowel disease ulcerative colitis, as examples to facilitate the discussion of how microbial therapy might be rationally designed for specific gastrointestinal diseases. Fecal microbiota transplantation has already shown some efficacy in the treatment of both these disorders; detailed comparisons of studies evaluating commensal and probiotic organisms in the context of these disparate gastrointestinal diseases may shed light on potential protective mechanisms and elucidate how future microbial therapies can be tailored to particular diseases.

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Section: Microbial Taxa Associated With Colonization Resistance Againsupporting

confidence: 79%

Section: Risk Factors For Developing CDImentioning

confidence: 99%

Gleaning Insights from Fecal Microbiota Transplantation and Probiotic Studies for the Rational Design of Combination Microbial Therapies

et al. 2017

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“…found that samples from asymptomatic carriers exhibited decreased diversity, similar to samples obtained from CDI patients, but were structurally more similar to healthy control samples (66). The asymptomatic carrier specimens contained fewer Proteobacteria than CDI samples and a greater abundance of Bifidobacteria, which were completely lacking in the CDI specimens (66). These data suggest that the presence or absence of certain microbial taxa is more important than microbial diversity when considering CDI susceptibility.…”

Section: Difficile and The Gut Microbiomementioning

confidence: 96%

Structural and functional changes within the gut microbiota and susceptibility to Clostridium difficile infection

2016

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Alteration of the gut microbial community structure and function through antibiotic use increases susceptibility to colonization by Clostridium difficile and other enteric pathogens. However, the mechanisms that mediate colonization resistance remain elusive. As the leading definable cause of infectious diarrhea, toxigenic C. difficile represents a burden for patients and health care systems, underscoring the need for better diagnostics and treatment strategies. Next-generation sequence data has increased our understanding of how the gut microbiota is influenced by many factors including diet, disease, aging and drugs. However, a microbial-based biomarker differentiating C. difficile infection from antibiotic-associated diarrhea remains elusive. Metabolomics profiling, which is highly responsive to changes in physiological conditions, have shown promise in differentiating subtle disease phenotypes that exhibit a nearly identical microbiome community structure, suggesting metabolite-based biomarkers may be an ideal diagnostic for identifying patients with CDI. This review focuses on the current understanding of structural and functional changes to the gut microbiota during C. difficile infection obtained from studies assessing the microbiome and metabolome of samples from patients and murine models.

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“…Two small studies have suggested that differences in the host microbiota could be a potential mechanism that distinguishes between asymptomatic carriage and disease (61, 62). By comparing microbial community composition between four patients with CDI, four asymptomatically colonized patients and non-colonized controls, Vincent et al (62) found that organisms classified as members of the Clostridiales incertae sedis XI family, Eubacterium species, or Clostrdium species other than C. difficile were enriched in asymptomatically colonized patients compared to patients with symptomatic CDI.…”

Section: Clostridium Difficile Carriage and Diseasementioning

confidence: 99%

“…By comparing microbial community composition between four patients with CDI, four asymptomatically colonized patients and non-colonized controls, Vincent et al (62) found that organisms classified as members of the Clostridiales incertae sedis XI family, Eubacterium species, or Clostrdium species other than C. difficile were enriched in asymptomatically colonized patients compared to patients with symptomatic CDI. By comparing eight symptomatically infected patients, eight asymptomatically colonized C. difficile patients, and healthy controls, Zhang et al (61) observed trends towards increased levels of Bacteroides, Lachnospiraceae incertae sedis , and Clostridium XIVa species and statistically significant decreases in the levels of Escherichia/Shigella species in asymptomatically colonized patients compared to healthy controls. Both asymptomatically colonized patients and patients with CDI also had significantly decreased microbial diversity compared to healthy controls.…”

Section: Clostridium Difficile Carriage and Diseasementioning

confidence: 99%

Control of Clostridium difficile Infection by Defined Microbial Communities

Collins

Auchtung

2017

Microbiol Spectr

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Summary Each year in the United States, billions of dollars are spent combating almost half a million Clostridium difficile infections (CDI) and trying to reduce the ~29,000 patient deaths where C. difficile has an attributed role (1). In Europe, disease prevalence varies by country and level of surveillance, though yearly costs are estimated at €3 billion (2). One factor contributing to the significant healthcare burden of C. difficile is the relatively high frequency of recurrent C. difficile infections(3). Recurrent C. difficile infection (rCDI), i.e., a second episode of symptomatic CDI occurring within eight weeks of successful initial CDI treatment, occurs in ~25% of patients with 35-65% of these patients experiencing multiple episodes of recurrent disease(4, 5). Using microbial communities to treat rCDI, either as whole fecal transplants or as defined consortia of bacterial isolates have shown great success (in the case of fecal transplants) or potential promise (in the case of defined consortia of isolates). This review will briefly summarize the epidemiology and physiology of C. difficile infection, describe our current understanding of how fecal microbiota transplants treat recurrent CDI, and outline potential ways through which that knowledge can be used to rationally-design and test alternative microbe-based therapeutics.

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Insight into alteration of gut microbiota in Clostridium difficile infection and asymptomatic C. difficile colonization

Cited by 115 publications

References 30 publications

Gleaning Insights from Fecal Microbiota Transplantation and Probiotic Studies for the Rational Design of Combination Microbial Therapies

Gleaning Insights from Fecal Microbiota Transplantation and Probiotic Studies for the Rational Design of Combination Microbial Therapies

Structural and functional changes within the gut microbiota and susceptibility to Clostridium difficile infection

Control of Clostridium difficile Infection by Defined Microbial Communities

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