Fourteen microbial strains isolated from conventional rats were inoculated into axenic rats and mice receiving identical diets. The populations of these organisms which became established in the feces of gnotobiotic adult recipient rats and mice were quite similar. The only major difference was that one strain, belonging to the genus Clostridium, disappeared from the feces of gnotobiotic mice, whereas this strain became established in gnotobiotic rats. Most of the strictly anaerobic strains were absent or present only in small numbers before weaning in young rats and mice. A clear-cut barrier effect against Salmonella typhimurium was found in adult gnotobiotic mice colonized with a complex flora derived from a conventional chicken. The microflora established in these recipient mice exerted the same barrier effect when further transferred into axenic chickens. Inoculation of feces from a human donor into adult gnotobiotic recipient mice produced colonization by several strains from the donor, whereas other strains, belonging to the genera Bifidobacterium, Lactobacillus, and Clostridium were present in the donor, but did not persist in recipient mice. In these mice, nonetheless, the colonizing human fecal flora exerted an effective barrier against a toxigenic strain of Clostridium difficile. This barrier effect spontaneously disappeared several weeks later. Administration of clindamycin to the recipient mice led to large variations in the number of viable cells of C. difficile.

Gnotobiotic mice died 2 days after inoculation of a cytotoxigenic Clostridium difficile strain. Protection occurred when mice were previously inoculated with a strain of Escherichia coli or Bifidobacterium bifidum. Intestinal cytotoxin production was highly reduced in the surviving mice, whereas the C. difficile population level did not decrease to a great extent.

Oral preventive treatment of gnotobiotic mice by Saccharomyces boulardii significantly decreased mortality following Clostridium difficile infection. A single S. boulardii ingestion protected 16% of mice, whereas 56% were protected when S. boulardii was given continuously in the drinking water. No direct antagonistic effect of the yeast on C. difficile numbers was detected, whereas a modulation of fecal cytotoxin production was demonstrated.

When axenic mice fed a commercial diet were monoassociated with two toxigenic strains of Clostridium difficile, 100% of them died 3 days after inoculation and both enterotoxin and cytotoxin were produced in their intestinal tract. However, when axenic mice were fed various semisynthetic diets before C. difficile challenge, some of them survived and their fecal cytotoxin and enterotoxin productions were highly reduced, whereas the C. difficile population level did not decrease to a great extent. Thus, gnotobiotic mice associated with C. difficile were a good model for the study of modulation by the dietary regimen of intestinal cytotoxin and enterotoxin production.

Clostridium difficile, C. perfringens, and C. tertium are very often present simultaneously in the feces of conventional diarrheic young hares, whereas these three bacterial species are rarely encountered and never present simultaneously in the feces of healthy young hares. When a strain of each of the three bacterial species was monoassociated with axenic young hares, the appearance of pathological disorders was only observed in animals monoassociated with C. difficile, when the number of C. difficile exceeded 10(8) per g of fresh feces. When a strain of C. perfringens or a strain of C. tertium, or both, was associated with C. difficile, diarrhea and death occurred more rapidly than in hares monoassociated with C. difficile. C. difficile and C. perfringens became established more rapidly when disassociated than when monoassociated with axenic hares. The association of C. perfringens and C. tertium with axenic hares did not bring about any pathological disorders. It may be concluded that C. difficile is the causal agent of neonatal diarrhea in conventional and gnotobiotic young hares and that other strains of Clostridium enhance its pathogenic effect. C difficile alone or associated with C. perfringens or C. tertium does not play any pathogenic role in young rats, mice, or rabbits.