Alimentary and Pharmaceutical Approach to Natural Antimicrobials against Clostridioides difficile Gastrointestinal Infection

Abstract

Incidence of Clostridioides difficile infection (CDI) has been increasing in recent decades due to different factors, namely (i) extended use of broad-spectrum antibiotics, (ii) transmission within asymptomatic and susceptible patients, and (iii) unbalanced gastrointestinal microbiome and collateral diseases that favor C. difficile gastrointestinal domination and toxin production. Although antibiotic therapies have resulted in successful control of CDI in the last 20 years, the development of novel strategies is urged in order to combat the capability of C. difficile to generate and acquire resistance to conventional treatments and its consequent proliferation. In this regard, vegetable and marine bioactives have emerged as alternative and effective molecules to fight against this concerning pathogen. The present review examines the effectiveness of natural antimicrobials from vegetable and algae origin that have been used experimentally in in vitro and in vivo settings to prevent and combat CDI. The aim of the present work is to contribute to accurately describe the prospective use of emerging antimicrobials as future nutraceuticals and preventive therapies, namely (i) as dietary supplement to prevent CDI and reduce CDI recurrence by means of microbiota modulation and (ii) administering them complementarily to other treatments requiring antibiotics to prevent C. difficile gut invasion and infection progression.

Antimicrobial Potential of Herbal Products Against Clostridioides difficile

“…Also, an in vitro study [55] observed the synergistic effect of the sub-MIC (1/2 MIC) berberine chloride with vancomycin. Bearing in mind the data presented, we can agree with the statement [62], that natural antimicrobial agents derived from plant sources are an innovative and sustainable option in controlling pathogens. However, it is necessary to investigate in vivo efficiency and toxicological safety of herbal products, as well as their effects on normal intestinal microbiota.…”

Antibacterial and antibiofilm activities of some plant essential oils and synergistic effects of cinnamon essential oil with vancomycin against Clostridioides difficile: in vitro study

“…Natural antimicrobial agents derived from plant sources are an innovative and sustainable option in controlling pathogens (Tortajada‐Girbes et al . 2021).…”

“…The rapid emergence of hypervirulent C. difficile isolates (Mody et al 2020) and the resistance of C. difficile to conventional antibiotic therapy encourage the development of new strategies for its control. Natural antimicrobial agents derived from plant sources are an innovative and sustainable option in controlling pathogens (Tortajada-Girbes et al 2021).…”