Biofilm Formation of Clostridioides difficile, Toxin Production and Alternatives to Conventional Antibiotics in the Treatment of CDI

Abstract

Clostridioides difficile is considered a nosocomial pathogen that flares up in patients exposed to antibiotic treatment. However, four out of ten patients diagnosed with C. difficile infection (CDI) acquired the infection from non-hospitalized individuals, many of whom have not been treated with antibiotics. Treatment of recurrent CDI (rCDI) with antibiotics, especially vancomycin (VAN) and metronidazole (MNZ), increases the risk of experiencing a relapse by as much as 70%. Fidaxomicin, on the other hand, proved more effective than VAN and MNZ by preventing the initial transcription of RNA toxin genes. Alternative forms of treatment include quorum quenching (QQ) that blocks toxin synthesis, binding of small anion molecules such as tolevamer to toxins, monoclonal antibodies, such as bezlotoxumab and actoxumab, bacteriophage therapy, probiotics, and fecal microbial transplants (FMTs). This review summarizes factors that affect the colonization of C. difficile and the pathogenicity of toxins TcdA and TcdB. The different approaches experimented with in the destruction of C. difficile and treatment of CDI are evaluated.

Antimicrobial Effects of Some Natural Products on Adhesion and Biofilm Inhibition of Clostridioides difficile

“…In addition to toxin production, biofilm formation by C. difficile is a crucial factor in bacterial pathogenicity and persistence [ 8 , 9 , 10 ]. Biofilms are structured communities of bacteria embedded within a matrix of extracellular polymeric substances, which may include proteins, polysaccharides, and DNA [ 8 , 9 , 10 ]. Biofilms promote the adhesion of C. difficile to the gastrointestinal lining.…”

“…Understanding the significance of C. difficile biofilms is crucial for developing more effective strategies to prevent and treat CDIs. Researchers continue to explore the methods of disrupting or inhibiting biofilm formation as well as to develop novel therapies that can target bacteria within biofilms or prevent bacterial adhesion [ 10 ].…”