Gut Microbiota Composition Associated with Clostridioides difficile Colonization and Infection

Abstract

Clostridioides difficile is an anaerobic Gram-positive and spore-forming bacterium. The majority of C. difficile strains produce two toxins, A and B, associated with the development of acute diarrhea and/or colitis. In this review, two situations are distinguished: C. difficile infection (CDI) and asymptomatic colonization (AC). The main objective of this review is to explore the available data related to the link between the gut microbiota and the development of CDI. The secondary aim is to provide more information on why some people colonized with toxigenic C. difficile develop an infection while others show no signs of disease. Several factors, such as the use of antibiotics and proton pump inhibitors, hospitalization, and age, predispose individuals to C. difficile colonization and/or C. difficile infection. The gut microbiota of people with AC showed decreased abundances of Prevotella, Alistipes, Bacteroides, Bifidobacterium, Dorea, Coprococcus, and Roseburia. The gut microbiota of people suffering from CDI showed reductions in the abundances of Lachnospiraceae, Ruminococcaceae, Blautia spp., Prevotella spp., Dialister spp., Bifidobacterium spp., Roseburia spp., Anaerostipes spp., Faecalibacterium spp. and Coprococcus spp., in comparison with healthy people. Furthermore, increases in the abundances of Enterococcaceae and Enterococcus were associated with C. difficile infection.

Epidemiological and microbiome associations of Clostridioides difficile carriage in infancy and early childhood

“… 21 , 24 , 25 These changes include an increase in Firmicutes/Bacteriodes ratio, Proteobacteria (Enterobacteriaceae/ Enterococcus ), Lactobacillus and Veilonella species and a decrease in Lachnospiraceae , Ruminococcaceae, Clostridium IV and XIV clusters, Faecalibacterium prausnitzii and Bifidobacterium species. 20 , 21 , 33 A limited number of cross-sectional studies investigating microbiome changes in colonization during infancy have described an increase in Firmicutes, Klebsiella species and decrease in Bifidobacterium species. 19 , 23 , 29 It is not clearly understood if C. diff is a mediator of these changes or just a part of the dysbiotic state.…”

Intestinal bacteria associated with irritable bowel syndrome and chronic fatigue

“…than healthy subjects. 35,36 The fecal levels of Alistipes spp. have been reported to be lower in IBS patients than healthy subjects.…”

“…23,41 A decreased abundance of Faecalibacterium prausnitzii has been reported in inflammatory bowel disease, chronic fatigue and Clostridioides difficile, and COVID-19 infections. 35,36,46,48,49 The abundance of Faecalibacterium prausnitzii has been found to be negatively correlates to the activity of inflammatory bowel disease, fatigue severity, and colorectal cancer as well as to correlate with cognitive scores and decreases in the Alzheimer's-type dementia. 42,49,50 The fecal levels of Faecalibacterium in IBS patients have been shown to be lower than those of healthy subjects.…”

“…61 On the contrary, in subjects with either asymptomatic colonization with Clostridioides difficile (CD) or suffering from CDI infection have lower abundance of Prevotella spp. 35 The fecal levels of Prevotella spp. have been reported to be lower in IBS patients than those of healthy subjects.…”

Gut Microbiota and Clostridium difficile: What We Know and the New Frontiers

“…Despite all this new evidence, there is currently still not full unanimity on defining the microbial species associated with asymptomatic colonization versus those related to the onset of CDI, which remains one of the current challenges to be addressed [ 47 , 63 ].…”