Clostridium difficile – From Colonization to Infection
Clostridium difficile is the most frequent cause of nosocomial antibiotic-associated diarrhea. The incidence of C. difficile infection (CDI) has been rising worldwide with subsequent increases in morbidity, mortality, and health care costs. Asymptomatic colonization with C. difficile is common and a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-04-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fmicb.2018.00646/full |
| _version_ | 1831754493934436352 |
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| author | Holger Schäffler Anne Breitrück Anne Breitrück |
| author_facet | Holger Schäffler Anne Breitrück Anne Breitrück |
| author_sort | Holger Schäffler |
| collection | DOAJ |
| description | Clostridium difficile is the most frequent cause of nosocomial antibiotic-associated diarrhea. The incidence of C. difficile infection (CDI) has been rising worldwide with subsequent increases in morbidity, mortality, and health care costs. Asymptomatic colonization with C. difficile is common and a high prevalence has been found in specific cohorts, e.g., hospitalized patients, adults in nursing homes and in infants. However, the risk of infection with C. difficile differs significantly between these cohorts. While CDI is a clear indication for therapy, colonization with C. difficile is not believed to be a direct precursor for CDI and therefore does not require treatment. Antibiotic therapy causes alterations of the intestinal microbial composition, enabling C. difficile colonization and consecutive toxin production leading to disruption of the colonic epithelial cells. Clinical symptoms of CDI range from mild diarrhea to potentially life-threatening conditions like pseudomembranous colitis or toxic megacolon. While antibiotics are still the treatment of choice for CDI, new therapies have emerged in recent years such as antibodies against C. difficile toxin B and fecal microbial transfer (FMT). This specific therapy for CDI underscores the role of the indigenous bacterial composition in the prevention of the disease in healthy individuals and its role in the pathogenesis after alteration by antibiotic treatment. In addition to the pathogenesis of CDI, this review focuses on the colonization of C. difficile in the human gut and factors promoting CDI. |
| first_indexed | 2024-12-21T23:38:37Z |
| format | Article |
| id | doaj.art-a3e19240488849fcbad6c8145f5e55c1 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-12-21T23:38:37Z |
| publishDate | 2018-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-a3e19240488849fcbad6c8145f5e55c12022-12-21T18:46:17ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2018-04-01910.3389/fmicb.2018.00646332266Clostridium difficile – From Colonization to InfectionHolger Schäffler0Anne Breitrück1Anne Breitrück2Division of Gastroenterology, Department of Medicine II, University of Rostock, Rostock, GermanyExtracorporeal Immunomodulation Unit, Fraunhofer Institute for Cell Therapy and Immunology, Rostock, GermanyInstitute of Medical Microbiology, Virology and Hygiene, University of Rostock, Rostock, GermanyClostridium difficile is the most frequent cause of nosocomial antibiotic-associated diarrhea. The incidence of C. difficile infection (CDI) has been rising worldwide with subsequent increases in morbidity, mortality, and health care costs. Asymptomatic colonization with C. difficile is common and a high prevalence has been found in specific cohorts, e.g., hospitalized patients, adults in nursing homes and in infants. However, the risk of infection with C. difficile differs significantly between these cohorts. While CDI is a clear indication for therapy, colonization with C. difficile is not believed to be a direct precursor for CDI and therefore does not require treatment. Antibiotic therapy causes alterations of the intestinal microbial composition, enabling C. difficile colonization and consecutive toxin production leading to disruption of the colonic epithelial cells. Clinical symptoms of CDI range from mild diarrhea to potentially life-threatening conditions like pseudomembranous colitis or toxic megacolon. While antibiotics are still the treatment of choice for CDI, new therapies have emerged in recent years such as antibodies against C. difficile toxin B and fecal microbial transfer (FMT). This specific therapy for CDI underscores the role of the indigenous bacterial composition in the prevention of the disease in healthy individuals and its role in the pathogenesis after alteration by antibiotic treatment. In addition to the pathogenesis of CDI, this review focuses on the colonization of C. difficile in the human gut and factors promoting CDI.http://journal.frontiersin.org/article/10.3389/fmicb.2018.00646/fullClostridium difficilemicrobiotaClostridium difficile infectionCDIasymptomatic colonization |
| spellingShingle | Holger Schäffler Anne Breitrück Anne Breitrück Clostridium difficile – From Colonization to Infection Frontiers in Microbiology Clostridium difficile microbiota Clostridium difficile infection CDI asymptomatic colonization |
| title | Clostridium difficile – From Colonization to Infection |
| title_full | Clostridium difficile – From Colonization to Infection |
| title_fullStr | Clostridium difficile – From Colonization to Infection |
| title_full_unstemmed | Clostridium difficile – From Colonization to Infection |
| title_short | Clostridium difficile – From Colonization to Infection |
| title_sort | clostridium difficile from colonization to infection |
| topic | Clostridium difficile microbiota Clostridium difficile infection CDI asymptomatic colonization |
| url | http://journal.frontiersin.org/article/10.3389/fmicb.2018.00646/full |
| work_keys_str_mv | AT holgerschaffler clostridiumdifficilefromcolonizationtoinfection AT annebreitruck clostridiumdifficilefromcolonizationtoinfection AT annebreitruck clostridiumdifficilefromcolonizationtoinfection |