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A Review of Mixed Strain Clostridium difficile Colonization and Infection

Pete Dayananda1,2, Mark H Wilcox1,2

  • 1Department of Microbiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.

Frontiers in Microbiology
|April 27, 2019
PubMed

Insights

Multiple Clostridium difficile strains can infect the colon, but dual infections remain rare (5-10%). Understanding strain interactions could reveal new ways to prevent C. difficile infection (CDI).

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Clostridium difficile is an opportunistic pathogen not typically found in the human gut microbiota.
  • The presence of multiple C. difficile strains in the colon suggests repeated exposures or persistent colonization.
  • Dual-strain Clostridium difficile infection (CDI) was first documented in 1983, but its incidence remains stable at approximately 5-10% despite advanced detection methods.

Purpose of the Study:

  • To review the occurrence and implications of dual-strain Clostridium difficile infections.
  • To highlight the need for further research into the interactions between co-infecting or colonizing C. difficile strains.
  • To explore potential mechanisms for preventing CDI based on strain interactions.

Main Methods:

  • Review of existing literature on dual-strain Clostridium difficile infections.
  • Analysis of epidemiological data on the prevalence of multiple C. difficile strains in patients.
  • Discussion of the potential inhibitory effects of one C. difficile strain on another.

Main Results:

  • The rate of dual-strain recovery in patients with CDI has consistently remained around 5-10% since 1983.
  • Evidence suggests that one C. difficile strain can inhibit the colonization or infection by another.
  • Colonization with non-toxigenic C. difficile strains may reduce the risk of developing CDI.

Conclusions:

  • Further investigation into the interactions between C. difficile strains is crucial for understanding CDI pathogenesis.
  • Identifying mechanisms of strain interference could lead to novel strategies for preventing Clostridium difficile infection.
  • More research is needed to determine the clinical significance and potential harm associated with dual-strain CDI.
Keywords:
antibioticcarriagecoloncompetitionmicrobiome

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