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Related Experiment Video

Updated: Dec 17, 2025

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
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Microbiota-associated Risk Factors for Clostridioides difficile Acquisition in Hospitalized Patients: A Prospective,

Philipp Solbach1,2,3,4, Patrick Chhatwal2,3, Sabrina Woltemate2,3

  • 1Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|June 27, 2020
PubMed
Summary

Certain gut bacteria like Gemmiger spp. and Ruminococcus spp. may protect against hospital-acquired Clostridioides difficile (C. difficile) colonization. This finding offers insights into preventing C. difficile infection (CDI) through microbiome modulation.

Keywords:
Gemmiger sppdifficilebile acidsmicrobiotatoxigenic

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Area of Science:

  • Microbiology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Asymptomatic Clostridioides difficile colonization is a known precursor to C. difficile infection (CDI).
  • Understanding the role of the gut microbiota in colonization resistance is crucial for preventing CDI.
  • Prospective data on C. difficile colonization and its relationship with the microbiome are limited.

Purpose of the Study:

  • To investigate the relationship between gut microbiota composition and the acquisition of C. difficile colonization in hospitalized patients.
  • To identify specific microbial species or functional pathways associated with protection against C. difficile acquisition.
  • To provide prospective data on C. difficile colonization dynamics during hospitalization.

Main Methods:

  • A prospective observational study enrolled 1506 patients across five academic hospitals.
  • Fecal samples were collected on admission and discharge for longitudinal analysis in 936 patients.
  • C. difficile status was determined by GDH EIA and real-time PCR; 16S rRNA gene sequencing was used for microbiota analysis.

Main Results:

  • Hospital admission colonization rates were 5.5% for toxigenic C. difficile (TCD) and 3.7% for non-toxigenic C. difficile (NTCD).
  • During hospitalization, 1.7% of patients acquired TCD, with risk factors including lung disease, GI endoscopy, and antibiotics.
  • Protective species included Gemmiger spp., Odoribacter splanchnicus, and Ruminococcus spp.; steroid biosynthesis was an underrepresented pathway in those acquiring colonization.

Conclusions:

  • Specific commensal bacteria, including Gemmiger spp., Odoribacter splanchnicus, and Ruminococcus spp., are associated with reduced risk of C. difficile acquisition.
  • The findings highlight the potential of the gut microbiome in mediating colonization resistance against C. difficile.
  • Targeting microbial pathways like steroid biosynthesis may offer novel strategies for CDI prevention.