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Clostridioides difficile Detection in a Human CRC Cohort
S M Anderson1, Z Cing2, J L Drewes1
1Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Open Forum Infectious Diseases
|April 13, 2026
Summary
Clostridioides difficile is frequently found in colorectal cancer (CRC) tumors, though in low amounts. This bacterium
Area of Science:
- Microbiome research
- Gastroenterology
- Oncology
Background:
- The gut microbiome's role in colorectal cancer (CRC) pathogenesis is not fully understood.
- Human CRC-derived Clostridioides difficile strains induce tumorigenesis in mouse models.
- C. difficile's contribution to human CRC requires further investigation.
Purpose of the Study:
- To investigate the hypothesis that C. difficile contributes to human CRC pathogenesis.
- To determine if C. difficile is enriched in CRC tumors compared to paired normal tissues.
Main Methods:
- Analysis of matched tumor/normal tissue samples from 108 individuals undergoing CRC resection in Kuala Lumpur, Malaysia.
- Assessment of C. difficile prevalence using 16S rRNA amplicon sequencing, culture, and PCR.
- High-resolution taxonomic assignment for precise bacterial identification.
Main Results:
- C. difficile detection was prevalent (38% of individuals) but present in low abundance in tumors (median 0.01%).
- C. difficile detection was significantly higher in biofilm-positive tumor tissues (81%) compared to biofilm-negative.
- Exploratory analyses revealed distinct taxonomic and functional pathway differences between C. difficile-positive and -negative groups.
Conclusions:
- C. difficile is frequently detected in the tumor microbiome of colorectal cancer patients.
- Despite low abundance, C. difficile may significantly impact the tumor microbiome's composition and function.
- Further research is warranted to elucidate C. difficile's precise role in CRC development and progression.
