Measuring C. difficile Adhesion to Mucosal Surfaces

Colonization of the host gastrointestinal tract by Clostridioides difficile requires attachment to host tissues which is likely an integrative process potentially involving multiple modes of attachment, host cells, extracellular structures, and bacterial aggregation. Attachment to host mucosa represents a novel mechanism for understanding C. difficile's persistence, either during infection or asymptomatic colonization. In this chapter, we describe methods for directly measuring the in vitro attachment of C. difficile to mucin hydrogels from a variety of sources.