The SEASON GAP score is useful in ruling out CDI in patients with tube feeding, thus reducing unnecessary CD testing and antimicrobial use.

This article explores what we know so far about the role of the gut microbiota in diverticulitis and discusses two recent clinical trials on the role of probiotics in managing acute uncomplicated diverticulitis.

An uncommon case of monomicrobial Clostridioides difficile septicemia in a 63-year-old man was reported in Zhejiang, China. Once diagnosed, vancomycin treatment cleared the infections. The patient had no remarkable medical history, and the inspection showed no overt gastrointestinal symptoms, …

Patients with hepatic cirrhosis are more susceptible to Clostridioides difficile infection (CDI) and colonization with Clostridioides difficile (C. difficile). Asymptomatic C. difficile colonization is thought to predispose to subsequent CDI. However, the dynamic gut micr …

The incidence of rec CDI is ⬆️. After an initial episode, ⤴️35% have recurrence. ⤴️60% who have a recurrence have another one. Exposure to antibiotics is a critical modifiable risk factor. Most cases occur within 2 wks of antibiotic Rx. #CDiff #antibiotics #antibioticstewardship pic.twitter.com/NTgwYohGZ0— Satyendra Dhar, MD MHA FHM (@DharSaty) March 2, 2022

The technology platform could speed up the development of novel therapeutics to combat virulence.

C. difficile infection (CDI) is a highly inflammatory disease mediated by the production of two large toxins that weaken the intestinal epithelium and cause extensive colonic tissue damage. Antibiotic alternative therapies for CDI are urgently needed as current antibiotic regimens prolong the perturbation of the microbiota and lead to high disease recurrence rates. Inflammation is more closely correlated with CDI severity than bacterial burden, thus therapies that target the host response represent a promising yet unexplored strategy for treating CDI. Intestinal bile acids are key regulators of gut physiology that exert cytoprotective roles in cellular stress, inflammation and barrier integrity, yet the dynamics between bile acids and host cellular processes during CDI have not been investigated. Here we show that several bile acids are protective against apoptosis caused by C. difficile toxins in Caco-2 cells and that protection is dependent on conjugation. Out of 20 tested bile acids, taurine conjugated ursodeoxycholic acid (TUDCA) was the most potent inhibitor yet unconjugated UDCA did not alter toxin-induced apoptosis. TUDCA treatment decreased expression of genes in lysosome associated and cytokine signaling pathways. TUDCA did not affect C. difficile growth or toxin activity in vitro whereas UDCA significantly reduced toxin activity in a Vero cell assay and decreased tcdA gene expression. These results demonstrate that bile acid conjugation can have profound effects on C. difficile as well as the host and that conjugated and unconjugated bile acids may exert different therapeutic mechanisms against CDI.

Recurrent infections occurred in 23.9% of the 134-patient study.

Diarrhea is common, has several predictors, and prompts changes in patient care, is associated with longer time to discharge but not mortality.

The anaerobic bacterium Clostridioides difficile represents one of the most problematic pathogens, especially in hospitals. Dysbiosis has been proven to largely reduce colonization resistance against this intestinal pathogen. The beneficial effect of the microbiota is closely associated with …

Clostridioides difficile can rarely have a wide variety of extra-colonic manifestations.Patients with sickle cell disease may have a higher predisposition to extra-colonic C. difficile infection (CDI) with high mortality and recurrence rates.Intravenous metronidazole or vancomycin are …

Management of initial and recurrent Cdiff Infection (CDI) #MedTwitter #SHMConverge #MedEd #HospitalMedicine #Cdiff pic.twitter.com/bsFsxjSMlq— BJHM (@brownjhm) April 8, 2022

Involvement of the Colon in Necrotizing pancreatitis is marked by a severe inflammatory response that has both local and systemic consequences. Learn more.

SignificanceAntibiotic exposure stands among the most used interventions to drive microbial communities away from undesired states. How the ecology of microbial communities shapes their recovery-e.g., posttreatment shifts toward Clostridioides difficile infections in the gut-after antibiotic …

Prophylactic probiotic use and nasogastric tube placement may be risk factors for the initial recurrence of CDI. It is noteworthy that CDI that occurs during the use of prophylactic probiotics may be prone to recurrence.

Dietary fiber has a potential to modulate the gut microbiota in sows. We hypothesized that a maternal diet rich in either high- or low-fermentable fiber during gestation and lactation influences Clostridioides difficile gut colonization in suckling piglets. Twenty sows were fed gestation and lactati …

“RT @MMckracken: Honoured to have been given the opportunity to present our #cdiff #spores research from the #joshilab at #Microbio22… Words…”

Clostridioides difficile (CD), a nosocomial gut pathogen, produces two major exotoxins, TcdA and TcdB, which disrupt the gut epithelial barrier and induce inflammatory/immune responses, leading to symptoms ranging from mild diarrhoea to pseudomembranous colitis and potentially to death. The e …

The recurrent CDI cohort were nearly 10 times likelier to suffer from a CDI-associated death than the primary CDI cohort.

New research shows #Cdiff is linked to longer, more intensive hospital stays for older adults & potential death. Those with recurrent #CDI were nearly 10X more likely to have a CDI-associated death than those with a primary CDI case. From @mdmagazine: https://t.co/5jP38imang pic.twitter.com/0OYBQn7euw— Halosil International (@HaloSavesLives) April 6, 2022

Comparative analysis of Clostridioides difficile whole-genome sequencing (WGS) data enables fine scaled investigation of transmission and is increasingly becoming part of routine surveillance. However, these analyses are constrained by the computational requirements of the large volumes of da …

Time to reach out to the #Cdiff twitter community. Does anyone have or know where we can get anti-FliC antibodies? We need it for a few WB, so not a huge amount.— Paula Salgado (@pssalgado) January 28, 2022

Clostridioides difficile is an urgent threat in hospital-acquired infections world-wide, yet the microbial composition associated with C. difficile, in particular in C. difficile infection (CDI) cases, remains poorly characterised. Here, we analysed 534 metagenomes from 10 publicly available CDI study populations. While we detected C. difficile in only 30% of CDI samples, multiple other toxigenic species capable of inducing CDI-like symptomatology were prevalent, raising concerns about CDI overdiagnosis. We further tracked C. difficile in 42,814 metagenomic samples from 253 public studies. We found that C. difficile prevalence, abundance and association with other bacterial species is age-dependent. In healthy adults, C. difficile is a rare taxon associated with an overall species richness reduction, while in healthy infants C. difficile is a common member of the gut microbiome and its presence is associated with a significant increase in species richness. More specifically, we identified a group of species co-occurring with C. difficile exclusively in healthy infants, enriched in obligate anaerobes and in species typically found in the gut microbiome of healthy adults. Overall, gut microbiome composition in presence of C. difficile in healthy infants is associated with multiple parameters linked to a healthy gut microbiome maturation towards an adult-like state. Our results suggest that C. difficile is a commensal in infants, and that its asymptomatic carriage is dependent on the surrounding microbial context. ### Competing Interest Statement The authors have declared no competing interest.

Group 3 innate lymphocytes (ILC3s) are rare immune cells localized in mucosal tissues, especially the gastrointestinal (GI) tract. Despite their rarity, they are a major source of the cytokine interleukin-22 (IL-22), which protects the GI epithelium during inflammation and infection. Although ILC3s …

Endolysin is a phage-encoded cell-wall hydrolase which degrades the peptidoglycan layer of the bacterial cell wall. The enzyme is often expressed at the late stage of the phage lytic cycle and is required for progeny escape. Endolysins of bacteriophage that infect Gram-positive bacteria often compri …

C. difficile spores were found to survive the acidity and cooking of fermented pork summer sausage and storage at 4°C for 3 months, thereby highlighting the need for effective intervention strategies to reduce the risk of C. difficile contamination in pork products.

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