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Cited by 124Clostridium difficile and Clostridium perfringens researchGut microbiota and healthBacterial Identification and Susceptibility Testing

Bloom and bust: intestinal microbiota dynamics in response to hospital exposures and Clostridium difficile colonization or infection

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Vincent, Caroline, Miller, Mark A., Edens, Thaddeus J., Mehrotra, Sudeep, Dewar, Ken, Manges, Amee R.·2016·Microbiome
DOI 10.1186/s40168-016-0156-3PMC PMC4791782
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Abstract

BACKGROUND: Clostridium difficile infection (CDI) is the leading infectious cause of nosocomial diarrhea. Hospitalized patients are at increased risk of developing CDI because they are exposed to C. difficile spores through contact with the hospital environment and often receive antibiotics and other medications that can disrupt the integrity of the indigenous intestinal microbiota and impair colonization resistance. Using whole metagenome shotgun sequencing, we examined the diversity and composition of the fecal microbiota in a prospective cohort study of 98 hospitalized patients. RESULTS: Four patients had asymptomatic C. difficile colonization, and four patients developed CDI. We observed dramatic shifts in the structure of the gut microbiota during hospitalization. In contrast to CDI cases, asymptomatic patients exhibited elevated relative abundance of potentially protective bacterial taxa in their gut at the onset of C. difficile colonization. Use of laxatives was associated with significant reductions in the relative abundance of Clostridium and Eubacterium; species within these genera have previously been shown to enhance resistance to CDI via the production of secondary bile acids. Cephalosporin and fluoroquinolone exposure decreased the frequency of Clostridiales Family XI Incertae Sedis, a bacterial family that has been previously associated with decreased CDI risk. CONCLUSIONS: This study underscores the detrimental impact of antibiotics as well as other medications, particularly laxatives, on the intestinal microbiota and suggests that co-colonization with key bacterial taxa may prevent C. difficile overgrowth or the transition from asymptomatic C. difficile colonization to CDI.

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Authors
Vincent, C., Miller, M. A., Edens, T. J., Mehrotra, S., Dewar, K., & Manges, A. R.
Affiliations
  • McGill University and Génome Québec Innovation Centre (CA)
  • Jewish General Hospital (CA)
  • New York Genome Center (US)
  • University of British Columbia (CA)
Corresponding author
Manges, Amee R.
ORCID
Venue
Microbiome
Publisher
Springer Science and Business Media LLC
Published
2016-03-14
Volume
4
Issue
1
Pages
12-12
ISSN
2049-2618 (ISSN-L)
DOI
10.1186/s40168-016-0156-3
PMC
PMC4791782
OpenAlex
W2299465765
Cited by
124
References
8
Citations by year
2026: 3 · 2025: 10 · 2024: 14 · 2023: 12 · 2022: 12 · 2021: 18 · 2020: 19 · 2019: 13 · 2018: 9 · 2017: 12 · 2016: 2
FWCI
8.96
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Microbiome (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • cIRcle (University of British Columbia) (submittedVersion, cc-by)
Funders
  • Canadian Institutes of Health Research (CA) (GSD-113375)
  • Pfizer (US) (WS1954106)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
Keywords
Clostridium difficile infection, Clostridium difficile colonization, gut microbiota, gut microbiota dynamics, hospitalized patients, nosocomial diarrhea, antibiotic exposure, laxatives, secondary bile acids, colonization resistance, fecal microbiota composition
MeSH terms
Gastrointestinal Microbiome, Aged, Anti-Bacterial Agents, Bile Acids and Salts, Cephalosporins, Cross Infection, Diarrhea, Enterocolitis, Pseudomembranous, Eubacterium, Female, Humans, Male, Middle Aged, Prospective Studies, Clostridioides difficile, Fluoroquinolones, Laxatives, Metagenome

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