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C. difficile may proliferate as a result of dysbiosis
Dysbiosis creates an insufficiency of Bacteroidetes and Firmicutes, which may lead to an environment suited for the growth of C. difficile infection (CDI).1,2
Dysbiosis is the disruption of the volume and diversity of the gut microbiome. This may be attributed to factors including stress, diet, hygiene, and antibiotic use. Dysbiosis is associated with a range of gastrointestinal (GI) and non-GI diseases including neurologic, metabolic, liver, inflammatory, and infectious diseases.1,3,4
The gut microbiota generally play a role in colonization resistance by which the native organisms prevent pathogenic microbes from flourishing. Disruption of the gut microbiome leads to an environment suited for the proliferation of C. difficile.1,2
When the relationship between the gut and its healthy flora becomes imbalanced, dysbiosis results. This leads to an intestinal microenvironment susceptible to pathogenic insult from opportunistic bacteria, such as CDI—capable of causing a wide spectrum of symptoms ranging from mild diarrhea to sepsis to mortality.1
Typically, antibiotic use treats the acute infection. However, antibiotics do not restore the microbiome, potentially increasing the risk of recurrence.5 Thus starts a vicious cycle.
For illustrative purposes.
aRisk of recurrence is highest in the 3-month period following antibiotic treatment of index CDI.11
THE BURDEN OF CDI MAY INCREASE
WHEN THE INFECTION RECURS
Can the power of the microbiome be
unlocked to break the cycle of rCDI?
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- Hensgens MPM, Goorhuis A, Dekkers OM, Kuijper EJ. Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. J Antimicrob Chemother. 2012;67(3):742-748.
- Wilcox MH, McGovern BH, Hecht GA. The efficacy and safety of fecal microbiota transplant for recurrent Clostridium difficile infection: current understanding and gap analysis. Open Forum Infect Dis. 2022;7(5):ofaa114.