Clostridium difficile: One Nasty Bug

I found this research really interesting.

Clostridium difficile, as many of you know, is a normal part of our gut biome, but heavy infections cause severe and recurrent – sometimes fatal – bouts of diarrhea.  Because the bacteria can form resistant spores when in unhospitable environments, it is very hard to kill.  It is also a real problem in places like hospitals, where it is regularly passed to the sick and immune suppressed.

C.diff also regularly occurs in those taking, or who have just finished, antibiotics.

Researchers at North Carolina State have just shown that using antibiotics creates what they are calling a “banquet” for C.diff, , “…by altering the native gut bacteria that would normally compete with C. diff for nutrients.”[i]

Native, healthy bacteria compete with C.diff for nutrients, specifically the amino acid, proline.  When they are killed off by antibiotics, the hardy and resist C.diff is left with a veritable smorgasbord.

The scientists infected antibiotic-treated mice with C.diff and monitored their gut environments at regular intervals, using various techniques to analyze gut contents in order to find out which nutrients the bacteria were eating.  As C.diff increased, proline levels decreased.  They also found that a byproduct of proline digestion increased, indicating that the C.diff was definitely metabolizing it and more than that, early in the infection, when proline was most abundant, the bacteria’s genes that are related to proline metabolism increased.

Wow.  It’s really no wonder C.diff is such a huge and growing problem.  Talking about opportunistic…

The CDC’s website states that C.diff affects about a half million people per year and 15,000 of those died within 30 days directly from the infection.  [ii]  The researchers at North Carolina State say, “Hopefully this information could lead to the development of better probiotics, or ‘good’ bacteria that can outcompete C. diff for nutrients in the gut. The ultimate goal is to control these bacteria in ways that don’t rely solely on antibiotics.”  Fecal transplant works beautifully, but is unfortunately difficult to do as many doctors are not familiar or comfortable with it…and to boot, many patients find it distasteful.  (Call me crazy but…it’s a lot more tasteful than profound and recurrent, potentially fatal, diarrhea!) But…better probiotics would be a great step forward as well.

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[i] https://www.sciencedaily.com/releases/2018/03/180328204122.htm

[ii] https://www.cdc.gov/media/releases/2015/p0225-clostridium-difficile.html