The Gut Bacterial Community Potentiates Clostridioides difficile Infection Severity. 2022

Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA.

The severity of Clostridioides difficile infections (CDI) has increased over the last few decades. Patient age, white blood cell count, and creatinine levels as well as C. difficile ribotype and toxin genes have been associated with disease severity. However, it is unclear whether specific members of the gut microbiota are associated with variations in disease severity. The gut microbiota is known to interact with C. difficile during infection. Perturbations to the gut microbiota are necessary for C. difficile to colonize the gut. The gut microbiota can inhibit C. difficile colonization through bile acid metabolism, nutrient consumption, and bacteriocin production. Here, we sought to demonstrate that members of the gut bacterial communities can also contribute to disease severity. We derived diverse gut communities by colonizing germfree mice with different human fecal communities. The mice were then infected with a single C. difficile ribotype 027 clinical isolate, which resulted in moribundity and histopathologic differences. The variation in severity was associated with the human fecal community that the mice received. Generally, bacterial populations with pathogenic potential, such as Enterococcus, Helicobacter, and Klebsiella, were associated with more-severe outcomes. Bacterial groups associated with fiber degradation and bile acid metabolism, such as Anaerotignum, Blautia, Lactonifactor, and Monoglobus, were associated with less-severe outcomes. These data indicate that, in addition to the host and C. difficile subtype, populations of gut bacteria can influence CDI disease severity. IMPORTANCE Clostridioides difficile colonization can be asymptomatic or develop into an infection ranging in severity from mild diarrhea to toxic megacolon, sepsis, and death. Models that predict severity and guide treatment decisions are based on clinical factors and C. difficile characteristics. Although the gut microbiome plays a role in protecting against CDI, its effect on CDI disease severity is unclear and has not been incorporated into disease severity models. We demonstrated that variation in the microbiome of mice colonized with human feces yielded a range of disease outcomes. These results revealed groups of bacteria associated with both severe and mild C. difficile infection outcomes. Gut bacterial community data from patients with CDI could improve our ability to identify patients at risk of developing more severe disease and improve interventions that target C. difficile and the gut bacteria to reduce host damage.

UI MeSH Term Description Entries
D003015 Clostridium Infections Infections with bacteria of the genus CLOSTRIDIUM and closely related CLOSTRIDIOIDES species. Clostridioides Infections,Clostridioides difficile Infection,Clostridioides perfringens Food Poisoning,Clostridioides perfringens Infections,Clostridioides sordellii Infection,Clostridium difficile Infections,Clostridium sordellii Infections,Clostridium difficile Infection,Clostridium perfringens Food Poisoning,Clostridium perfringens Infections,Clostridium sordellii Infection,Infections, Clostridium,Clostridioides Infection,Clostridioides perfringens Infection,Clostridium Infection,Clostridium perfringens Infection,Infection, Clostridioides difficile,Infection, Clostridioides sordellii,Infection, Clostridium,Infection, Clostridium difficile,Infection, Clostridium sordellii
D005243 Feces Excrement from the INTESTINES, containing unabsorbed solids, waste products, secretions, and BACTERIA of the DIGESTIVE SYSTEM.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069196 Gastrointestinal Microbiome All of the microbial organisms that naturally exist within the GASTROINTESTINAL TRACT. Enteric Bacteria,Gastric Microbiome,Gastrointestinal Flora,Gastrointestinal Microbial Community,Gastrointestinal Microbiota,Gastrointestinal Microflora,Gut Flora,Gut Microbiome,Gut Microbiota,Gut Microflora,Intestinal Flora,Intestinal Microbiome,Intestinal Microbiota,Intestinal Microflora,Bacteria, Enteric,Flora, Gastrointestinal,Flora, Gut,Flora, Intestinal,Gastric Microbiomes,Gastrointestinal Microbial Communities,Gastrointestinal Microbiomes,Gastrointestinal Microbiotas,Gut Microbiomes,Gut Microbiotas,Intestinal Microbiomes,Intestinal Microbiotas,Microbial Community, Gastrointestinal,Microbiome, Gastric,Microbiome, Gastrointestinal,Microbiome, Gut,Microbiome, Intestinal,Microbiota, Gastrointestinal,Microbiota, Gut,Microbiota, Intestinal,Microflora, Gastrointestinal,Microflora, Gut,Microflora, Intestinal
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001419 Bacteria One of the three domains of life (the others being Eukarya and ARCHAEA), also called Eubacteria. They are unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. Bacteria can be classified by their response to OXYGEN: aerobic, anaerobic, or facultatively anaerobic; by the mode by which they obtain their energy: chemotrophy (via chemical reaction) or PHOTOTROPHY (via light reaction); for chemotrophs by their source of chemical energy: CHEMOLITHOTROPHY (from inorganic compounds) or chemoorganotrophy (from organic compounds); and by their source for CARBON; NITROGEN; etc.; HETEROTROPHY (from organic sources) or AUTOTROPHY (from CARBON DIOXIDE). They can also be classified by whether or not they stain (based on the structure of their CELL WALLS) with CRYSTAL VIOLET dye: gram-negative or gram-positive. Eubacteria
D001647 Bile Acids and Salts Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. Bile Acid,Bile Salt,Bile Salts,Bile Acids,Acid, Bile,Acids, Bile,Salt, Bile,Salts, Bile
D016360 Clostridioides difficile A common inhabitant of the colon flora in human infants and sometimes in adults. The type species Clostridioides difficile is formerly known as Clostridium difficile. It is a causative agent for CLOSTRIDIOIDES INFECTIONS and is associated with PSEUDOMEMBRANOUS ENTEROCOLITIS in patients receiving antibiotic therapy. Clostridium difficile
D051379 Mice The common name for the genus Mus. Mice, House,Mus,Mus musculus,Mice, Laboratory,Mouse,Mouse, House,Mouse, Laboratory,Mouse, Swiss,Mus domesticus,Mus musculus domesticus,Swiss Mice,House Mice,House Mouse,Laboratory Mice,Laboratory Mouse,Mice, Swiss,Swiss Mouse,domesticus, Mus musculus

Related Publications

Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
October 2017, Scientific data,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
January 2024, Microbiome research reports,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
December 2023, Biomedical journal,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
February 2023, Microbiology (Reading, England),
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
August 2022, Burns : journal of the International Society for Burn Injuries,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
January 2021, JCI insight,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
February 2023, Anaerobe,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
October 2018, Annals of internal medicine,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
March 2020, Clinics in colon and rectal surgery,
Nicholas A Lesniak, and Alyxandria M Schubert, and Kaitlin J Flynn, and Jhansi L Leslie, and Hamide Sinani, and Ingrid L Bergin, and Vincent B Young, and Patrick D Schloss
February 2021, Diseases of the colon and rectum,
Copied contents to your clipboard!