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Pathogens
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Advanced Research on Clostridium difficile
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Advanced Research on Clostridium difficile

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Bacterial Pathogens".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 8523

Special Issue Editor

Prof. Dr. Gayane Martirosian

E-Mail Website
Guest Editor
Department of Medical Microbiology, Medical University of Silesia, 40-752 Katowice, Poland
Interests: Clostridioides difficile; Clostridioides difficile infection (CDI); infectious diseases

Special Issue Information

Dear Colleagues,

Clostridioides difficile infection (CDI) is the biggest clinical and therapeutic problem among hospitalized patients, especially the elderly population. Researchers have recently begun to pay attention to toxigenicity, sporulation, biofilm formation, and increasing antibiotic resistance of infective C. difficile strains. The next important issue is diagnostics as, regardless of known diagnostic algorithms, discordances may be observed between different tests. The epidemiological situation in Europe and around the world is changing, so different hyperepidemic ribotypes of C. difficile are circulated in different countries. These strains have an increased ability to sporulate, and C. difficile spores can remain in a hospital environment for months and years. The organization of significant disinfection procedures to eliminate spores is an additional problem. Treatment of CDI is not always simple, regardless of well-known active antibiotics and recently proposed new treatment schemes. Recurrences of CDI (rCDI) are common, and treatment is not easy. Fecal microbiota transplantation (FMT) is a very effective treatment used in different cases; however, some doubts are also noted. Another important problem is the fact that many domestic and wild animals serve as an additional source of C. difficile. This Special Issue of Pathogens will focus on the characteristics of this anaerobic bacterium, its toxins and other virulence factors, antibiotic resistance, diagnosis of CDI, treatment possibilities, and new options and the development of a vaccine.

Prof. Dr. Gayane Martirosian
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Clostridioides difficile
  • Clostridioides difficile infection (CDI)
  • toxins
  • virulence factors
  • antibiotic resistance
  • diagnosis
  • treatment
  • new options and development of a vaccine

Published Papers (4 papers)

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Research

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11 pages, 284 KiB  
Article
Antibiotic Resistance Profile of RT 027/176 Versus Other Clostridioides difficile Isolates in Silesia, Southern Poland
by Małgorzata Aptekorz, Krzysztof Sacha, Zygmunt Gofron, Monika Kabała, Celine Harmanus, Ed Kuijper and Gayane Martirosian
Pathogens 2022, 11(8), 949; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11080949 - 22 Aug 2022
Cited by 5 | Viewed by 1554
Abstract
Clostridioides difficile is an important health care-associated pathogen. The aim of this study was to analyze the antibiotic susceptibility of C. difficile isolates from feces of patients from 13 hospitals in Silesia, Poland. The incidence of CDI per 100.000 people in Silesia in [...] Read more.
Clostridioides difficile is an important health care-associated pathogen. The aim of this study was to analyze the antibiotic susceptibility of C. difficile isolates from feces of patients from 13 hospitals in Silesia, Poland. The incidence of CDI per 100.000 people in Silesia in 2018–2019 was higher than the average in Poland (39.3–38.7 vs. 30.2–29.5, respectively). The incidence doubled from 26.4 in 2020 to 55.1 in 2021. Two hundred and thirty stool samples tested positive for GDH (glutamate dehydrogenase) and toxins were cultured anaerobically for C. difficile. The isolates were characterized, typed, and tested for susceptibility to 11 antibiotics by E-test (EUCAST, 2021). The genes of toxins A/B and binary were detected by mPCR. Of 215 isolates, 166 (77.2%) were classified as RT 027 and 6 (2.8%) as related RT 176. Resistance to ciprofloxacin (96.7%), moxifloxacin (79.1%), imipenem (78.1%), penicillin (67%), and rifampicin (40.5%) was found. The ermB gene was detected in 79 (36.7%) strains. Multidrug resistance (MDR) was confirmed in 50 (23.3%) strains of RT 027 (94%). We concluded that a high prevalence of MDR among hypervirulent RT 027/176 C. difficile was found in the Silesian region of Poland, emphasizing the need to enhance regional infection control on CDI and antibiotic stewardships. Full article
(This article belongs to the Special Issue Advanced Research on Clostridium difficile)
11 pages, 587 KiB  
Article
Risk Factors for Hospital Readmission for Clostridioides difficile Infection: A Statewide Retrospective Cohort Study
by Gregorio Benitez, Fadi Shehadeh, Markos Kalligeros, Evangelia K. Mylona, Quynh-Lam Tran, Ioannis M. Zacharioudakis and Eleftherios Mylonakis
Pathogens 2022, 11(5), 555; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11050555 - 08 May 2022
Cited by 1 | Viewed by 1525
Abstract
(1) Background: Clostridioides difficile infection (CDI) is associated with a high recurrence rate, and a significant proportion of patients with CDI are readmitted following discharge. We aimed to identify the risk factors for CDI-related readmission within 90 days following an index hospital stay [...] Read more.
(1) Background: Clostridioides difficile infection (CDI) is associated with a high recurrence rate, and a significant proportion of patients with CDI are readmitted following discharge. We aimed to identify the risk factors for CDI-related readmission within 90 days following an index hospital stay for CDI. (2) Methods: We analyzed the electronic medical data of admitted patients in our health system over a two-year period. A multivariate logistic regression model, supplemented with bias-corrected and accelerated confidence intervals (BCa-CI), was implemented to assess the risk factors. (3) Results: A total of 1253 adult CDI index cases were included in the analysis. The readmission rate for CDI within 90 days of discharge was 11% (140/1253). The risk factors for CDI-related readmission were fluoroquinolone exposure within 90 days before the day of index CDI diagnosis (aOR: 1.58, 95% CI: 1.05–2.37), higher Elixhauser comorbidity score (aOR: 1.05, 95% CI: 1.02–1.07), and being discharged home (aOR: 1.64, 95% CI: 1.06–2.54). In contrast, a longer length of index stay (aOR: 0.97, 95% BCa-CI: 0.95–0.99) was associated with reduced odds of readmission for CDI. (4) Conclusion: More than 1 out of 10 patients were readmitted for CDI following an index hospital stay for CDI. Patients with recent previous fluoroquinolone exposure, greater overall comorbidity burden, and those discharged home are at higher risk of readmission for CDI. Full article
(This article belongs to the Special Issue Advanced Research on Clostridium difficile)
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Review

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19 pages, 1652 KiB  
Review
Gut Microbiota Composition Associated with Clostridioides difficile Colonization and Infection
by Elisa Martinez, Bernard Taminiau, Cristina Rodriguez and Georges Daube
Pathogens 2022, 11(7), 781; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens11070781 - 08 Jul 2022
Cited by 19 | Viewed by 2847
Abstract
Clostridioides difficile is an anaerobic Gram-positive and spore-forming bacterium. The majority of C. difficile strains produce two toxins, A and B, associated with the development of acute diarrhea and/or colitis. In this review, two situations are distinguished: C. difficile infection (CDI) and asymptomatic [...] Read more.
Clostridioides difficile is an anaerobic Gram-positive and spore-forming bacterium. The majority of C. difficile strains produce two toxins, A and B, associated with the development of acute diarrhea and/or colitis. In this review, two situations are distinguished: C. difficile infection (CDI) and asymptomatic colonization (AC). The main objective of this review is to explore the available data related to the link between the gut microbiota and the development of CDI. The secondary aim is to provide more information on why some people colonized with toxigenic C. difficile develop an infection while others show no signs of disease. Several factors, such as the use of antibiotics and proton pump inhibitors, hospitalization, and age, predispose individuals to C. difficile colonization and/or C. difficile infection. The gut microbiota of people with AC showed decreased abundances of Prevotella, Alistipes, Bacteroides, Bifidobacterium, Dorea, Coprococcus, and Roseburia. The gut microbiota of people suffering from CDI showed reductions in the abundances of Lachnospiraceae, Ruminococcaceae, Blautia spp., Prevotella spp., Dialister spp., Bifidobacterium spp., Roseburia spp., Anaerostipes spp., Faecalibacterium spp. and Coprococcus spp., in comparison with healthy people. Furthermore, increases in the abundances of Enterococcaceae and Enterococcus were associated with C. difficile infection. Full article
(This article belongs to the Special Issue Advanced Research on Clostridium difficile)
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Other

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10 pages, 4005 KiB  
Opinion
Non-Toxin-Based Clostridioides difficile Vaccination Approaches
by Agnieszka Razim, Sabina Górska and Andrzej Gamian
Pathogens 2023, 12(2), 235; https://0-doi-org.brum.beds.ac.uk/10.3390/pathogens12020235 - 02 Feb 2023
Cited by 6 | Viewed by 1969
Abstract
Clostridioides difficile (CD) is a Gram-positive, anaerobic bacterium that infects mainly hospitalized and elderly people who have been treated with long-term antibiotic therapy leading to dysbiosis. The deteriorating demographic structure and the increase in the number of antibiotics used indicate that the problem [...] Read more.
Clostridioides difficile (CD) is a Gram-positive, anaerobic bacterium that infects mainly hospitalized and elderly people who have been treated with long-term antibiotic therapy leading to dysbiosis. The deteriorating demographic structure and the increase in the number of antibiotics used indicate that the problem of CD infections (CDI) will continue to increase. Thus far, there is no vaccine against CD on the market. Unfortunately, clinical trials conducted using the CD toxin-based antigens did not show sufficiently high efficacy, because they did not prevent colonization and transmission between patients. It seems that the vaccine should also include antigens found in the bacterium itself or its spores in order not only to fight the effects of toxins but also to prevent the colonization of the patient. This literature review summarizes the latest advances in research into vaccine antigens that do not contain CD toxins. Full article
(This article belongs to the Special Issue Advanced Research on Clostridium difficile)
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