Clostridium difficile infection is a serious medical problem. Frequent relapses and terrible consequences such as pseudomembranous colitis make the lives of infected patients miserable. Scientists in the UK have however discovered a mixture of bacteria which guarantees a success of a Clostridium difficile eradication therapy. The new possible remedy surprisingly contains three novel species of bacteria.
Clostridium difficile is a gram-positive bacterium that naturally inhabits the intestine of about 3% of adults and 66% of children. Nevertheless it’s a significant healthcare-associated pathogen entering the body by means of an accidental ingestion of spores. In healthy individuals, with a normal, balanced gut flora it does not cause any symptoms. The problem arises when, through a careless use of the broad spectrum antibiotics (such as ampicillin, amoxicillin, clindamycin, lincomycin, or cephalosporins) the intestinal bacterial balance is severely impaired. Expansion of Clostridium difficile and a subsequent production of toxins A and B leads to serious consequences, including pseudomembranous colitis-a disease of often vicious course and long and difficult treatment. In severe cases, it can lead to dehydration, edema from hypoalbuminemia and even a shock as well as severe complications such as acute megacolon, or colon perforation.
Treatment consists of Clostriudium difficile elimination by the administration of one of the three effective antibiotics: Metronidazole, Vancomycin, or Fidaxomycin. In order to accelerate the restoration of the intestinal flora, patients are recommended to receive probiotics along with the antibiotic therapy. Relapses, even after an intensive treatment are observed in 10-25% of cases. Researchers from UK examining dysbiosis associated with Clostridium difficile infections have discovered how to prevent those difficult relapses.
During the conducted experiments, rodents have been infected with Clostridium difficile genotype 027/BI (responsible for infections in Europe, North America and Australia), causing a highly contagious, chronic digestive system disease along with a severe dysbiosis. Treatment with vancomycin had been successful at first, but soon relapse has been observed. The discovery was made, that C difficile 027 produces spores of considerable resistance to antibiotics. Eradication of bacteria capable of producing such resistant spores is virtually impossible and leads to chronic dysbiosis within the digestive system.
Fecal transplantation therapy with the material collected from healthy individuals has led to a rapid restoration of bacterial balance in the intestines of infected mice, inducing eradication of Clostridium difficile 027/BI. In the course of this treatment, there have been no relapses observed. The promising results have motivated researchers to work further –to determine an optimal mixture of bacteria, providing a quick and permanent restoration of a healthy bacterial flora in individuals infected with C difficile.
The mix effective against Clostridium difficile contained six phylogenetically different intestinal bacteria, including three novel species. The bacteria used for the experiment were: Staphylococcus warneri, Enterococcus hirae, Lactobacillus reuteri, and three novel species, Anaerostipes sp nov., Bacteroidetes sp nov. and Enterorhabdus sp nov. Only such a mixture proved to be suitable for optimum restoration of the natural intestinal flora, leading to the eradication of C difficile. A set of obligate and facultative anaerobic bacteria species represents three of the four major intestinal microorganisms.
The researchers suggest that their findings will help to reduce the number of unnecessary antibiotic therapy, which in the era of rapidly developing drug resistance is a very important achievement. Research shows how important it is for our body to have a proper intestinal balance- administrating the right mix of bacteria is able to fight off serious infections. Perhaps the discovery will be useful for the treatment of other dysbiosis-related diseases in the future.
Written by: Maria Bilińska
Source:
1. http://www.nhs.uk/translationpolish/documents/clostridium_difficile_polish_final.pdf
2. http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1002995
3. http://en.wikipedia.org/wiki/Clostridium_difficile
4. http://en.wikipedia.org/wiki/Pseudomembranous_colitis
5. http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-clostridium-difficile-infection-in-adults
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