It is known that disruption of gut microbiota by use of antibiotics makes individuals more vulnerable to Clostridium difficile infection (CDI). Also, antibiotic treatment for CDI can eliminate potentially protective commensal bacteria, which could, in turn, facilitate Clostridium difficile reinfection. Thus, recurrence of those infections remains a clinical challenge.
In this “Between Bedside to Bench” article in the Nature Medicine journal, Taur and Pamer discussed the potential of fecal microbiota transplant (FMT) to treat or even prevent Clostridium difficile infection, as an alternative approach to reconstruct microbiota in patients with recurrent CDI. Moreover, the authors examined several studies that proposed different mechanisms to explain FMT efficacy. As the authors pointed out, there is a great interest in identifying the specific bacterial species that confer protection against CDI. Focusing on normal microbiota, they described several hypotheses on mechanisms for microbiota-mediated suppression of CDI, such as the loss of short-chain fatty acids or the modification of bile salts.
The authors concluded that future research on CDI should address this in several ways. For instance, increasing our understanding of microbiota-mediated protection against CDI and the specific microbial contributors involved, or improved probiotic administration along with targeted therapies that interfere with C. difficile germination and growth.
Taur Y & Pamer EG. (2014) Harnessing microbiota to kill a pathogen: fixing the microbiota to treat Clostridium difficile infections Nature Medicine 20(3) pp. 246-247. doi:10.1038/nm.3492