Bacterial and fungal microbiota changes distinguish C. difficile infection from other forms of diarrhea: Results of a prospective inpatient study

William Sangster, John P. Hegarty, Kathleen M. Schieffer, Justin R. Wright, Jada Hackman, David R. Toole, Regina Lamendella, David B. Stewart

Research output: Contribution to journalArticle

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Abstract

This study sought to characterize the bacterial and fungal microbiota changes associated with Clostridium difficile infection (CDI) among inpatients with diarrhea, in order to further explain the pathogenesis of this infection as well as to potentially guide new CDI therapies. Twenty-four inpatients with diarrhea were enrolled, 12 of whom had CDI. Each patient underwent stool testing for CDI prior to being treated with difficile-directed antibiotics, when appropriate. Clinical data was obtained from the medical record, while each stool sample underwent 16S rRNA and ITS sequencing for bacterial and fungal elements. An analysis of microbial community structures distinct to the CDI population was also performed. The results demonstrated no difference between the CDI and non-CDI cohorts with respect to any previously reported CDI risk factors. Butyrogenic bacteria were enriched in both CDI and non-CDI patients. A previously unreported finding of increased numbers of Akkermansia muciniphila in CDI patients was observed, an organism which degrades mucin and which therefore may provide a selective advantage toward CDI. Fungal elements of the genus Penicillium were predominant in CDI; these organisms produce antibacterial chemicals which may resist recovery of healthy microbiota. The most frequent CDI microbial community networks involved Peptostreptococcaceae and Enterococcus, with decreased population density of Bacteroides. These results suggest that the development of CDI is associated with microbiota changes which are consistently associated with CDI in human subjects. These gut taxa contribute to the intestinal dysbiosis associated with C. difficile infection.

Original languageEnglish (US)
Article number789
JournalFrontiers in Microbiology
Volume7
Issue numberMAY
DOIs
StatePublished - Jan 1 2016

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Clostridium Infections
Clostridium difficile
Inpatients
Diarrhea
Prospective Studies
Infection
Microbiota
Mycobiome
Community Networks
Dysbiosis
Bacteroides
Penicillium
Enterococcus
Mucins
Population Density

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)

Cite this

Sangster, William ; Hegarty, John P. ; Schieffer, Kathleen M. ; Wright, Justin R. ; Hackman, Jada ; Toole, David R. ; Lamendella, Regina ; Stewart, David B. / Bacterial and fungal microbiota changes distinguish C. difficile infection from other forms of diarrhea : Results of a prospective inpatient study. In: Frontiers in Microbiology. 2016 ; Vol. 7, No. MAY.
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Bacterial and fungal microbiota changes distinguish C. difficile infection from other forms of diarrhea : Results of a prospective inpatient study. / Sangster, William; Hegarty, John P.; Schieffer, Kathleen M.; Wright, Justin R.; Hackman, Jada; Toole, David R.; Lamendella, Regina; Stewart, David B.

In: Frontiers in Microbiology, Vol. 7, No. MAY, 789, 01.01.2016.

Research output: Contribution to journalArticle

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