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Harnessing Microbiota to Kill a Pathogen: The sweet tooth of Clostridium difficile

Nature Medicine volume 20, pages 248–249 (2014)Cite this article

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Clostridium difficile infection (CDI) is a leading cause of antibiotic-associated diarrhea, and its incidence and severity have notably increased in developed countries in the last few decades1. Besides diarrhea, its symptoms can include abdominal pain, fever, nausea and vomiting, and in severe cases, systemic inflammation, renal and respiratory failure2. CDI has become more refractory to traditional treatment with the emergence of multidrug resistance strains and is more likely to relapse1. Although commensal strains of C. difficile are widely occurring members of the gut microbiome in healthy individuals3, pathogenic strains are often transmitted in hospital and, increasingly, community settings via the oral-fecal route through contaminated hands and surfaces. The main cause of CDI is the use of antibiotics, particularly fluoroquinolones, and the risk and duration of the infection increase with antibiotic dose2. As antibiotics also have profound detrimental effects on the biomass and diversity of the gut microbiome4, this provides an opportunity for C. difficile overgrowth.

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Figure 1: Sialic acid consumption in C. difficile infection after antibiotic treatment.

Marina Corral Spence

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  1. Ruth E. Ley is at the Department of Microbiology, Cornell University, Ithaca, New York, USA.,

    Ruth E Ley

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  1. Ruth E Ley
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Correspondence to Ruth E Ley.

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Ley, R. Harnessing Microbiota to Kill a Pathogen: The sweet tooth of Clostridium difficile. Nat Med 20, 248–249 (2014). https://doi.org/10.1038/nm.3494

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