Next Article in Journal
Effects of Spore-Displayed p75 Protein from Lacticaseibacillus rhamnosus GG on the Transcriptional Response of HT-29 Cells
Previous Article in Journal
Microbial Genetics and Evolution
Review

Concurrent and Subsequent Co-Infections of Clostridioides difficile Colitis in the Era of Gut Microbiota and Expanding Treatment Options

1
Unit of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin, 10149 Torino, Italy
2
Unit of Infectious Diseases, AOU “Città della Salute e della Scienza”, Department of Medical Sciences, University of Turin, 10149 Torino, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Lynne V. Mcfarland
Microorganisms 2022, 10(7), 1275; https://doi.org/10.3390/microorganisms10071275
Received: 29 May 2022 / Revised: 19 June 2022 / Accepted: 22 June 2022 / Published: 23 June 2022
(This article belongs to the Section Gut Microbiota)
We narratively reviewed the physiopathology, epidemiology, and management of co-infections in Clostridioides difficile colitis (CDI) by searching the following keywords in Embase, MedLine, and PubMed: “Clostridium/Clostridioides difficile”, “co-infection”, “blood-stream infection” (BSI), “fungemia”, “Candida”, “Cytomegalovirus”, “probiotics”, “microbial translocation” (MT). Bacterial BSIs (mainly by Enterobacteriaceae and Enterococcus) and fungemia (mainly by Candida albicans) may occur in up to 20% and 9% of CDI, increasing mortality and length of hospitalization. Up to 68% of the isolates are multi-drug-resistant bacteria. A pivotal role is played by gut dysbiosis, intestinal barrier leakage, and MT. Specific risk factors are represented by CDI-inducing broad-spectrum antibiotics, oral vancomycin use, and CDI severity. Probiotics administration (mainly Saccharomyces and Lactobacillus) during moderate/severe CDI may favor probiotics superinfection. Other co-infections (such as Cytomegalovirus or protozoa) can complicate limited and specific cases. There is mounting evidence that fidaxomicin, bezlotoxumab, and fecal microbiota transplantation can significantly reduce the rate of co-infections compared to historical therapies by interrupting the vicious circle between CDI, treatments, and MT. Bacterial BSIs and candidemia represent the most common co-infections in CDI. Physicians should be aware of this complication to promptly diagnose and treat it and enforce preventive strategies that include a more comprehensive consideration of newer treatment options. View Full-Text
Keywords: Clostridioides difficile; co-infection; blood-stream infection; Enterobacteriaceae; Candida; probiotics; Cytomegalovirus; gut microbiota; microbial translocation; fecal microbiota transplantation Clostridioides difficile; co-infection; blood-stream infection; Enterobacteriaceae; Candida; probiotics; Cytomegalovirus; gut microbiota; microbial translocation; fecal microbiota transplantation
Show Figures

Figure 1

MDPI and ACS Style

Trunfio, M.; Scabini, S.; Rugge, W.; Bonora, S.; Di Perri, G.; Calcagno, A. Concurrent and Subsequent Co-Infections of Clostridioides difficile Colitis in the Era of Gut Microbiota and Expanding Treatment Options. Microorganisms 2022, 10, 1275. https://doi.org/10.3390/microorganisms10071275

AMA Style

Trunfio M, Scabini S, Rugge W, Bonora S, Di Perri G, Calcagno A. Concurrent and Subsequent Co-Infections of Clostridioides difficile Colitis in the Era of Gut Microbiota and Expanding Treatment Options. Microorganisms. 2022; 10(7):1275. https://doi.org/10.3390/microorganisms10071275

Chicago/Turabian Style

Trunfio, Mattia, Silvia Scabini, Walter Rugge, Stefano Bonora, Giovanni Di Perri, and Andrea Calcagno. 2022. "Concurrent and Subsequent Co-Infections of Clostridioides difficile Colitis in the Era of Gut Microbiota and Expanding Treatment Options" Microorganisms 10, no. 7: 1275. https://doi.org/10.3390/microorganisms10071275

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop