Diarrhoeal events can trigger long-term Clostridium difficile colonization with recurrent blooms
Diarrhoeal events can trigger long-term Clostridium difficile colonization with recurrent blooms
复制标题
DOI：
10.1038/s41564-020-0668-2
复制
发表时间：
2020-02-10
影响因子：
28.3
通讯作者：
Polz, Martin F.
中科院分区：
文献类型：
--
作者：
VanInsberghe, David;Elsherbini, Joseph A.;Polz, Martin F.
胃肠道紊乱，如非抗生素引起的腹泻，促进易感性定植艰难梭菌，提供额外的见解，非抗生素独立触发这种infection.Although艰难梭菌被广泛认为是一种抗生素和医院相关的病原体，最近的证据表明，这是一个不充分的描述的风险和水库。一个共同的线索，连接所有主要的感染危险因素是他们与胃肠道紊乱，但这种关系，以C。艰难定殖从未被直接测试过。在这里，我们表明，干扰所造成的事件触发易感性的C。艰难的殖民利用人类肠道微生物组的调查数据，我们检测到C。在食物中毒和霍乱弧菌感染后恢复的人群中，携带者保持殖民长达一年的时间尺度，并经历了高度可变的模式C。艰难梭菌丰度，其中增加脱落在短时间内的1-2天中断一周的时间，其中C。艰难梭菌检测不到。考虑到短时间的脱落事件通常与胃肠道紊乱有关，我们的研究结果有助于解释为什么C。在腹泻患者中经常检测到艰难梭菌作为共感染病原体。为了直接测试腹泻对定植敏感性的影响，我们开发了一种可变干扰强度的小鼠模型，这使我们能够在没有疾病的情况下监测定植。当小鼠暴露于无毒力C.艰难梭菌孢子摄入的泻药量增加，更多的人经历了C。艰难的花朵。我们的研究结果表明，殖民化的可能性是最高的几天后立即急性干扰，这表明这可能是一个重要的窗口，在此期间，传输可以中断，感染的发生率降低。
Gastrointestinal disturbances, such as non-antibiotic-induced diarrhoea, promote susceptibility to colonization by Clostridium difficile, providing additional insights into antibiotic-independent triggers for this infection.Although Clostridium difficile is widely considered an antibiotic- and hospital-associated pathogen, recent evidence indicates that this is an insufficient depiction of the risks and reservoirs. A common thread that links all major risk factors of infection is their association with gastrointestinal disturbances, but this relationship to C. difficile colonization has never been tested directly. Here, we show that disturbances caused by diarrhoeal events trigger susceptibility to C. difficile colonization. Using survey data of the human gut microbiome, we detected C. difficile colonization and blooms in people recovering from food poisoning and Vibrio cholerae infections. Carriers remained colonized for year-long time scales and experienced highly variable patterns of C. difficile abundance, where increased shedding over short periods of 1-2 d interrupted week-long periods in which C. difficile was undetectable. Given that short shedding events were often linked to gastrointestinal disturbances, our results help explain why C. difficile is frequently detected as a co-infecting pathogen in patients with diarrhoea. To directly test the impact of diarrhoea on susceptibility to colonization, we developed a mouse model of variable disturbance intensity, which allowed us to monitor colonization in the absence of disease. As mice exposed to avirulent C. difficile spores ingested increasing quantities of laxatives, more individuals experienced C. difficile blooms. Our results indicate that the likelihood of colonization is highest in the days immediately following acute disturbances, suggesting that this could be an important window during which transmission could be interrupted and the incidence of infection lowered.