Dissecting the link between Clostridioides difficile, the intestinal microbiota and host factors to determine patient outcome.

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Clostridioides difficile is the leading cause of nosocomial antibiotic-associated diarrhoea worldwide, yet little is known about colonisation of the intestinal tract and disease relapse. Treatment with antibiotics for an underlying condition alters the intestinal microbiota, which results in susceptibility to colonisation with C. difficile. Current data indicates that 20-30% of patients suffering from C. difficile infection (CDI) relapse within two months post-treatment with increasing probability of relapsing multiple times, indicating the presence of a potential reservoir of C. difficile re-seeding the intestinal tract of susceptible patients. We suggest there are there are distinct community and proteomic signatures linked to C. difficile disease.