艰难梭菌是一种厌氧革兰氏阳性和孢子形成细菌。大多数艰难梭菌菌株产生两种毒素,A和B,与急性腹泻和/或结肠炎的发展有关。在这次审查中,区分两种情况:艰难梭菌感染(CDI)和无症状定植(AC)。这篇综述的主要目的是探索与肠道微生物群和CDI发展之间联系的可用数据。次要目的是提供更多信息,说明为什么一些被产毒艰难梭菌定植的人会感染,而另一些人则没有疾病迹象。几个因素,例如使用抗生素和质子泵抑制剂,住院治疗,和年龄,个体易患艰难梭菌定植和/或艰难梭菌感染。患有AC的人的肠道微生物群显示Prevotella的丰度降低,Alistipes,拟杆菌,双歧杆菌,Dorea,球菌,和Roseburia.患有CDI的人的肠道微生物群显示Lachnospirosaceae的丰度减少,Ruminocycaceae,Blautiaspp.,普雷沃氏菌属。,Dialisterspp.,双歧杆菌属。,Roseburiaspp.,厌氧菌属。,粪杆菌。和球菌属。,与健康人相比。此外,肠球菌科和肠球菌的丰度增加与艰难梭菌感染有关。
Clostridioides difficile is an anaerobic Gram-positive and spore-forming bacterium. The majority of C. difficile strains produce two toxins, A and B, associated with the development of acute diarrhea and/or colitis. In this review, two situations are distinguished: C. difficile infection (CDI) and asymptomatic colonization (AC). The main objective of this review is to explore the available data related to the link between the gut microbiota and the development of CDI. The secondary aim is to provide more information on why some people colonized with toxigenic C. difficile develop an infection while others show no signs of disease. Several factors, such as the use of antibiotics and proton pump inhibitors, hospitalization, and age, predispose individuals to C. difficile colonization and/or C. difficile infection. The gut microbiota of people with AC showed decreased abundances of Prevotella, Alistipes, Bacteroides, Bifidobacterium, Dorea, Coprococcus, and Roseburia. The gut microbiota of people suffering from CDI showed reductions in the abundances of Lachnospiraceae, Ruminococcaceae, Blautia spp., Prevotella spp., Dialister spp., Bifidobacterium spp., Roseburia spp., Anaerostipes spp., Faecalibacterium spp. and Coprococcus spp., in comparison with healthy people. Furthermore, increases in the abundances of Enterococcaceae and Enterococcus were associated with C. difficile infection.