Clostridioides difficile: Current overview and future perspectives

Joanna Giles*, April Roberts

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

The most common world-wide cause of antibiotic-associated infectious diarrhea and colitis is the toxin producing bacterium, Clostridioides difficile (C. difficile). Here we review the background and characteristics of the bacterium and the toxins produced together with the epidemiology and the complex pathogenesis that leads to a broad clinical spectrum of disease. The review describes the difficulties faced in obtaining a quick and accurate diagnosis despite the range of sensitive and specific diagnostic tools available. We also discuss the problem of disease recurrence and the importance of disease prevention. The high rates of infection recurrence mean that treatment strategies are constantly under review and we outline the diverse treatment options that are currently in use and explore the emerging treatment options of pulsed antibiotic use, microbial replacement therapies and the use of monoclonal antibodies. We summarize the future direction of treatment strategies which include the development of novel antibiotics, the administration of oral polyclonal antibody formulations, the use of vaccines, the administration of competitive non-toxigenic spores and the neutralization of antibiotics at the microbiota level. Future successful treatments will likely involve a combination of therapies to provide the most effective and robust approach to C. difficile management.

Original languageEnglish
Title of host publicationImmunotherapeutics
EditorsRossen Donev
PublisherAcademic Press Inc.
Pages215-245
Number of pages31
ISBN (Print)9780323992275
DOIs
Publication statusPublished - Jan 2022

Publication series

NameAdvances in Protein Chemistry and Structural Biology
Volume129
ISSN (Print)1876-1623
ISSN (Electronic)1876-1631

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Inc.

Keywords

  • Antibiotic resistance
  • C. difficile
  • CDI
  • CDI diagnosis
  • CDI treatment
  • Fecal transplantation
  • Immunotherapy of CDI
  • Microbiota
  • Oral antibodies

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