1887

Abstract

infection (CDI) is the most common identifiable cause of diarrhoea in hospitalized patients. Current therapies rely on the administration of metronidazole or vancomycin, which reduce vegetative populations of in the bowel. Recurrence of the disease when treatment with these antibiotics ceases indicates that metronidazole and vancomycin affect not only but also commensal populations that normally mediate competitive exclusion. Fidaxomicin is a new antibiotic that inhibits . Our study shows that fidaxomicin had little effect on the composition of the faecal microbiota in terms of its major phylogenetic clusters. Notably, clostridial clusters XIVa and IV, and , were much less affected by fidaxomicin compared to vancomycin treatment. These findings help to explain the substantially reduced rates of relapse following treatment of CDI with fidaxomicin in recent clinical trials.

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2010-11-01
2024-12-03
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References

  1. Bäckhed F., Ding H., Wang T., Hooper L. V., Koh G. Y., Nagy A., Semenkovich C. F., Gordon J. I. 2004; The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A 101:15718–15723
    [Google Scholar]
  2. Calfee D. P. 2008; Clostridium difficile: a reemerging pathogen. Geriatrics 63:10–21
    [Google Scholar]
  3. Gill S. R., Pop M., DeBoy R. T., Eckburg P. B., Turnbaugh P. J., Samuel B. S., Gordon J. I., Relman D. A., Fraser-Liggett C. M., Nelson K. E. 2006; Metagenomic analysis of the human distal gut microbiome. Science 312:1355–1359
    [Google Scholar]
  4. Gore C., Munro K., Lay C., Bibiloni R., Morris J., Woodcock A., Custovic A., Tannock G. W. 2008; Bifidobacterium pseudocatenulatum is associated with atopic eczema: a nested case-control study investigating the fecal microbiota of infants. J Allergy Clin Immunol 121:135–140
    [Google Scholar]
  5. Hardin G. 1960; The competitive exclusion principle. Science 131:1292–1297
    [Google Scholar]
  6. Hooper L. V. 2004; Bacterial contributions to mammalian gut development. Trends Microbiol 12:129–134
    [Google Scholar]
  7. Lay C., Rigottier-Gois L., Holmstrom K., Rajilic M., Vaughan E. E., de Vos W. M., Collins M. D., Thile R., Namsolleck P. other authors 2005; Colonic microbiota signatures across five northern European countries. Appl Environ Microbiol 71:4153–4155
    [Google Scholar]
  8. Louie T. J., Emery J., Krulicki W., Byrne B., Mah M. 2009a; OPT-80 eliminates Clostridium difficile and is sparing of Bacteroides species during treatment of C. difficile infection. Antimicrob Agents Chemother 53:261–263
    [Google Scholar]
  9. Louie T., Miller M., Donskey C., Mullane K., Goldstein E. J. C. 2009b; Clinical outcomes, safety and pharmacokinetics of fidaxomicin in a phase 2 trial of patients with Clostridium difficile infection. Antimicrob Agents Chemother 53:223–228
    [Google Scholar]
  10. Miller M. 2010; Fidaxomicin (OPT-80) for the treatment of Clostridium difficile infection. Expert Opin Pharmacother 11:1569–1578
    [Google Scholar]
  11. Moore W. E. C., Cato E. P., Holdeman L. V. 1978; Some current concepts in intestinal bacteriology. Am J Clin Nutr 31 (Suppl. 10):S33–S42
    [Google Scholar]
  12. Rinttilä T., Kassinen A., Malinen E., Krogius L., Palva A. 2004; Development of an extensive set of 16S rDNA-targeted primers for quantifification of pathogenic and indigenous bacteria in faecal samples by real-time PCR. J Appl Microbiol 97:1166–1177
    [Google Scholar]
  13. Rubin T. A., Gessert C. E., Aas J. 2009; Stool transplantation for older patients with Clostridium difficile infection. J Am Geriatr Soc 57:2386–2387
    [Google Scholar]
  14. Shannon-Lowe J., Matheson N. J., Cooke F. J., Aliyu S. H. 2010; Prevention and medical management of Clostridium difficile infection. BMJ 340:c1296
    [Google Scholar]
  15. Tannock G. W., Munro K., Bibiloni R., Simon M. A., Hargreaves P., Gopal P., Harmsen H., Welling G. 2004; Impact of consumption of oligosaccharide-containing biscuits on the fecal microbiota of humans. Appl Environ Microbiol 70:2129–2136
    [Google Scholar]
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