RESUMEN
Clostridioides difficile infections (CDIs) continue to be a persistent healthcare concern despite newer antibiotic treatments, enhanced infection control practices, and preventive strategies focused on restoring the protective intestinal microbial barrier. Recent strides in gene sequencing research have identified many genes regulating diverse virulence factors for CDIs. These genes may be over- or under-expressed when triggered by various environmental and nutritional factors. The aims of this paper are to review the important genes involved in C. difficile pathogenesis and to identify modifiable environmental, nutritional, and other factors that may trigger the expression of these genes and thus offer new strategies to prevent CDIs.
RESUMEN
AIMS: Clostridioides difficileâ¯infections (CDI) are a major cause of morbidity and mortality in hospitalized patients. A probiotic formulation (Bio-K+) comprised ofâ¯Lactobacillus acidophilusâ¯CL1285, Lacticaseibacillus caseiâ¯LBC80R, and Lacti. rhamnosusâ¯CLR2 strains have been shown to reduce the incidence of CDI and antibiotic-associated diarrhea (AAD). This research aims to therefore elucidate the mechanism of action ofâ¯the three probiotic strained againstâ¯C. difficile R20291, independently of the acidification of the environment.â¯. METHODS AND RESULTS: Antitoxin activity was evaluated using ELISA method and the expression ofâ¯C. difficileâ¯genes was evaluated using transcriptomic analysis in co-culture assays conducted in a bioreactor allowing precise control of the pH. The fermentation results demonstrated a decrease for toxin A and many genes directly related toâ¯C. difficileâ¯virulence were underexpressed in the co-cultures. CONCLUSIONS: The lactobacilli tested could have a role in the motility, the quorum sensing (QS), the survival of the spores, and the germination potential of the spores, which are essential elements for the virulence ofâ¯C. difficile.â¯.