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Zhonghua Nei Ke Za Zhi 2021 May;60(5):469-472

Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China.

Intern Med 2021 Apr 26. Epub 2021 Apr 26.

Department of General Internal Medicine and Infectious Diseases, National Hospital Organization Tokyo Medical Center, Japan.

Trop Anim Health Prod 2021 Apr 23;53(2):284. Epub 2021 Apr 23.

Department of Anaerobic Vaccine Research and Production, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Shahid Beheshti Blvd., P.O. Box: 31975/148, Hesarak, Karaj, Alborz Province, Iran.

Clostridium is a Gram-positive, rod-shaped, anaerobic, and spore-forming bacterium, which is found in the surrounding environments throughout the world. Clostridium species cause botulism, tetanus, enterotoxaemia, gas gangrene, necrotic enteritis, pseudomembranous colitis, blackleg, and black disease. Clostridium infection causes severe economic losses in livestock and poultry industries. Read More

Cureus 2021 Mar 8;13(3):e13763. Epub 2021 Mar 8.

Gastroenterology, BronxCare Health System, Bronx, USA.

 species are spore-forming gram-positive anaerobic rod bacteria that cause a broad range of infections in humans, including intra-abdominal infections, myonecrosis, and bacteremia. Pseudomembranous colitis (PMC) is a severe form of infection caused by  .Clostridialbacteremia usually occurs in the settings of neutropenia, alcohol abuse, diabetes mellitus, sickle cell anemia, malignancy, hemodialysis, inflammatory bowel disease, and AIDS. Read More

J Med Microbiol 2021 Apr;70(4)

Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo 143-8540, Japan.

infection (CDI) causes toxin-mediated enteropathy, such as antibiotic-associated diarrhoea and pseudomembranous colitis. Rho-glucosylating toxin A (TcdA) and toxin B (TcdB) have been clearly implicated in pathogenesis, whereas the virulence of binary toxin (CDT) is still debated. We hypothesized that CDT is involved in the host immune response and plays a pivotal role in establishing virulence by modulating pro-inflammatory cytokine production; this is achieved through the integral Toll-like receptor (TLR) signalling pathways. Read More

Int J Mol Sci 2021 Mar 13;22(6). Epub 2021 Mar 13.

Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

Novel therapeutics are needed to treat pathologies associated with the binary toxin (CDT), particularly when infection (CDI) occurs in the elderly or in hospitalized patients having illnesses, in addition to CDI, such as cancer. While therapies are available to block toxicities associated with the large clostridial toxins (TcdA and TcdB) in this nosocomial disease, nothing is available yet to treat toxicities arising from strains of CDI having the binary toxin. Like other binary toxins, the active CDTa catalytic subunit of CDT is delivered into host cells together with an oligomeric assembly of CDTb subunits via host cell receptor-mediated endocytosis. Read More

BMJ Case Rep 2021 Apr 1;14(4). Epub 2021 Apr 1.

Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA

A 20-year-old Caucasian man with a history of psoriasis presented to the emergency department due to a 2-week history of severe polyarthralgia and a 3-week history of non-bloody diarrhoea. The initial workup 2 days prior in an urgent care clinic returned negative for all enteric pathogens including nucleic acid amplification test. Investigations revealed colitis on CT and pseudomembranous colitis on colonoscopy. Read More

Int J Med Microbiol 2021 Apr 2;311(3):151484. Epub 2021 Mar 2.

Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Pettenkoferstr. 9a, Munich, Germany; German Center for Infection Research (DZIF), Partner Site LMU Munich, Munich, Germany. Electronic address:

Colonization resistance (CR), the ability to block infections by potentially harmful microbes, is a fundamental function of host-associated microbial communities and highly conserved between animals and humans. Environmental factors such as antibiotics and diet can disturb microbial community composition and thereby predispose to opportunistic infections. The most prominent is Clostridioides difficile, the causative agent of diarrhea and pseudomembranous colitis. Read More

Dig Liver Dis 2021 Mar 9. Epub 2021 Mar 9.

Institute of Pathology, ASST Spedali Civili, Brescia, Italy.

Pathologists are often called upon to diagnose colitides that differ from the two main forms of inflammatory bowel disease (IBD). These non-IBD colitides include infectious colitis, microscopic colitis, ischemic colitis, eosinophilic colitis, autoimmune enterocolitis, segmental colitis associated with diverticulosis, drug-induced colitis, radiation colitis and diversion colitis. The diagnosis of these different disease entities relies on the histopathological examination of endoscopic biopsies of the gastrointestinal tract. Read More

Biochim Biophys Acta Biomembr 2021 Jun 6;1863(6):183603. Epub 2021 Mar 6.

Institute of Pharmacology and Toxicology, Ulm University Medical Center, Ulm, Germany.

Clostridioides (C.) difficile is clinically highly relevant and produces several AB-type protein toxins, which are the causative agents for C. difficile-associated diarrhea and pseudomembranous colitis. Read More

Pathologica 2021 Feb;113(1):54-65

University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy.

Non-IBD colitides (NIBDC) are intestinal diseases clinically and endoscopically overlapping with Inflammatory Bowel Diseases (IBD), sometimes with a similar histological picture. NIBDC include entities such as infectious colitis, ischemic colitis, pseudomembranous colitis, eosinophilic colitis, autoimmune enterocolitis, segmental colitis associated with diverticulosis, drug-induced colitis, radiation-induced colitis, diversion colitis, and microscopic colitis, this last including two entities: collagenous and lymphocytic colitis. The knowledge of the most useful histological features and the main clinical data for each entity is mandatory in daily clinical practice, for correct pathological diagnosis and clinical management. Read More

Emerg Microbes Infect 2021 Dec;10(1):687-699

Center of Tree Shrew Germplasm Resources, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research and Development on Severe Infectious Diseases, Yunnan Innovation Team of Standardization and Application Research in Tree Shrew, Kunming, China.

is the predominant antibiotic-associated enteropathogen associated with diarrhoea or pseudomembranous colitis in patients worldwide. Previously, we identified RT078 isolates (CD21062) from elderly patients in China, including two new ribotype strains (CD10010 and CD12038) belonging to the ST11 group, and their genomic features were also investigated. This study compared sporulation, spore germination, toxin expression, flagellar characteristics, and adhesion among these strains in vitro and analysed their pathogenic ability in vivo using animal models. Read More

Microorganisms 2021 Feb 2;9(2). Epub 2021 Feb 2.

Synthetic Biology Research Centre, The University of Nottingham Biodiscovery Institute, University Park, Nottingham NG7 2RD, UK.

is the main cause of health-care-associated infectious diarrhoea. Toxins, TcdA and TcdB, secreted by this bacterium damage colonic epithelial cells and in severe cases this culminates in pseudomembranous colitis, toxic megacolon and death. Vaccines in human trials have focused exclusively on the parenteral administration of toxin-based formulations. Read More

PLoS Pathog 2021 01 28;17(1):e1009197. Epub 2021 Jan 28.

Key Laboratory of Structural Biology of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China.

Clostridioides difficile toxin B (TcdB) is a key virulence factor that causes C. difficile associated diseases (CDAD) including diarrhea and pseudomembranous colitis. TcdB can be divided into multiple subtypes/variants based on their sequence variations, of which four (TcdB1-4) are dominant types found in major epidemic isolates. Read More

Nat Commun 2021 01 19;12(1):462. Epub 2021 Jan 19.

Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA.

Clostridioides difficile is a bacterial pathogen that causes a range of clinical disease from mild to moderate diarrhea, pseudomembranous colitis, and toxic megacolon. Typically, C. difficile infections (CDIs) occur after antibiotic treatment, which alters the gut microbiota, decreasing colonization resistance against C. Read More

Cureus 2020 Dec 31;12(12):e12396. Epub 2020 Dec 31.

Internal Medicine, Taibah University, Medina, SAU.

We report a case of a 57-year-old male with a past medical history of controlled hypertension and type 2 diabetes mellitus, who had unusual elevated serum concentration levels of vancomycin during oral treatment for pseudomembranous colitis. Both measured serum vancomycin levels of 39 μg/ml and cerebrospinal fluid level of 5.7 μg/mL were documented and associated with unexplained neurological symptoms and sexual dysfunction. Read More

Int J Food Microbiol 2021 Feb 19;339:109032. Epub 2020 Dec 19.

German Federal Institute for Risk Assessment, Department Biological Safety, Unit Bacterial Toxins, Food Service, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany.

Clostridioides difficile is one of the most frequent causes of nosocomial infections in humans leading to (antibiotic-associated) diarrhea and severe pseudomembranous colitis. With an increasing frequency, C. difficile infections (CDI) are also observed independently of hospitalization and the age of the patients in an ambulant setting. Read More

J Infect Dev Ctries 2020 12 31;14(12):1461-1465. Epub 2020 Dec 31.

Department of Gastrointestinal and Digestive Surgery, Hôtel Dieu de France, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.

Introduction: The objectives of the present study were to investigate epidemiology, correlations, severity, and therapeutic response of Clostridioides difficile infections in a Lebanese tertiary care hospital.

Methodology: In this retrospective cohort study, patients having at least one positive Clostridioides difficile test (antigen glutamate dehydrogenase/GDH with toxins, or PCR) were studied.

Results: Among 58 patients, 20 (34. Read More

Int J Surg Case Rep 2021 Jan 9;78:155-158. Epub 2020 Dec 9.

Department of Anesthesiology, Hospital of Traumatology and Orthopedics, Riga, Latvia; Faculty of Medicine, University of Latvia, Riga, Latvia.

Introduction: Clostridium difficile is one of the most common healthcare-associated infections. Pseudomembranous colitis is a serious complication of Clostridium difficile infection (CDI) after septic surgery and antibacterial therapy. A sudden white blood cell (WBC) count increase and extremely high leucocytosis may be a predictor of a poor outcome. Read More

Pol Arch Intern Med 2021 02 14;131(2):121-127. Epub 2020 Dec 14.

Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland

Introduction: The use of antibiotics and possibility of microbiota disruption during the coronavirus disease 2019 (COVID‑19) pandemic have raised questions about the incidence of Clostridioides difficile infection (CDI).

Objectives: This study aimed to assess the frequency of and risk factors for CDI in patients with COVID‑19.

Patients And Methods: We conducted a retrospective, single‑center evaluation study on the frequency of and risk factors for CDI in patients with COVID‑19 and in the prepandemic era. Read More

Am Surg 2020 Oct;86(10):1269-1276

VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Diverting loop ileostomy (DLI) with colonic lavage has been proposed as an alternative to total abdominal colectomy (TAC) for fulminant infection (CDI). Controversy exists regarding the mortality benefit and outcomes of this surgical approach. We conducted a MEDLINE database search for articles between 1999 and 2019 pertaining to DLI for the surgical treatment of CDI. Read More

Case Rep Gastroenterol 2020 Sep-Dec;14(3):522-526. Epub 2020 Oct 27.

Pediatric Gastroenterology, Peyton Manning Children's Hospital, Indianapolis, Indiana, USA.

infection rates have been rising within the last decade and more pediatric patients have been suffering from this type of infection. However, this bacterium is a well-known contaminant in the normal flora of the colon in patients under the age of 2 years, and therefore consensus guidelines have recommended against routine testing for this infection, unless clinically indicated. We present here a case of a very young infant who presented with symptoms of food refusal, poor weight gain, abdominal distention, and colitis noted on imaging. Read More

J Biomed Nanotechnol 2020 Jun;16(6):954-964

infection (CDI) has become the main cause of diarrhea-related diseases in domestic (China) inpatients. High-sensitivity and high-specificity detection methods for CDI must be applied clinically for CDI supervisory control. In this paper, we introduce a detection method for and Norovirus based on real-time PCR. Read More

PLoS One 2020 9;15(11):e0241903. Epub 2020 Nov 9.

Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France.

Clostridioides difficile is responsible for various intestinal symptoms from mild diarrhea to severe pseudomembranous colitis and is the primary cause of antibiotic-associated diarrhea in adults. Metronidazole was the first-line treatment for mild to moderate C. difficile infections for 30 years. Read More

Hist Cienc Saude Manguinhos 2020 Jul-Sep;27(3):859-878

Pesquisador, Instituto Oswaldo Cruz/Fiocruz. Rio de Janeiro - RJ - Brasil

In 1958, Eiseman and contributors published the first scientific paper reporting the use of fecal microbiota transplant for treating pseudomembranous colitis. The relevance of this innovative paper was only acknowledged in 1990. The academic literature on the theme is characterized by a narrative that has undergone successive revisions. Read More

Dis Colon Rectum 2020 09;63(9):1317-1326

Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.

Background: Emergency surgery is often required for fulminant Clostridium difficile colitis. Total abdominal colectomy has been the treatment of choice despite high morbidity and mortality.

Objective: The aim of this meta-analysis was to evaluate postoperative mortality and morbidity after total abdominal colectomy and loop ileostomy with colonic lavage in patients with fulminant C difficile colitis. Read More

Int Med Case Rep J 2020 9;13:409-414. Epub 2020 Sep 9.

Girum General Hospital, Addis Ababa, Ethiopia.

We present a series of four patients who had been admitted to two hospitals in Addis Ababa after presenting with persistent and chronic diarrhoea. All patients were subsequently diagnosed to have Clostridioides difficile-associated pseudomembranous colitis, a disease that has long been regarded as a rare diagnosis in sub-Saharan Africa, and which has not yet been reported in Ethiopia. This case series is believed to create a much-needed awareness among physicians on the existence of this treatable but potentially fatal disease. Read More

J Biol Chem 2020 12 25;295(49):16785-16796. Epub 2020 Sep 25.

Université Paris-Saclay, INRAE, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France. Electronic address:

is an anaerobic and spore-forming bacterium responsible for 15-25% of postantibiotic diarrhea and 95% of pseudomembranous colitis. Peptidoglycan is a crucial element of the bacterial cell wall that is exposed to the host, making it an important target for the innate immune system. The peptidoglycan is largely -deacetylated on its glucosamine (93% of muropeptides) through the activity of enzymes known as -deacetylases, and this -deacetylation modulates host-pathogen interactions, such as resistance to the bacteriolytic activity of lysozyme, virulence, and host innate immune responses. Read More

Ann Hematol 2020 Nov 24;99(11):2547-2553. Epub 2020 Sep 24.

Department of Medicine, Hematology/Oncology, University Hospital, Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.

Patients with acute myeloid leukemia (AML) are often exposed to broad-spectrum antibiotics and thus at high risk of Clostridioides difficile infections (CDI). As bacterial infections are a common cause for treatment-related mortality in these patients, we conducted a retrospective study to analyze the incidence of CDI and to evaluate risk factors for CDI in a large uniformly treated AML cohort. A total of 415 AML patients undergoing intensive induction chemotherapy between 2007 and 2019 were included in this retrospective analysis. Read More

PLoS Pathog 2020 09 22;16(9):e1008852. Epub 2020 Sep 22.

Department of Biochemistry, University of Toronto, and Program in Molecular Medicine, The Hospital for Sick Children, Toronto, ON, Canada.

Enzymatic inactivation of Rho-family GTPases by the glucosyltransferase domain of Clostridioides difficile Toxin B (TcdB) gives rise to various pathogenic effects in cells that are classically thought to be responsible for the disease symptoms associated with C. difficile infection (CDI). Recent in vitro studies have shown that TcdB can, under certain circumstances, induce cellular toxicities that are independent of glucosyltransferase (GT) activity, calling into question the precise role of GT activity. Read More