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C. difficile bacteria seen through a scanning electron microscope and colored green. Image Credit: Janice Carr via CDC |
Clostridioides difficile (C. diff) intestinal infections can cause severe, debilitating diarrhea in patients who are hospitalized or on immunosuppressive therapies. The infections can be very hard to eradicate, roaring back when patients try to taper their antibiotics. Many people wind up on antibiotics for months and can become resistant to three or more of them.
“Often being on antibiotics isn’t sufficient,” explained Meenakshi Rao, Harvard Medical School assistant professor of pediatrics at Boston Children’s Hospital. “The infection can catalyze severe, runaway inflammation, especially in patients with inflammatory bowel disease.”
This inflammation, in turn, promotes C. diff colonization of intestinal tissue. And antibiotics themselves could be part of the problem.
“Once we attack C. diff with antibiotics, it disrupts the gut microbiome,” said Min Dong, HMS associate professor of surgery at Boston Children’s, whose lab studies bacterial toxins and how to combat them. “That creates an opportunity for severe, recurring infection, and it becomes a vicious cycle.”