Nat. Rev. Gastroenterol. Hepatol. doi: /nrgastro

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Presentation transcript:

Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2016.25 Figure 1 Model for Clostridium difficile acquisition, germination and infection Figure 1 | Model for Clostridium difficile acquisition, germination and infection. At least four events are integral to C. difficile pathogenesis before the development of symptomatic infection. a | Transmission of spores via the faecal-oral route. b | Exposure to antibiotics (or immunosuppressants) establishes susceptibility to infection through perturbation of the intestinal microbiota. c | Transformation of spores into vegetative bacteria through interaction with small molecular germinants, such as bile acids. d | Release of C. difficile toxins, which are essential for the disease manifestations. Symptoms can range from mild diarrhoea to life-threatening pseudomembranous colitis. e | At radiography, colonic and small bowel dilatation can be seen with mucosal thickening as evidenced by 'thumb-printing'. PaLoc, pathogenicity locus. *Diagrammatic only, inaccurate morphology and scale. Martin, J. S. H. et al. (2016) Clostridium difficile infection: epidemiology, diagnosis and understanding transmission Nat. Rev. Gastroenterol. Hepatol. doi:10.1038/nrgastro.2016.25