Microbiologic factors affecting Clostridium difficile recurrence C.H. Chilton, D.S. Pickering, J. Freeman  Clinical Microbiology and Infection  Volume 24, Issue 5, Pages 476-482 (May 2018) DOI: 10.1016/j.cmi.2017.11.017 Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions

Fig. 1 The Microbiological factors affecting C. difficile infection and recurrence. 1. The Microbiota - A ‘healthy’ microbiota is refractive to C. difficile spore colonisation, but once microbiota populations are disrupted (e.g. by antibiotic exposure), C. difficile infection (CDI) can occur. Antibiotic treatment of CDI can resolve the infection, but can maintain the microbiota in a disrupted state, leaving a patient susceptible to recurrence of CDI. This can lead to a vicious cycle of recurrent disease. 2. C. difficile spore viability - A disrupted microbiota will not lead to CDI (or recurrent CDI) unless C. difficile spores are present in the gut. These spores must germinate, proliferate and release toxin for a symptomatic recurrent episode to occur. Clinical Microbiology and Infection 2018 24, 476-482DOI: (10.1016/j.cmi.2017.11.017) Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases Terms and Conditions