Acidified nitrite: a host defence against colonization with C. difficile spores?
Proton pump inhibitor (PPI) use increases the risk of Clostridium difficile infection (CDI) despite C. difficile spores being acid resistant. Swallowed saliva contains nitrite which reacts with gastric acid, producing bactericidal nitrogen oxides. With 5mM nitrite at pH 2 (reflecting normal gastric conditions) all C. difficile spores were killed within 15 min. No reduction in count was seen with the same nitrite concentration at pH 5, representing gastric conditions in patients taking PPIs, even after 60 min. Reduced gastric acidification of salivary nitrite may explain the increased risk of CDI in patients taking PPIs.
Microbiology Department, Plymouth Hospitals NHS Trust, Plymouth, UK. Electronic address: Richard.cunningham@nhs.net.
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Cunningham
Microbiology Department, Plymouth Hospitals NHS Trust, Plymouth, UK.
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Mustoe
Microbiology Department, Plymouth Hospitals NHS Trust, Plymouth, UK.
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L
Spiller
Gastroenterology Department, Plymouth Hospitals NHS Trust, Plymouth, UK.
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Lewis
Peninsula College of Medicine & Dentistry, St Luke's Campus, Magdalen Road, University of Exeter, UK.
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Benjamin
D000900:Anti-Bacterial Agents / Q000378:metabolism* / Q000494:pharmacology; D016360:Clostridioides difficile / Q000187:drug effects* / Q000276:immunology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D050296:Microbial Viability / Q000187:drug effects; D009573:Nitrites / Q000378:metabolism* / Q000494:pharmacology; D009589:Nitrogen Oxides / Q000378:metabolism* / Q000494:pharmacology; D013171:Spores, Bacterial / Q000187:drug effects* / Q000276:immunology*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D009573:Nitrites; D009589:Nitrogen Oxides
Acidified nitrite; Clostridium difficile infection; Proton pump inhibitor; Spore