title: Antimicrobial Use, Human Gut Microbiota and Clostridium difficile Colonization and Infection.
abstract: Clostridium difficile infection (CDI) is the most important cause of nosocomial diarrhea. Broad-spectrum antimicrobials have profound detrimental effects on the structure and diversity of the indigenous intestinal microbiota. These alterations often impair colonization resistance, allowing the establishment and proliferation of C. difficile in the gut. Studies involving animal models have begun to decipher the precise mechanisms by which the intestinal microbiota mediates colonization resistance against C. difficile and numerous investigations have described gut microbiota alterations associated with C. difficile colonization or infection in human subjects. Fecal microbiota transplantation (FMT) is a highly effective approach for the treatment of recurrent CDI that allows the restoration of a healthy intestinal ecosystem via infusion of fecal material from a healthy donor. The recovery of the intestinal microbiota after FMT has been examined in a few reports and work is being done to develop custom bacterial community preparations that could be used as a replacement for fecal material.
authors.affiliation: Department of Microbiology and Immunology, McGill University, Montréal, QC H3A 2B4, Canada. caroline.vincent3@mail.mcgill.ca.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vincent
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada. amee.manges@ubc.ca.
authors.forename: Amee R
authors.initials: AR
authors.lastname: Manges
keywords: Clostridium difficile infection; antimicrobials; colonization resistance; fecal microbiota transplantation; intestinal microbiota