Abstract
Clostridiodes difficile comprises a public-health threat that has been understudied in Colombia. Hypervirulent strains of C. difficile harbor multiple toxins, can be easily spread, and can have their onset of disease within healthcare facilities (HCFO) and the community (CO). Studies have shown that a disrupted microbiota (e.g., dysbiosis) may allow C. difficile infection (CDI). It has been suggested that dysbiosis prevents colonization by the anaerobic eukaryote Blastocystis, possibly due to an increase in luminal oxygen tension. No study has found co-occurrence of CDI and Blastocystis. Therefore, we aimed to determine the frequencies of C. difficile and Blastocystis infection/colonization in 220 diarrheal fecal samples. Molecular detection by PCR for both microorganisms was performed, with descriptive analyses of four variables (CDI detection, determination of C. difficile toxigenic profiles, Blastocystis detection, and patient site of onset). We demonstrate a significant association between the presence of Blastocystis and CDI, with coinfection found in 61 patients, and show a high frequency of CDI among both HCFO and CO groups. Our results of coinfection frequencies could support hypotheses that suggest Blastocystis can adapt to dysbiosis and oxidative stress. Further, the presence of toxigenic C. difficile occurring outside healthcare facilities shown here raises the alarm for community wide spread.
Highlights
Studies focused on the composition of the intestinal microbiota have indicated that some of its members may have a modulating effect on the diversity of other populations of microorganisms [1].This is the case of Clostridioides difficile, which may be a negative modulator of the microbiota [2], which means that it can decrease the diversity of other groups of bacteria in the gut
Most of the patients with Blastocystis or C. difficile or with some C. difficile toxin belonged to CO (Figure 1A,B)
Within CO, 37 patients were negative for both study microorganisms (Blastocystis and C. difficile) (Figure 1A)
Summary
Studies focused on the composition of the intestinal microbiota have indicated that some of its members may have a modulating effect on the diversity of other populations of microorganisms [1]. This is the case of Clostridioides difficile, which may be a negative modulator of the microbiota [2], which means that it can decrease the diversity of other groups of bacteria in the gut. Some authors have pointed out that C. difficile infection (CDI) is related to the decrease in beneficial bacteria while increasing the abundance of bacteria belonging to the Enterobacteriaceae family or other groups of bacterial pathogens [3].
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