Researchers found C. difficile has a secret ally

Children's Hospital of Philadelphia researchers found that Enterococcus, an antibiotic-resistant pathogen, works with Clostridioides difficile, or C. diff, to change the metabolic environment in the gut so C. diff can thrive, Science Daily reported Nov. 16.

C. diff is a bacteria that causes severe intestinal illness; it is difficult to study and treat. Approximately 1 in 6 patients infected with C. diff will be reinfected within two months.

The study, published in Nature, analyzed stool samples from 54 pediatric patients infected with C. diff. Researchers found these patients had high levels of Enterococcus and established a positive correlation between enterococcal and C. diff burdens.

"When we talk about bacterial infections, we often just think of the pathogen itself, but the 'bystanders' in the gut can have a huge impact on the course of infection," senior author Joseph Zackular, PhD, investigator and assistant professor of pathology and laboratory medicine at Children's Hospital of Philadelphia, told Science Daily. "This study reveals that the coincidence of two pathogenic organisms — Enterococcus and C. difficile — is more than a coincidence; they truly take advantage of each other. Understanding this relationship, as well as other factors that contribute to clinical outcomes of C. difficile infection, is essential for combating this urgent public health challenge."

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