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Intestinal Microbiota in Elderly Inpatients with Clostridioides difficile Infection

Authors Vakili B, Fateh A, Asadzadeh Aghdaei H, Sotoodehnejadnematalahi F, Siadat SD

Received 9 May 2020

Accepted for publication 21 July 2020

Published 5 August 2020 Volume 2020:13 Pages 2723—2731

DOI https://doi.org/10.2147/IDR.S262019

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Bahareh Vakili,1 Abolfazl Fateh,2 Hamid Asadzadeh Aghdaei,3 Fattah Sotoodehnejadnematalahi,1 Seyed Davar Siadat2

1Department of Biology, School of Basic Science, Science and Research Branch, Islamic Azad University, Tehran, Iran; 2Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran; 3Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence: Seyed Davar Siadat Tel +98 2164112282
Fax +98 2166465132
Email siadat2019@gmail.com

Purpose: The incidence of Clostridioides difficile infection (CDI) has been reported as 10-fold higher among the elderly population than in young adults. The aim of this study was to compare the targeted bacteria population in the fecal microbiota in two groups of hospitalized elderly, categorized according to CDI and non-CDI.
Patient and Methods: In this case–control study, 84 fecal samples of the 28 patients with CDI and 56 non-CDI patients (> 65 years) were studied. C. difficile isolates were characterized by anaerobic culture and multiplex PCR. Quantitative PCR was used to analyze the bacterial elements.
Results: CDI group differed significantly for a prolonged hospital stay, previous surgery, residence in nursing home and exposure to a range of antibiotics including quinolone, clindamycin and cephalosporin. CDI group had significantly fewer members of Bacteroides spp., Clostridium cluster IV, Bifidobacterium spp., Faecalibacterium prausnitzii, and Prevotella spp. in their fecal microbiota than the control group (P < 0.05). The abundances of Akkermansia muciniphila, Lactobacillus spp., Escherichia coli and Klebsiella spp. were higher in group CDI compared with the control group (P < 0.05).
Conclusion: CDI status is associated with the abundance of some bacterial populations. In this study, an increase in Akkermansia muciniphila, Lactobacillus spp., and Enterobacteriaceae genus was highlighted in CDI patients. A reduction in butyrate-producing bacteria was found in CDI patients. The differences in the composition of fecal microbiota can help to understand how antimicrobial agents impact on gut homeostasis and lead to loss of colonization resistance to C. difficile.

Keywords: Clostridioides difficile, risk factors, elderly, fecal microbiota

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