About this webinar

Clostridioides (previously known as Clostridium) difficile (C. difficile) is a key cause of healthcare-associated infections and poses a substantial public health threat that carries high morbidity and mortality rates, especially amongst affected elderly patients (>65 years). C. difficile infection (CDI) also places a considerable burden on healthcare systems worldwide, with up to one-third of patients who develop an initial episode of CDI subsequently going on to develop a recurrence.

C. difficile bacteria is widely found in the environment, especially in the soil, and in the digestive system of animals and humans. In healthy individuals, a healthy gut microbiota comprising a broad consortium of micro-organisms is able to prevent C. difficile from multiplying to harmful levels in the gut and thus provide resistance against CDI. However, disruption of the composition and/or diversity (i.e. dysbiosis) of the gut microbiota allows proliferation of C. difficile and the subsequent production of toxins that lead to clinical symptoms of CDI, which range from mild diarrhoea through to, in severe and complicated cases, toxic megacolon, and even death. In addition, the diagnosis and management of patients with CDI is often complicated due to the presence of other dysbiosis-associated co-morbidities (e.g. Crohn’s disease and ulcerative colitis), while emerging evidence suggests that there is an increased risk of post-infection irritable bowel syndrome following CDI.

Current clinical guidelines issued by infectious disease and/or gastroenterology societies in the United States and Europe recommend oral antibiotics (vancomycin, metronidazole or fidaxomicin) as first-line therapy for the initial episode of CDI, as well as for first recurrence of CDI, depending on the severity of the condition. While antibiotic treatment of CDI can resolve the infection, it can also maintain the microbiota in a disrupted state; thus, leaving a patient susceptible to recurrence of CDI and, ultimately, leading to a vicious cycle of recurrent disease.

The relationship between CDI and dysbiosis means that treatment approaches should also consider the impact on the gut microbiome. Indeed, this is reflected in clinical guidelines with the inclusion of non-antibiotic treatments, such as fecal microbiota transplantation and monoclonal antibody. In addition, different non-antibiotic modalities, such as antibodies, microbiota-based therapeutics and vaccines, are currently being actively investigated in the prevention or treatment of recurrent CDI.

While there is widespread scientific literature regarding CDI, there is still a need to better inform the wider medical community on the importance of recognising the microbiome-mediated nature of CDI and how different treatment modalities available can help to resolve the condition and/or restore the gut microbiota to avoid recurrence.