Decreased diversity of the fecal Microbiome in recurrent Clostridium difficile-associated diarrhea

J Infect Dis. 2008 Feb 1;197(3):435-8. doi: 10.1086/525047.


Antibiotic-associated diarrhea due to Clostridium difficile (CDAD) is thought to reflect colonization of a disrupted microbial community by the pathogen. We profiled the fecal microbiota of patients with CDAD (both initial and recurrent episodes) by culture-independent phylogenetic analysis of 16S rRNA-encoding gene sequences. Compared with those from control subjects and patients with an initial episode, the fecal communities in patients with recurrent CDAD were highly variable in bacterial composition and were characterized by markedly decreased diversity. Preservation and restoration of the microbial diversity could represent novel strategies for prevention and treatment of recurrent CDAD, which is often recalcitrant to existing therapies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Clostridioides difficile / genetics*
  • Clostridioides difficile / isolation & purification
  • Diarrhea
  • Drug Administration Schedule
  • Enterocolitis, Pseudomembranous / chemically induced*
  • Feces / microbiology*
  • Female
  • Genetic Variation
  • Humans
  • Male
  • Phylogeny
  • Recurrence
  • Reference Values


  • Anti-Bacterial Agents