Outcome of relapsing Clostridium difficile infections do not correlate with virulence-, spore- and vegetative cell-associated phenotypes

Ángela Plaza-Garrido, Camila Miranda-Cárdenas, Pablo Castro-Córdova, Valeria Olguín-Araneda, Glenda Cofré-Araneda, Cristian Hernández-Rocha, Robert Carman, Patricio Ibáñez, Warren N. Fawley, Mark H. Wilcox, Fernando Gil, Iván L. Calderón, Juan A. Fuentes, Ana María Guzmán-Durán, Manuel Alvarez-Lobos, Daniel Paredes-Sabja

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


One of the main clinical challenges of Clostridium difficile infections (CDI) is the high rate of relapse episodes. The main determinants involved in relapse of CDI include the presence of antibiotic-resistant C. difficile spores in the colonic environment and a permanent state of dysbiosis of the microbiota caused by antibiotic therapy. A possible scenario is that phenotypes related to the persistence of C. difficile spores might contribute to relapsing infections. In this study, 8 C. difficile isolates recovered from 4 cases with relapsing infection, and 9 isolates recovered from single infection cases were analyzed for PCR ribotyping and the presence of tcdA, tcdB and cdtAB genes. Factors associated to spore persistence, sporulation, spore adherence and biofilm formation and sporulation during biofilm formation were characterized. We also evaluated motility and cytotoxicity. However, we observed no significant difference in the analyzed phenotypes among the different clinical outcomes, most likely due to the high variability observed among strains within clinical backgrounds in each phenotype and the small sample size. It is noteworthy that C. difficile spores adhered to similar extents to undifferentiated and differentiated Caco-2 cells. By contrast, spores of all clinical isolates tested had increased germination efficiency in presence of taurocholate, while decreased sporulation rate during biofilm development in the presence of glucose. In conclusion, these results show that, at least in this cohort of patients, the described phenotypes are not detrimental in the clinical outcome of the disease.

Original languageEnglish
Pages (from-to)30-38
Number of pages9
Publication statusPublished - 1 Dec 2015


  • Biofilm
  • Clostridium difficile
  • Recurrent CDI
  • Relapse
  • Relapsing CDI
  • Spore adherence
  • Spore germination
  • Sporulation

ASJC Scopus subject areas

  • Microbiology
  • Infectious Diseases


Dive into the research topics of 'Outcome of relapsing Clostridium difficile infections do not correlate with virulence-, spore- and vegetative cell-associated phenotypes'. Together they form a unique fingerprint.

Cite this