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1、NIHPublicAccessAuthorManuscriptGastroenterology.Authormanuscript;availableinPMC2015May01.NIH-PAAuthorManuscriptPublishedinfinaleditedformas:NIH-PAAuthorManuscriptNIH-PAAuthorManuscriptGastroenterology.2014May;146(6):1547–1553.doi:10.1053/j.gastro.2014.01.059
2、.RoleoftheIntestinalMicrobiotainResistancetoColonizationbyClostridiumdifficleRobertA.Britton1andVincentB.Young2,31DepartmentofMicrobiologyandMolecularGenetics,MichiganStateUniversity,EastLansing,Michigan488242DivisionofInfectiousDiseases,DepartmentofInternal
3、Medicine,UniversityofMichigan,AnnArbor,MI,481093DepartmentofMicrobiologyandImmunology,UniversityofMichigan,AnnArbor,MI,48109AbstractAntibiotic-associatedinfectionwiththebacterialpathogenClostridiumdifficileisamajorcauseofmorbidityandincreasedhealthcarecosts.
4、Cdifficileinfection(CDI)followsdisruptionoftheindigenousgutmicrobiotabyantibiotics.AntibioticscreateanenvironmentwithintheintestinethatpromotesCdifficilesporegermination,vegetativegrowth,andtoxinproduction,leadingtoepithelialdamageandcolitis.Studiesofpatient
5、swithCDIandanimalmodelshaveshownthattheindigenousmicrobiotacaninhibitexpansionandpersistenceofCdifficile.Althoughthespecificmechanismsoftheseprocessesarenotknown,theyarelikelytointerferewithkeyaspectsofthepathogen’sphysiology,includingsporegerminationandcomp
6、etitivegrowth.IncreasingourunderstandingofhowtheintestinalmicrobiotamanageCdifficilecouldleadtobettermeansofcontrollingthisimportantnosocomialpathogen.KeywordsColonizationresistance;Cdifficile;microbiome;microbialecology;antibioticsIntroductionThefulfillment
7、ofKoch’spostulatesforCdifficilein1977wasoneofthefirstformalrecognitionsofamicrobiome-relateddisease.AlthoughCdifficileitselffitintothemoldofatypicalbacterialpathogen,Cdifficileinfection(CDI)wasuniqueinthatpreviousantibiotictreatmentofthepatientwasnecessaryfo
8、rdevelopmentofthefulldiseasephenotype.WereviewCdifficileasapathogenicorganismanddiscussthebasic©2014TheAmericanGastroenterologicalAssociation.PublishedbyElsevierInc.Allrightsreserved.Corresponde
