The Intersection Between Colonization Resistance, Antimicrobial Stewardship, and Clostridium difficile. Curr Infect Dis Rep 2018 Jun 07;20(8):27
Date
06/09/2018Pubmed ID
29882079DOI
10.1007/s11908-018-0631-zScopus ID
2-s2.0-85048289861 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
PURPOSE OF REVIEW: Colonization resistance refers to the innate defense provided by the indigenous microbiota against colonization by pathogenic organisms. We aim to describe how this line of defense is deployed against Clostridium difficile and what the implications are for interventions directed by Antimicrobial Stewardship Programs.
RECENT FINDINGS: The indigenous microbiota provides colonization resistance through depletion of nutrients, prevention of access to adherence sites within the gut mucosa, production of inhibitory substances, and stimulation of the host's immune system. The ability to quantify colonization resistance could provide information regarding periods of maximal vulnerability to colonization with pathogens and also allow the identification of mechanisms of restoration of colonization resistance. Methods utilized to determine the composition of the gut microbiota include sequencing technologies and measurement of concentration of specific bacterial metabolites. Use of innovations in the quantification of colonization resistance can expand the role of Antimicrobial Stewardship from prevention of disruption of the indigenous microbiota to restoration of colonization resistance.