Abstract

Clostridioides difficile infection (CDI) is a serious disease with a high recurrence rate. The single and mixed biofilms formed by C. difficile in the gut contribute to the formation of recurrent CDI (rCDI). In parallel, other gut microbes influence the formation and development of C. difficile biofilms, also known as symbiotic biofilms. Interactions between members within the symbiotic biofilm are associated with the worsening or alleviation of CDI. These interactions include effects on C. difficile adhesion and chemotaxis, modulation of LuxS/AI-2 quorum sensing (QS) system activity, promotion of cross-feeding by microbial metabolites, and regulation of intestinal bile acid and pyruvate levels. In the process of C. difficile biofilms control, inhibition of C. difficile initial biofilm formation and killing of C. difficile vegetative cells and spores are the main targets of action. The role of symbiotic biofilms in CDI suggested that targeting interventions of C. difficile-promoting gut microbes could indirectly inhibit the formation of C. difficile mixed biofilms and improved the ultimate therapeutic effect. In summary, this review outlines the mechanisms of C. difficile biofilm formation and summarises the treatment strategies for such single and mixed biofilms, aiming to provide new ideas for the prevention and treatment of CDI.

摘要

艰难梭菌感染（CDI）是一种具有高复发率的严重疾病。艰难梭菌在肠道中形成的单一和混合生物膜有助于复发性 CDI (rCDI) 的形成。与此同时，其他肠道微生物会影响艰难梭菌生物膜（也称为共生生物膜）的形成和发育。共生生物膜内成员之间的相互作用与 CDI 的恶化或缓解有关。这些相互作用包括对艰难梭菌粘附和趋化性的影响、LuxS/AI-2 群体感应 (QS) 系统活性的调节、微生物代谢物促进交叉喂养以及肠道胆汁酸和丙酮酸水平的调节。在艰难梭菌的过程中生物膜控制、抑制艰难梭菌初始生物膜形成和杀死艰难梭菌营养细胞和孢子是主要作用目标。共生生物膜在CDI中的作用提示靶向干预艰难梭菌促肠道微生物可间接抑制艰难梭菌混合生物膜的形成，提高最终治疗效果。综上所述，本文概述了艰难梭菌生物膜形成的机制，并总结了单一和混合生物膜的治疗策略，旨在为CDI的防治提供新思路。