Published in Critical Reviews in Microbiology | DOI: 10.1080/1040841X.2022.2072705, 15, May 2023
Authors: Rusha Pal, Ahmad I M Athamneh, Riddhi Deshpande, Jose A R Ramirez, Kayode T Adu, Pushpanathan Muthuirulan, Shrikant Pawar, Manuele Biazzo, Yiorgos Apidianakis, Ulrik Kraemer Sundekilde, Cesar de la Fuente-Nunez, Mark G Martens, George P Tegos, Mohamed N Seleem
Clostridioides difficile infection (CDI) is a life-threatening disease caused by the Gram-positive, opportunistic intestinal pathogen C. difficile. Despite the availability of antimicrobial drugs to treat CDI, such as vancomycin, metronidazole, and fidaxomicin, recurrence of infection remains a significant clinical challenge. The use of live commensal microorganisms, or probiotics, is one of the most investigated non-antibiotic therapeutic options to balance gastrointestinal (GI) microbiota and subsequently tackle dysbiosis. In this review, we will discuss major commensal probiotic strains that have the potential to prevent and/or treat CDI and its recurrence, reassess the efficacy of probiotics supplementation as a CDI intervention, delve into lessons learned from probiotic modulation of the immune system, explore avenues like genome-scale metabolic network reconstructions, genome sequencing, and multi-omics to identify novel strains and understand their functionality, and discuss the current regulatory framework, challenges, and future directions.