C. difficile infection: studying the role of the virome

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Fecal transplant is a known treatment for Clostridium difficile (CD) infections, especially for antibiotic-resistant cases, with a success rate of almost 90%. During the transfer of the fecal microbiota, it is not only the bacterial microbiota from a healthy subject that is implanted in the recipient, it is the entire virome (composed of bacteriophages, among others), with potential repercussions on the recipient’s microbiota. Chinese researchers studied the connection between the transfer of this virome and the success of treatment. The authors concentrated on Caudovirales bacteriophages, characterizing them by sequencing. They successfully showed that subjects infected with CD had more Caudovirales, but that they were less diverse than in a healthy individual. By bringing a complete microbiota (bacteria and phages) to a sick patient, a significant reduction in Caudovirales was observed. Furthermore, the subject was cured when the Caudovirales bacteriophages from the donor became a large percentage of the enteric virome in those patients. These results show that CD infections are characterized by enteric dysbiosis in the virome, and that Caudovirales bacteriophages play a role in the effectiveness of treatment by fecal transplant.

Sources :
Zuo T. et al. Bacteriophage transfer during faecal microbiota transplantation in Clostridium difficile infection is associated with treatment outcome. Gut. 2017 May 24. pii: gutjnl-2017-313952. https://www.ncbi.nlm.nih.gov/pubmed/28539351