Clostridium butyricum therapy for mild-moderate Clostridioides difficile infection and the impact of diabetes mellitus

Bioscience of Microbiota, Food and Health

article

Jen-Chieh LEE¹  Chun-Wei CHIU²  Pei-Jane TSAI³  Ching-Chi LEE¹  I-Hsiu HUANG⁷  Wen-Chien KO¹  Yuan-Pin HUNG¹ 

[1] Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University;Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, No. 125, Jhongshan Rd., West Central Dist.;Department of Medical Laboratory Science and Biotechnology, National Cheng Kung University, Medical College, No.1, University Road;Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University;Center of Infectious Disease and Signaling Research, National Cheng Kung University;Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University;Department of Biochemistry and Microbiology, Oklahoma State University Center for Health Sciences;Department of Medicine, College of Medicine, National Cheng Kung University, 1 University Road

关键词: Clostridioides difficile infection;    Clostridium butyricum;    diabetes mellitus;    probiotics;    metronidazole;    mild-moderate;   

DOI  :  10.12938/bmfh.2021-049

学科分类：生物科学（综合）

来源: Nihon Bifizusukin Senta / Japan Bifidus Foundation

【 摘 要 】

The therapeutic effect of Clostridium butyricum for adults with Clostridioides difficile infection (CDI) was investigated. A retrospective study was conducted in medical wards of Tainan Hospital, Ministry of Health and Welfare, between January 2013 and April 2020. The disease severity of CDI was scored based on the Clinical Practice Guidelines of the IDSA/SHEA. Treatment success was defined as the resolution of diarrhea within six days of a therapeutic intervention without the need to modify the therapeutic regimen. In total, 241 patients developed CDI during hospitalization in the study period. The treatment success rates for the 99 patients with mild-moderate CDI among them were as follows: metronidazole, 69.4%; C. butyricum, 68.2%; metronidazole plus C. butyricum, 66.7%; and oral vancomycin, 66.7% (p=1.00). Patients with treatment success were less likely to have diabetes mellitus than those with treatment failure (38.2% vs. 61.3%, p=0.05). Patients treated with C. butyricum alone or in combination with metronidazole had shorter durations of diarrhea than those treated with metronidazole alone (3.1 ± 2.0 days or 3.5 ± 2.4 days vs. 4.2 ± 3.5 days; p=0.43 or 0.71), although the differences were not statistically significant. In conclusion, the treatment success rate of C. butyricum alone or in combination with metronidazole for patients with CDI was non inferior to that of metronidazole alone. The presence of diabetes mellitus in affected individuals is a risk factor for treatment failure.

【 授权许可】

CC BY