Pal, Rusha; Athamneh, Ahmad I. M.; Deshpande, Riddhi; Ramirez, Jose A. R.; Adu, Kayode T.; Muthuirulan, Pushpanathan; Pawar, Shrikant; Biazzo, Manuele; Apidianakis, Yiorgos; Sundekilde, Ulrik Kraemer; de la Fuente-Nunez, Cesar; Martens, Mark G.; Tegos, George P.; Seleem, Mohamed N. (Taylor & Francis, 2022-05-15)
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.