Rossana Rosa1, Curtis J Donskey2, L Silvia Munoz-Price3. 1. UnityPoint Health, 1212 Pleasant Street Suite 300, Des Moines, IA, 50309, USA. rossana.m.rosa@gmail.com. 2. Geriatric Research, Education and Clinical Center, Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA. 3. Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Abstract
PURPOSE OF REVIEW: Colonization resistance refers to the innate defense provided by the indigenous microbiota against colonization by pathogenic organisms. We aim to describe how this line of defense is deployed against Clostridium difficile and what the implications are for interventions directed by Antimicrobial Stewardship Programs. RECENT FINDINGS: The indigenous microbiota provides colonization resistance through depletion of nutrients, prevention of access to adherence sites within the gut mucosa, production of inhibitory substances, and stimulation of the host's immune system. The ability to quantify colonization resistance could provide information regarding periods of maximal vulnerability to colonization with pathogens and also allow the identification of mechanisms of restoration of colonization resistance. Methods utilized to determine the composition of the gut microbiota include sequencing technologies and measurement of concentration of specific bacterial metabolites. Use of innovations in the quantification of colonization resistance can expand the role of Antimicrobial Stewardship from prevention of disruption of the indigenous microbiota to restoration of colonization resistance.
PURPOSE OF REVIEW: Colonization resistance refers to the innate defense provided by the indigenous microbiota against colonization by pathogenic organisms. We aim to describe how this line of defense is deployed against Clostridium difficile and what the implications are for interventions directed by Antimicrobial Stewardship Programs. RECENT FINDINGS: The indigenous microbiota provides colonization resistance through depletion of nutrients, prevention of access to adherence sites within the gut mucosa, production of inhibitory substances, and stimulation of the host's immune system. The ability to quantify colonization resistance could provide information regarding periods of maximal vulnerability to colonization with pathogens and also allow the identification of mechanisms of restoration of colonization resistance. Methods utilized to determine the composition of the gut microbiota include sequencing technologies and measurement of concentration of specific bacterial metabolites. Use of innovations in the quantification of colonization resistance can expand the role of Antimicrobial Stewardship from prevention of disruption of the indigenous microbiota to restoration of colonization resistance.
Authors: Tamar F Barlam; Sara E Cosgrove; Lilian M Abbo; Conan MacDougall; Audrey N Schuetz; Edward J Septimus; Arjun Srinivasan; Timothy H Dellit; Yngve T Falck-Ytter; Neil O Fishman; Cindy W Hamilton; Timothy C Jenkins; Pamela A Lipsett; Preeti N Malani; Larissa S May; Gregory J Moran; Melinda M Neuhauser; Jason G Newland; Christopher A Ohl; Matthew H Samore; Susan K Seo; Kavita K Trivedi Journal: Clin Infect Dis Date: 2016-04-13 Impact factor: 9.079
Authors: Mark E Obrenovich; MaryAnn Tima; Alex Polinkovsky; Renliang Zhang; Steven N Emancipator; Curtis J Donskey Journal: Antimicrob Agents Chemother Date: 2017-07-25 Impact factor: 5.191
Authors: Sandrine Isaac; Jose U Scher; Ana Djukovic; Nuria Jiménez; Dan R Littman; Steven B Abramson; Eric G Pamer; Carles Ubeda Journal: J Antimicrob Chemother Date: 2016-10-05 Impact factor: 5.790
Authors: Turki Abujamel; Jennifer L Cadnum; Lucy A Jury; Venkata C K Sunkesula; Sirisha Kundrapu; Robin L Jump; Alain C Stintzi; Curtis J Donskey Journal: PLoS One Date: 2013-10-02 Impact factor: 3.240