Growth inhibition of Clostridium difficile by intestinal flora of infant faeces in continuous flow culture.

Growth of Clostridium difficile was inhibited more strongly in continuous flow (CF) culture with C. difficile-negative faeces of infants than with C. difficile-positive faeces. Culture of faecal flora of infants yielded a greater variety of bacterial species in C. difficile-negative than in C. difficile-positive faeces. In the mixed CF culture of C. difficile with Enterococcus avium, Bacteroides distasonis, Eubacterium lentum, C. ramosum, C. perfringens and either Escherichia coli or Klebsiella pneumoniae isolated from C. difficile-negative faeces, inhibition of growth of C. difficile was demonstrated when the pH of the culture medium was decreased. Amino-acid analysis of CF cultures showed considerable utilisation of aspartic acid, serine, threonine, arginine and asparagine. A marked increase in concentrations of citrulline and ornithine was found in the culture that inhibited growth of C. difficile. The addition of citrulline and ornithine into a Gifu anaerobic medium (GAM) broth produced no inhibition of growth of C. difficile. The addition of the mixture of the depleted amino acids (aspartic acid, serine, threonine, arginine and asparagine) to the culture filtrate or adjustment of the pH of the culture filtrate induced considerable growth of C. difficile. These results suggest that the inhibition of growth of C. difficile may be due to consumption of amino acids by intestinal flora, and not to the presence of inhibitors produced by the intestinal flora.