Jacek Piatek1*, Malgorzata Bernatek1, Jadwiga Maciukaj2 and Henning Sommermeyer1
1Department of Health Sciences, Calisia University, Poland
2Department of Infectious Diseases, State Hospital in Starachowice, Poland
Recurrent Clostridioides (C.) difficile Infection (CDI) is a major complication of the management
of CDI and affects between 12% to 24% of all CDI patients. We report a case of CDI triggered by
therapy with the broad-spectrum antibiotic cefuroxime, followed by three episodes of recurrent
CDI. The initial CDI and the first recurrence were treated with vancomycin combined with a threestrain
probiotic. This treatment was initially successful but was soon followed by a new recurrence.
The second recurrent CDI was treated with vancomycin combined with a mono-strain synbiotic
(one probiotic strain plus fructooligosaccharides) which was also only transiently successful. The
third recurrent CDI was treated with vancomycin combined this time with a nine-strain synbiotic
resulting in a sustained elimination of C. difficile. The three different probiotic bacteria containing
products were characterized regarding their ability to inhibit the in-vitro growth of C. difficile. All
products inhibited the growth of C. difficile, with the nine-strain synbiotic being the most effective.
The clinical observations and the results from the in-vitro experiments suggest that certain products
containing probiotic bacteria might contribute to break the cycle of recurrent CDI. More research,
including clinical studies, should be performed to investigate the potential role of probiotics/
synbiotics in the management of recurrent CDI.
Probiotics; Synbiotics; Recurrent Clostridioides (Clostridium) difficile infection; Antibiotic therapy
Piatek J, Bernatek M, Maciukaj J, Sommermeyer H. Breaking the Cycle of Recurrent Clostridioides difficile Infections: Can Probiotic Bacteria Contribute?. Ann Clin Med Res. 2021; 2(6): 1046..