Abstract
Normal gut structure and function is the end-product of a complex set of interactions between the host and the complex microflora that inhabits the gastrointestinal tract. This balanced interaction is subjected both directly and indirectly to environmental influences, such as dietary factors, which can affect gut function directly through effects on the host or indirectly by effects on the gut microflora. In many cases these are an interactive loop of cause and effect whereby changes to the host alter the gut microflora, which in turn influences gut function. The ‘environmental’ factor that is most likely to have a significant direct impact on the gut microflora is antibiotic treatment.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Abrams, G. D. and Bishop, J. E. (1966) Effect of the normal microbial flora on the resistance of the small intestine to infections. Journal of Bacteriology, 92, 1604–1608.
Amon, H. V. and Phillips, S. F. (1973) Inhibition of colonic water and electrolyte absorption by fatty acids in man. Gastroenterology, 65, 744–749.
Bartlett, J. G., Tedesco, F. J., Shull, S. et al. (1980) Symptomatic relapse after oral vancomycin therapy of antibiotic-associated pseudomembranous colitis. Gastroenterology, 78, 431–434.
Biller, J. A., Katz. A. J., Flores, A. F. et al. (1995) Treatment of recurrent Clostridium difficile colitis with Lactobacillus GG. Journal of Pediatric Gastroenterology and Nutrition, 21, 224–226.
Binder, H. J. and Rawlins, C. L. (1973) Effect of conjugated bile salts on electrolyte ransport in rat colon. Journal of Clinical Investigation, 52, 1460–1466.
Borriello, S. P. (1984a) Bacteria and gastrointestinal secretion and motility. Scandinavian Journal of Gastroenterology, 19 (Suppl. 93), 115–121.
Borriello, S. P. (ed.) (1984b) Antibiotic-Associated Diarrhoea and Colitis. Martinus Nijhoff, Boston, MA.
Borriello, S. P. (1989) Influence of the normal gut flora of the gut on Clostridium ifficile, in The Regulatory and Protective Role of the Normal Microflora, (eds. Grubb, T. Midtvedt and E. Norrin ), Macmillan, Basingstoke, pp 239–251.
Borriello, S. P. (1990) Pathogenesis of Clostridium difficile infection of the gut. ournal of Medical Microbiology, 33, 207–215.
Borriello, S. P. (1992) Possible mechanisms of action of antimicrobial agent-associated gastrointestinal symptoms. Postgraduate Medical Journal, 68 (Suppl. 3), S38 — S42.
Borriello, S. P. (1998) Pathogenesis of Clostridium difficile infection. Journal of Antimicrobial Chemotherapy,in press.
Borriello, S. P. and Barclay, F. E. (1985) Protection of hamsters against Clostridium difficile ileocaecitis by prior colonisation with non-pathogenic strains. Journal of Medical Microbiology, 19, 339–349.
Borriello, S. P. and Barclay, F. E. (1986) An in-vitro model of colonisation resistance to Clostridium difficile infection. Journal of Medical Microbiology, 21, 299–309.
Borriello, S. P. and Carman, R. J. (1988) Other clostridial causes of diarrhoea and colitis in man and animals, in Clostridium difficile: Its Role in Intestinal Disease, (eds R. D. Rolfe and S. M. Finegold ), Academic Press, San Diego, CA, pp. 65–98.
Borriello, S. P., Barclay, F. E. and Welch, A. R. (1988) Evaluation of the predictive capability of an in-vitro model of colonisation resistance to Clostridium difficile infection. Microbiology Ecology in Health and Disease, 1, 61A.
Borriello, S. P., Larson, H. E., Welch, A. R. et al. (1984) Enterotoxigenic Clostridium perfringens: a possible cause of antibiotic-associated diarrhoea. Lancet, i, 305–307.
Borriello, S. P., Barclay, F. E., Welch, A. R. et al. (1985a) Host and microbial determinants of the spectrum of Clostridium difficile mediated gastrointestinal disorders. Microecology and Therapy, 15, 231–236.
Borriello, S. P., Barclay, F. E., Welch, A. R. et al. (1985b) Epidemiology of diarrhoea caused by enterotoxigenic Clostridium perfringens. Journal of Medical Microbiology, 20, 363–372.
Boureau, H., Salanon, C., Decaaens, C. and Bourlioux, P. (1994) Caecal localisation of the specific microbiota resistant to Clostridium difficile colonisation in gnotobiotic mice. Microbial Ecology in Health and Disease, 7, 111–117.
Bowden, T. A., Mansberger, A. R. and Lykins, L. E. (1981) Pseudomembranous enterocolitis: mechanism of restoring flora homeostasis. American Surgeon, 47, 178–183.
Bright-Asare, P. and Binder, H. J. (1973) Stimulation of colonic secretion of water and electrolytes by hydroxy fatty acids. Gastroenterology, 64, 81–88.
Buts, J.-P., Corthier, G. and Delmee, M. (1993) Saccharomyces boulardii for Clostridium difficile associated enteropathies in infants. Journal of Pediatric Gastroenterology and Nutrition, 16, 419–425.
Cano, N., Chapoy, P. and Corthier, G. (1989) Saccharomyces boulardii: un traitment des colites pseudomembraneuses? Presse Medicale, 18, 1299.
Castagliuolo, I., LaMont, J. T., Nikulasson, S. T. and Pothoulakis, C. (1996) Saccharomyces boulardii protease inhibits Clostridium difficile toxin A effects in the rat ileum. Infection and Immunity, 64, 5225–5232.
Cherry, R. D., Portnoy, D., Jabbari, M. et al. (1982) Metronidazole: an alternative therapy for antibiotic-associated colitis. Gastroenterology, 82, 849–851.
Chia, J. K. S., Chan, S. M. and Goldstein, H. (1995) Baker’s yeast as adjunctive therapy for relapses of Clostridium difficile diarrhoea. Clinical Infectious Diseases, 20, 1581.
Clausen, M. R., Bronnen, H., Tvede, M. and Mortensen, P. B. (1991) Colonic fermentation to short-chain fatty acids is decreased in antibiotic-associated diarrhoea. Gastroenterology, 101, 1497–1504.
Corthier, G. Dubos, F. and Ducluzeau, R. (1986) Prevention of Clostridium difficile mortality in gnotobiotic mice by Saccharomyces boulardii. Canadian Journal of Microbiology, 32, 894–896.
Corthier, G. Dubos, F. and Raibaud, P. (1985) Modulation of cytotoxin production by Clostridium difficile in the intestinal tracts of gnotobiotic mice inoculated with various human intestinal bacteria. Applied and Environmental Microbiology, 49, 250–252.
Dubos, F., Martinet, L., Dabard, J. and Ducluzeau, R. (1984) Immediate postnatal inoculation of a microbial barrier to prevent neonatal diarrhoea induced by Clostridium difficile in young conventional and gnotobiotic hares. American Journal of Veterinary Research, 45, 1241–1244.
Ducluzeau, R., Dubos, F., Hudault, S. et al. (1981) Microbial barriers against enteropathogenic strains in the digestive tract of gnotoxenic animals. Application to the treatment of Clostridium difficile diarrhoea in the young hare, in Recent dvances in Germ free Research, (eds A. Sasaki, K. Ozawa and K. Hashimoto ), Tokai University Press, Tokyo.
Eisemann, B., Silem, W., Bascomb, W. S. and Kanvor, A. J. (1958) Fecal enema as an adjunct in the treatment of pseudomembranous enterocolitis. Surgery, 44, 854–858.
Gorbach, S. L., Chang, T.-W. and Goldin, B. (1987) Successful treatment of relapsing Clostridium difficile colitis with Lactobacillus GG. Lancet, ii, 1519.
Gracy, M., Papadimitriou, J. and Bower, G. (1974) Ultrastructural changes in the mall intestine of rats with self-filling blind loops. Gastroenterology, 67, 646–651.
Hofmann, A. F. (1967) The syndrome of ileal disease and the broken enterohepatic irculation: cholerheic enteropathy. Gastroenterology, 52, 752–757.
Itoh, K., Lee, W. K., Kawamura, H. et al. (1987) Intestinal bacteria antagonistic to Clostridium difficile in mice. Laboratory Animal, 21, 20–25.
James, AT., Webb, J. P. W. and Kellock, T. D. (1961) The occurrence of unusual fatty acids in faecal lipids from human beings with normal and abnormal fat absorption. Biochemical Journal, 78, 333–339.
Keighley, M. R. B., Burdon, D. W., Arabi, Y. et al. (1978) Randomised controlled trial of vancomycin for pseudomembranous colitis and post-operative diarrhoea. British Medical Journal, ii, 1667–1669.
Kimmey, M. B., Elmer, G. W., Surawicz, C. M. and McFarland, L. V. (1990) Prevention of further recurrences of Clostridium difficile colitis with Saccharomyces boulardii. Digestive Diseases and Sciences, 35, 897–901.
Kirwan, W. O., Smith, A. N., Mitchell, W. D. et al. (1975) Bile acids and colonic otility in the rabbit and the human. Part 1. The rabbit. Gut, 16, 894–902.
Larson, H. E. and Borriello, S. P. (1988) Infectious diarrhoea due to Clostridium perfringens. Journal of Infectious Diseases, 157, 390–391.
Larson, H. E. and Borriello, S. P. (1990) Quantitative study of antibiotic induced susceptibility to Clostridium difficile enterocolitis in hamsters. Antimicrobial Agents and Chemotherapy, 34, 1348–1353.
Larson, H. E., Price, A. B. and Borriello, S. P. (1980) Epidemiology of experimental enterocecitis due to Clostridium difficile. Journal of Infectious Diseases, 142, 408–413.
Larson, H. E., Barclay, F. E., Honour, P. and Hill I. D. (1982) Epidemiology of Clostridium difficile in infants. Journal of Infectious Diseases, 146, 727–733.
Lewis, S. J., Potts, L. F. and Barry, R. E. (1998) The therapeutic effects of Saccharomyces boulardii in the prevention of antibiotic related-diarrhoea in elderly patients. Journal of Hospital Infection,36, in press.
Libby, J. M., Donta, S. T. and Wilkins, T. D. (1983) Clostridium difficile toxin A in infants. Journal of Infectious Diseases, 148, 606.
Lyerly, D. M., Krivan, H. E. and Wilkins, T. D. (1988) Clostridium difficile its disease and toxins. Clinical Microbiology Reviews,1–18.
McFarland, L. V. and Bernasconi, P. (1993) Saccharomyces boulardii: a review of an innovative biotherapeutic agent. Microbial Ecology in Health and Disease, 6, 157–171.
McFarland, L. V., Surawicz, C. M., Greenberg, R. N. et al. (1994) A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. Journal of the American Medical Association, 271, 1913–1918.
Mekhjian, H. S., Phillips, S. F. and Hofmann, A. F. (1971) Colonic secretion of water and electrolytes induced by bile acids: perfusion studies in man. Journal of Clinical Investigation, 50, 1569–1577.
Pen, J. and Welling, G. W. (1981) The concentration of cholecystokinin in the intestinal tract of germ-free and control mice. Antonie van Leeuwenhoek, 47, 84–85.
Pothoulakis, C., Kelly, C. P., Joshi, M. A. et al. (1993) Saccharomyces boulardii inhibits Clostridium difficile toxin A binding and enterotoxicity in rat ileum. Gastroenterology, 104, 1108–1115.
Raibaud, P., Ducluzeau R., Dubos, F. et al. (1980) Implantation of bacteria from the digestive tract of man and various animals into gnotobiotic mice. American Journal of Clinical Nutrition, 33, 2440–2447.
Rolfe, R. D. (1984) Role of volatile fatty acids in colonisation resistance to Clostridium difficile. Infection and Immunity, 45, 185–191.
Rolfe, R. D. and Finegold, S. M. (eds) (1988) Clostridium difficile: Its Role in Intestinal Disease. Academic Press, San Diego, CA.
Schellenberg, D., Bonington, A., Champion, C. M. et al. (1994) Treatment of relapsing Clostridium difficile diarrhoea with brewer’s yeast. Lancet, 343, 171–172.
Schwan, A., Sjolin, S., Trottestam, U. and Aronsson, B. (1984) Relapsing Clostridium difficile enterocolitis cured by rectal infusion of normal faeces. Scandinavian Journal of Infectious Diseases, 16, 211–215.
Seal, D. V., Borriello, S. P., Barclay, F. et al. (1987) Treatment of relapsing Clostridium difficile diarrhoea by administration of a non-toxigenic strain. European Journal of Clinical Microbiology, 6, 51–53.
Seddon, S. V., Hemingway, I. and Borriello, S. P. (1990) Hydrolytic enzyme production by Clostridium difficile and its relationship to toxin production and virulence in the hamster model. Journal of Medical Microbiology, 31, 169–174.
Surawicz, C. M., Elmer, G. M., Speelman, P. et al. (1989a) Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology, 96, 981–988.
Surawicz, C. M., McFarland, L. V., Elmer, G. W. and Chirm, J. (1989b) Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii. American Journal of Gastroenterology,84 1285–1287.
Siitonen, S., Vapaatalo, H., Salminen, S. et al. (1990) Effect of Lactobacillus GG yoghurt in prevention of antibiotic associated diarrhoea. Annals of Medicine, 22, 57–59.
Toothaker, R. D. and Elmer, G. W. (1984) Prevention of clindamycin-induced mortality in hamsters by Saccharomyces boulardii. Antimicrobial Agents and Chemotherapy, 26, 552–556.
Tvede, M. and Rask-Maden, J. (1989) Bacteriotherapy for chronic relapsing Clostridium difficile diarrhoea in six patients. Lancet,i 1156–1160.
Wilcox, H. M. and Spencer, R. C. (1992) Clostridium difficile infection: responses, relapses and re-infections. Journal of Hospital Infection, 22, 85–92.
Williams, R., Piper, M., Borriello, S. P. et al. (1985) Diarrhoea due to enterotoxigenic Clostridium perfringens: clinical features and management of a cluster often cases. Age and Ageing, 14, 296–302.
Wilson, K. H. and Freter, R. (1986) Interaction of Clostridium difficile and Escherichia coli with microfloras in continuous-flow cultures and gnotobiotic mice. Infection and Immunity, 54, 354–358.
Wilson, K. H. and Perini, F. (1988) Role of competition for nutrients in suppression of Clostridium difficile by the colonic microflora. Infection and Immunity, 56, 2610–2614.
Wilson, K. H. and Sheagren, J. N. (1983) Antagonism of toxigenic Clostridium difficile by non-toxigenic C. difficile. Journal of Infectious Diseases,147 733–736.
Wilson, K. H., Silva, J. and Fekety, R. F. (1981) Suppression of Clostridium difficile by normal hamster cecal flora and prevention of antibiotic-associated cecitis. Infection and Immunity, 34, 626–628.
Wilson, K. H., Sheagren, J. N., Freter, R. et al. (1986) Gnotobiotic models for study of the microbial ecology of Clostridium difficile and Escherichia coli. Journal of Infectious Diseases,153 547–551.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Borriello, S.P., Roffe, C. (1999). The normal microflora and antibiotic-associated diarrhoea and colitis. In: Tannock, G.W. (eds) Medical Importance of the Normal Microflora. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3021-0_14
Download citation
DOI: https://doi.org/10.1007/978-1-4757-3021-0_14
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-4730-7
Online ISBN: 978-1-4757-3021-0
eBook Packages: Springer Book Archive