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Data concerning the human microbiota composition during  Clostridioides (Clostridium) difficile infection  (CDI) using next-generation sequencing are still limited. We aimed to confirm key features indicating  tcdB  positive patients and compare the microbiota composition between subgroups based on toxin gene load ( tcdB  gene) and presence of significant diarrhea. Ninety-nine fecal samples from 79  tcdB  positive patients and 20 controls were analyzed using 16S rRNA gene sequencing. Chao1 index for alpha diversity were calculated and principal coordinate analysis was performed for beta diversity using Quantitative Insights into Microbial Ecology (QIIME) pipeline. The mean relative abundance in each group was compared at phylum, family, and genus levels. There were significant alterations in alpha and beta diversity in  tcdB  positive patients (both colonizer and CDI) compared with those in the control. The mean Chao1 index of  tcdB  positive patients was significantly lower than the control group ( P <0.001), whereas there was no significant difference between  tcdB  groups and between colonizer and CDI. There were significant differences in microbiota compositions between  tcdB  positive patients and the control at phylum, family, and genus levels. Several genera such as  Phascolarctobacterium ,  Lachnospira ,  Butyricimonas ,  Catenibacterium ,  Paraprevotella ,  Odoribacter , and  Anaerostipes  were not detected in most CDI cases. We identified several changes in the microbiota of CDI that could be further evaluated as predictive markers. Microbiota differences between clinical subgroups of CDI need to be further studied in larger controlled studies.

plos one

Composition of gut microbiota in patients with toxigenic Clostridioides (Clostridium) difficile: Comparison between subgroups according to clinical criteria and toxin gene load