The rate and importance of Clostridium difficile in colorectal cancer patients
Gastroenterology and Hepatology from Bed to Bench,
Vol. 12 No. 4 (2019),
1 September 2019
,
Page 358-363
https://doi.org/10.22037/ghfbb.v12i4.1776
Abstract
Aim: The aim of this study was to analyze the Clostridium difficile and their toxins in cancerous tissues in comparison to their adjacent healthy tissues in patients with colorectal cancer (CRC) in Iran.
Background: Intestinal infection or colonization by microbial pathogens and their released metabolites may have a role in the exacerbation of CRC.
Methods: A total of 60 biopsy samples from 30 cancerous and 30 adjacent healthy tissues were collected from patients with CRC. Biopsies were homogenized and cultured in cycloserine cefoxitin fructose agar-agar medium to investigate the presence of C. difficile. DNA was extracted, PCR was performed on pure colonies for bacteria detection, and toxin genes were evaluated in each bacterium positive cases. Real-time PCR was performed on extracted DNA for quantitative comparison of Clostridium difficile in healthy and tumor tissues in CRC patients.
Results: Clostridium difficile was isolated from 18 of the cancerous tissue (60%) and 6 of their healthy adjacent tissue (20%) in the culture medium, but toxin genes were positive just in one sample in both groups. Real-time PCR showed the colonization in all samples.
Conclusion: This study showed a higher prevalence of Clostridium difficile in cancerous lesions in comparison to healthy tissues. We suggest that the investigation of the rate of CD of colorectal cancer patients before surgery is critical for patients. Further studies with more samples size to study the importance of this bacterium and its toxins in the investigation of colorectal cancer patients survey is recommended.
Keywords: CRC, Intestinal microbiota, Toxin, Clostridium difficile.
(Please cite as Jahani-Sherafat S, Azimirad M, Alebouyeh M, Ahmadi Amoli H, Hosseini P, Ghasemian-Safaei, Sharareh Moghim H. The rate and importance of Clostridium difficile in colorectal cancer patients. Gastroenterol Hepatol Bed Bench 2019;12(4):358-363).
- CRC
- Intestinal microbiota
- Toxin
- Clostridium difficile.
How to Cite
References
McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 2018;66:e1-48.
Farooq PD, Urrunaga NH, Tang DM, von Rosenvinge EC. Pseudomembranous colitis. Dis Mon 2015;61:181.
Asha NJ, Tompkins D, Wilcox MH. Comparative analysis of prevalence, risk factors, and molecular epidemiology of antibiotic-associated diarrhea due to Clostridium difficile, Clostridium perfringens, and Staphylococcus aureus. J Clin Microbiol 2006;44:2785-91.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86
Bishehsari F, Mahdavinia M, Vacca M, Malekzadeh R, Mariani-Costantini R. Epidemiological transition of colorectal cancer in developing countries: environmental factors, molecular pathways, and opportunities for prevention. World J Gastroenterol 2014;20:6055.
Hope ME, Hold GL, Kain R, El-Omar EM. Sporadic colorectal cancer-role of the commensal microbiota. FEMS Microbiol lett 2005;244:1-7.
Sobhani I, Tap J, Roudot-Thoraval F, Roperch JP, Letulle S, Langella P, et al. Microbial dysbiosis in colorectal cancer (CRC) patients. PloS One 2011;6:e16393.
Qin J, Li R, Raes J, Arumugam M, Burgdorf KS, Manichanh C, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature 2010;464:59-65.
Dethlefsen L, Huse S, Sogin ML, Relman DA. The pervasive effects of an antibiotic on the human gut microbiota, as revealed by deep 16s rRNA sequencing. PLoS Biol 2008;6:e280.
Thomas LV, Ockhuizen T. New insights into the impact of the intestinal microbiota on health and disease: a symposium report. Br J Nutr 2012;107:S1-13.
Rowland IR. The role of the gastrointestinal microbiota in colorectal cancer. Curr Pharm Des 2009;15:1524-7.
Jahani-Sherafat, S., Alebouyeh, M., Moghim, S., Ahmadi Amoli, H., and Ghasemian-Safaei, H. Role of gut microbiota in the pathogenesis of colorectal cancer; a review article. Gastroenterol Hepatol Bed Bench 2018;11:101–10913.
Lugito NP, Shin A, Kelly CP. A 21 Year-Old Male colorectal cancer Clostridium difficile and intestinal amebiasis infection. Indonesian J Cancer 2014;8:2.
Zheng y, Luo Y, Lv Y, Huang C, Sheng Q, et al. Clostridium difficile colonization in preoperative colorectal cancer patients. oncotarget 2017;8:11877-86.
Balram B, Battat R, Al-Khoury A, D’Aoust J, Afif W, Bitton A, et al. Risk factors associated with Clostridium difficile infection in inflammatory bowel disease: a systematic review and meta-analysis. J Crohn's Colitis 2018;13:27-38.
Marchesi JR, Adams DH, Fava F, Hermes GDA, Hirschfield GM, Hold G, et al. The gut microbiota and host health: a new clinical frontier. Gut 2016;65:330-9.
Lazar V, Ditu LM, Pircalabioru GG, Gheorghe I, Curutiu C, Holban AM, et al. Aspects of gut microbiota and immune system interactions in infectious diseases, immunopathology, and cancer. Front Immunol 2018;9:1830.
Kim S, Covington A, Pamer EG. The intestinal microbiota: Antibiotics, colonization resistance, and enteric pathogens. Immunol Rev 2017;279:90-105.
Rolhion N, Chassaing B. When pathogenic bacteria meet the intestinal microbiota. Biol Sci 2016;371.
Dong D, Ni Q, Wang C, Zhang L, Li Z, Jiang C, et al. Effects of intestinal colonization by Clostridium difficile and Staphylococcus aureus on microbiota diversity in healthy individuals in China. BMC Infect Dis 2018;18:207.
Shayganmehr F-S, Alebouyeh M, Azimirad M, Aslani MM, Zali MR. Association of tcdA+/tcdB+ Clostridium difficile genotype with emergence of multidrug-resistant strains conferring metronidazole resistant phenotype. Iranian Biomed J 2015;19:143.
Azimirad M, Dezfulian A, Alebouyeh M, Esfehani RB, Shahrokh S, Zali MR. Infection with enterotoxigenic Staphylococcus aureus as a concern in patients with gastroenteritis. J Glob Antimicrob Resist 2017;9:111-4.
Spigaglia P, Mastrantonio P. Molecular analysis of the pathogenicity locus and polymorphism in the putative negative regulator of toxin production (TcdC) among Clostridium difficile clinical isolates. J Clin Microbiol 2002;40:3470-5.
Persson S, Torpdahl M, Olsen K. New multiplex PCR method for the detection of Clostridium difficile toxin A (tcdA) and toxin B (tcdB) and the binary toxin (cdtA/cdtB) genes applied to a Danish strain collection. Clin Microbiol Infect 2008;14:1057-64.
Yang Y, Mang-Kun Chen, Bing-Ya Yang, Xian-Jie Huang, Xue-Rui Zhang, Liang-Qiang He, et al. Use of 16S rRNA gene-targeted group-specific primers for realtime PCR analysis of predominant bacteria in mouse feces. Appl Environ Microbiol J 2015;81:19
Penders J. Vink C. Driessen C. London N. Thijs C. Stobberingh E.E. Quantification of Bifidobacterium spp., Escherichia coli and Clostridium difficile in faecal samples of breast-fed and formula-fed infants by real-time PCR. FEMS Microbiol Lett 2005;243:141–7.
Azimirad M, Rostami-Nejad M, Rostami K, Naji T, Zali MR. The susceptibility of celiac disease intestinal microbiota to Clostridium difficile infection. Am J Gastroenterol. 2015;110:1740-1.
Uronis JM, Mühlbauer M, Herfarth HH, Rubinas TC, Jones GS, Jobin C. Modulation of the intestinal microbiota alters colitis-associated colorectal cancer susceptibility. PLoS One 2009;4:e6026.
Marchesi JR, Dutilh BE, Hall N, Peters W, Roelofs R, Boleij A, et al. Towards the human colorectal cancer microbiome. PloS One 2011;6:e20447.
Hung YP, Lee JC, Lin HJ, Liu HC, Wu YH, Tsai PJ, et al. Clinical impact of Clostridium difficile colonization. J Microbiol Immunol Infect 2015;48:241-8.
Singh H, Nugent Z, Yu BN, Lix LM, Targownik LE, Bernstein CN. Higher incidence of Clostridium difficile infection among individuals with inflammatory bowel disease. Gastroenterology 2017;153:430-8.
Terzic´ J, Grivennikov S, Karin E, Karin M. Inflammation and cancer. Gastroenterology 2010;138:2101–14.
Armin S, Shamsian S, Drakhshanfar H. Colonization with Clostridium difficile in Children with Cancer. Iran J Pediatr 2013;23:473-6.
Fang WJ, Jing DZ, Luo Y, Fu CY, Zhao P, Qian J, et al. Clostridium difficile carriage in hospitalized cancer patients: a prospective investigation in eastern China. BMC Infect Dis 2014;14:523.
- Abstract Viewed: 181 times
- PDF Downloaded: 129 times